the research enterprise: driven by the individual’s ... · the research enterprise: driven by the...

49
Sigrid Ladores, PhD, RN, PNP, CNE Philippine Nurses Associa1on of America 38 th Na1onal Conven1on – July 23-30, 2017 The Research Enterprise: Driven by the Individual’s Passion to Find Answers to Health-Related Ques1ons

Upload: doanxuyen

Post on 09-Jan-2019

221 views

Category:

Documents


0 download

TRANSCRIPT

SigridLadores,PhD,RN,PNP,CNEPhilippineNursesAssocia1onofAmerica

38thNa1onalConven1on–July23-30,2017

TheResearchEnterprise:DrivenbytheIndividual’sPassiontoFindAnswerstoHealth-RelatedQues1ons

DisclosureofConflictofInterest

•  None

Objec1ves

Bytheendofthispresenta1on,theaudiencewillbeableto…..

Describethejourneyofpursuingaresearch-focused

doctorate.

Discussthemilestonesof

researchincys1cfibrosis.

HighlightresearchconductedbyFilipinonursescien1sts.

Objec1ve1

First,Iwilldescribethejourneyofpursuingaresearch-focused

doctorate.

PhDvs.DNP

PhD

• Researchcareer• Developingnursingknowledge

• Leadershipexperienceinareaofsustainedresearchfunding

• Accesstoresearchse[ngsandresources

• Outcome:Developmentofnewknowledgeandscholarlyproducts

DNP

• Prac1cecareer•  Improvingpa1entcareoutcomes

• Leadershipexperienceinroleandpopula1onprac1ce

• Accesstodiverseprac1cese[ngs

• Outcome:Healthcareimprovementviaprac1ceandpolicychange

PhDvs.DNP

2015-2016:•  Studentsenrolledin

DNPprogramsincreasedfrom21,995to22,289

•  DNPgraduatesincreasedfrom4,100to4,855

SinceDNPmovementbeganin2004:•  EnrollmentinPhD

programshasincreasedby53.8%.

PhD

•  ProgramofStudy:74totalcreditsCourseNumber CourseName

NUR751Q** PhilosophicalFounda1onsofScience

NUR753Q NursingasaScien1ficDiscipline

NRM750Q** Founda1onsofQuan1ta1veResearch

NUR755Q** Cri1calAnalysesofTheories,ModelsandFrameworks

NRM780Q** Applica1onofResearchDesignPrinciplesI

NRM798QL ResearchImmersion NRM752Q** ResponsibleConductofResearch

NST778Q** DataManagement NUR742Q** Wri1ngaCareerDevelopmentGrant

Proposal NST758Q** Inferen1alSta1s1csI NRM798QL ResearchImmersion Elec1ve Substan1veCore

NUR760Q Scien1ficDissemina1on

NRM781Q** Quan1ta1veMeasurement NST779Q** Sta1s1calModeling1LinearModels

NRM782Q** Applica1onofResearchDesignPrinciples

NUR758Q** ResearchandHealthPolicy

NRM783Q** Founda1onsofQualita1veResearch

NST780Q** Sta1s1calModelingII–TopicsinMul1variateAnalysis

NUR797Q** Wri1ngtheDisserta1on

Elec1ve Substan1veCore

NUR799Q Disserta1on

NUR799Q Disserta1on

PhD

•  WhatdoyoudowithaPhD?– Focusonresearch– Academicfaculty– Becomeprimaryinves1gatoronresearchgrants

– Academicleadershipposi1ons– Directorsofresearchinhealthsystems

– Conductresearchthatinfluencesprac1ce

CommonPhDJobTitles

ChiefNurseResearcher

DirectorofNursingResearch

AssociateProfessor

ResearchPosi1onwithGovernmentOrganiza1ons

ex:CDC

DNP

•  Takes8semestersandisapart-1meprogram

DNP•  WhatdoyoudowithaDNP?–  Focusonnursingprac1ce–  Formulateandinterpretevidence-basedprac1ce– Healthpolicydevelopment– Advancedclinicalprac1ce–  Informa1ontechnology–  Educator– Directorofclinicalnursingathealthfacili1es– Useresearchtoadvancenursingprac1ce

