Maddocks Matthew, Brighton Lisa Jane, Connell Louise, Cowley Alison, Laird Barry, Peryer Guy, Petrasso Carmine, Ziegler Lucy, Harwood Rowan
King's College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK.
King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
Health Technol Assess. 2024 Apr 1:1-12. doi: 10.3310/PTHC7598.
Functional loss, the inability to perform necessary or desired tasks, is a common consequence of life-limiting illnesses and associated symptoms (pain, fatigue, breathlessness, etc.) and causes suffering for patients and families. Rehabilitation, a set of interventions designed to address functional loss, is recognised as essential within palliative care, as it can improve quality of life and reduce care costs. However, not everyone has equal access to rehabilitation. Despite limited life expectancy or uncertain ability to benefit from interventions, palliative rehabilitation services are often absent. This is partly due to a lack of high-quality research around optimal models of rehabilitation. Research in this area is methodologically challenging and requires multidisciplinary and cross-speciality collaboration.
We aimed to establish and grow a United Kingdom research partnership across diverse areas, commencing with partners from Edinburgh, East Anglia, Lancashire, Leeds, London and Nottingham, around the topic area of functional loss and rehabilitation in palliative and end-of-life care. The objectives were to (1) develop a multidisciplinary, cross-speciality research partnership, (2) generate high-priority unanswered research questions with stakeholders, (3) co-design and submit high-quality competitive research proposals, including (4) sharing topic and methodological expertise, and (5) to build capacity and capability to deliver nationally generalisable studies.
The partnership was established with professionals from across England and Scotland with complementary areas of expertise including complex palliative and geriatric research, physiotherapy, nursing, palliative medicine and psychology. Research questions were generated through a modified version of the Child Health and Nutrition Research Initiative, which allowed for the collation and refinement of research questions relating to functional loss and rehabilitation towards the end of life. Partnership members were supported through a series of workshops to transform research ideas into proposals for submission to stage one calls by the National Institute for Health and Care Research. The partnership not only supported students, clinicians and public members with training opportunities but also supported clinicians in securing protected time from clinical duties to allow them to focus on developing local research initiatives.
Through our partnership we established a network that offered researchers, clinicians, students and public members the chance to develop novel skills and explore opportunities for personal and professional development around the topic area of functional loss and rehabilitation in palliative and end-of-life care. The partnership was crucial to foster collaboration and facilitate exchange of ideas, knowledge and experiences to build joint research study proposals.
This article presents independent research funded by the National Institute for Health and Care Research (NIHR) programme as award number NIHR135171. A plain language summary of this article is available on the NIHR Journals Library website https://doi.org/10.3310/PTHC7598.
功能丧失,即无法完成必要或期望的任务,是危及生命的疾病及相关症状(疼痛、疲劳、呼吸急促等)的常见后果,会给患者及其家庭带来痛苦。康复是旨在解决功能丧失问题的一系列干预措施,在姑息治疗中被视为至关重要,因为它可以提高生活质量并降低护理成本。然而,并非每个人都能平等地获得康复服务。尽管预期寿命有限或从干预措施中获益的能力不确定,但姑息康复服务往往缺失。这部分是由于围绕最佳康复模式的高质量研究匮乏。该领域的研究在方法上具有挑战性,需要多学科和跨专业合作。
我们旨在建立并发展一个涵盖英国不同地区的研究伙伴关系,最初的合作伙伴来自爱丁堡、东安格利亚、兰开夏郡、利兹、伦敦和诺丁汉,围绕姑息和临终关怀中的功能丧失与康复这一主题领域展开合作。目标是:(1)建立一个多学科、跨专业的研究伙伴关系;(2)与利益相关者共同提出高度优先的未解决研究问题;(3)共同设计并提交高质量的竞争性研究提案,包括(4)分享主题和方法专业知识;(5)培养开展全国可推广研究的能力。
该伙伴关系由来自英格兰和苏格兰的专业人员组成,他们具有互补的专业领域,包括复杂姑息和老年病研究、物理治疗、护理、姑息医学和心理学。研究问题通过对儿童健康与营养研究倡议的修改版生成,这使得能够整理和完善与临终时功能丧失及康复相关的研究问题。通过一系列研讨会支持伙伴关系成员,将研究想法转化为提交给英国国家卫生与保健研究所第一阶段招标的提案。该伙伴关系不仅为学生、临床医生和公众成员提供培训机会,还支持临床医生从临床工作中争取到受保护的时间,以便他们专注于开展本地研究计划。
通过我们的伙伴关系,我们建立了一个网络,为研究人员、临床医生、学生和公众成员提供了发展新技能的机会,并围绕姑息和临终关怀中的功能丧失与康复主题领域探索个人和职业发展机会。该伙伴关系对于促进合作、便利思想、知识和经验的交流以构建联合研究提案至关重要。
本文介绍了由英国国家卫生与保健研究所(NIHR)项目独立资助的研究,资助编号为NIHR135171。本文的通俗易懂总结可在NIHR期刊图书馆网站https://doi.org/10.3310/PTHC7598上获取。