CommonDNPJobTitlesVicepresidentforNursingandClinicalServices

ProgramDirector

VicePresidentforPa1ent

Care

ChiefExecu1veOfficerHealthOfficer

CommissionerofHealth

QualityImprovement

Director

NeedforFilipinoNurses

•  DemographicSurveyofFilipinoAmericanNurses:– 3.7%hadamastersinhealthcare

– 12.3%hadanMSN– 0.6%hadaPhDorEdD

PassionBehindDoctoralDegree

Vision:Tobestengagetheneedsofstudentsand

society

Passion:Helpfuturestudentsandcolleagues

developtheirvisiontobe

engagedaspublicintellectualsin

theirresearchandteaching

Ac9on:Committoac1onandchanceof

failingpubliclytoensure

accountability

PassionBehindDoctoralDegree

•  Welearnfromourfailuresandwilleventuallysucceed

•  Wemusthavecouragetotakerisks•  Iftheworkwedomajers,wewillbedeterminedtodoitsuccessfully

•  Facultyencouragementeestodeveloppassionfortheirworkthatsustainsalifelongcommitment

CommonStrugglesofaPhDStudent

Applica'onprocess:

• References• Wri1ngsample• Iden1fyingpoten1alresearchinterestandmentor

Roletransi'on:

• Expertcliniciantonovicestudent

• Learningtothinkcri1cally

• Changesworldview• Socializa1onintoacademiaandresearch

• Work/lifebalance

CommonStrugglesofaPhDStudent

•  FinancialimplicaConsFull'mestudent•  Cannotworkfull1me•  Payfor9credithours(~$5,000persemester)•  Takesapproximately3-4years

Part'mestudent•  Canworkfull1me•  Payfor6credithours(~$2,500persemester)•  Takesapproximately5-6years

LessonsLearnedasPhDStudent

Resilience

Perseverance

Learntoadaptto"scien1ficwri1ng"

Abilitytotakeconstruc1vecri1cism

WhatisTenureandTenureTrack?

Tenure:•  Provideselevatedlevelofjobsecurity

•  Enhancedlevelofprotec1onforacademicfreedom

TenureTrack:•  Proba1onaryperiodlas1ng~5-7years.

•  Scholarship,service,andteachingareevaluatedbyanoversightcommijee.

•  Promo1onisvotedonbythecommijee.

CommonStrugglesofNewTenure-TrackAssistantProfessor

•  Whatdoestenuretrackentail?– Mee1ngthemissionoftheuniversityandschoolofnursing:•  Educa1on•  Scholarship•  Service

– Grantfundingtosupportresearch– Achievingwork-lifebalance– Beingaprofessional

Objec1ve2

Second,wewilldiscussthemilestonesofresearchin

cys1cfibrosis.

Cys1cFibrosis:Background

•  1989:CFgenediscoveredbyTsui,Riordan,Collins,andtheircolleagues.

•  Survival:

1990:31.9years

Now:49.7years

Cys1cFibrosis:Overview

Cys1cFibrosis

Autosomalrecessive

Abnormalchloridetransportacrosscellmembranes

Thickenedsecre1ons

Createsextensivetreatmentregimen

UnderlyingProblemwithCFTR

•  VideodepictsCFTRworkingproperlyvs.CFTRincys1cfibrosis.

Overview

TreatmentsCon1nued

•  Airwayclearance:Chestphysiotherapy(manualorvest).

•  Inhaledmedica'ons:givenvianebulizer.

•  Pancrea'cenzymes:takenwitheverymealtoimproveabsorp1on

•  2015:CFTRmodulatorstocorrectfunc1onofdefec1veproteincreatedbytheCFgene.

Complica1ons

DayintheLife

•  hjps://youtu.be/qmzvCnt5cHA

Cys1cFibrosisMilestones

1962:median

survivalagereaches10

years

1989:CFgene

discovered

1993:Pulmozymeapprovedtothinmucusinlungs

1997:Tobramycinapprovedthat

reduceshospitalstaysandimproveslungfunc1on

2002:azithromycinimproveslung

health

2003:3-D

structureofCFTRprotein

discovered

Cys1cFibrosisMilestones

2006:Ivacasor

entersclinicaltrialsand

targetsCFTRprotein

2012:FDA

approvesKalydecofor

G551Dmuta1onto

treatunderlyingcauseofCF

2015:FDAapprovesOrkambifor

doubleF508delmuta1on

2016:Cys1cFibrosisFounda1onmaintainsapipelineofpoten1altherapiestotargetCFinhopesforacure

EmergentIssuesinCFResearch

•  TreatmentsforraremutaConsthatwillnotbenefitfromfirst-generaConCFTRmodulators–  Cys1cFibrosisFounda1onlaunchednewNonsenseandRareMuta1onsTherapeu1csIni1a1ve

– UABandSouthernResearchareusingascreeningprocesstofindtherapiesforthesegene1cmuta1ons

EmergentIssuesinCFResearch

•  Addressingmentalhealth–  PeoplewithCFandtheirparentsare2-31mesmorelikelythanthegeneralpopula1ontohavedepression,anxietyorboth

–  CFFdevelopedthefirstprac1ceguidelinesfordepressionandanxietyin2015

– Dataonfollow-upwillbeinthe2016CFFannualreport

“Thereisnohealthwithoutmentalhealth”

-Cys9cFibrosisFounda9on

EmergentIssuesinCFResearch

•  FerClityandpregnancyinwomenwithCF– NumberofCFwomenwhobecamepregnanthasdoubledinthelast20years.

–  Inarecentstudy,32.8%ofwomenunderstoodhowCFaffectsfer1lity

– Lifeexpectancynowinthe40’s– Educa1onandpregnancyplanningwithcareteamisimpera1ve.

EmergentIssuesinCFResearch

•  LungTransplantaCon– Canextendandimprovelife– Requiresextensiveevalua1on– Morethan50%liveatleast5yearspost-transplant

– Risks:•  Rejec1on•  Infec1ons•  Cancer•  Sideeffectsofimmunosuppressivedrugs

CurrentResearch:CFFDrugPipeline

RestoreCFTRFunc1on

• 2drugsalreadyreachedpa1ents

• 7inphase2clinicaltrials

• 2inphase1clinicaltrials

MucociliaryClearance

• 2drugsalreadyreachedpa1ents

• 1inphase3clinicaltrials

• 4inphase2clinicaltrials

• 1inphase1clinicaltrials

An1-inflammatory

• 1drugalreadyreachedpa1ents

• 3inphase2clinicaltrials

• 1inphase1clinicaltrials

An1-Infec1ve

• 4drugsalreadyreachedpa1ents

• 4inphase2clinicaltrials

• 1inphase1clinicaltrials

Nutri1onal-GI

• 3drugsalreadyreachedpa1ents

• 1inphase3clinicaltrials

• 1inphase2clinicaltrials

MyResearch:NACFC

MyResearch:SNRS

MyResearch:Publica1ons

Objec1ve3

Lastly,IwillhighlightresearchconductedbyFilipinonursescien1sts.

FilipinoNurseScien1sts

MarlonGarzoSaria,PhD,RN,AOCNS®,FAAN

KarenMeneses,PhD,RN,FAAN

JosephD.Tariman,PhD,RN,ANP-BC,FAAN

MarlonGarzoSaria,PhD,RN,AOCNS®,FAAN

•  ResearchInterest:– Effectofcancerandcancer-relatedtoxici1esonpa1entoutcomes

–  Impactofcaregiverburdenoncaregiverwell-beingoutcomes,pa1enthealthoutcomes,andhealthcareu1liza1onoutcomes

•  Whythisarea?– Oncologynurse– WorkswithaPhysicianScien1st

”Iwanttohelppa1entsandfamiliesastheyliveeverydayoftheirliveswith

cancer.”

• PhD• Ge[ngcommissionedasairforceofficer

•  Induc1onasFellowofAmericanAcademyofNursing

•  SecretaryofOncologyNursingSociety• AssociateEditorforClinicalJournalofOncologyNursing

Top5professionalachievements

“Ge[ngmyPhDshowedmethat

perseverancetrumpstalent.”

MarlonGarzoSaria,PhD,RN,AOCNS®,FAAN

•  Adviceaboutpursuingagraduatedegree:–  Justdoit– Lifealwayshasdemandsthatwillbeareasonnottogobacktoschool

–  Ifyouwantit,youshoulddoit

“Wallsaretheretokeepthosewhodonotreallywantwhatisontheinsideout.”

MarlonGarzoSaria,PhD,RN,AOCNS®,FAAN

KarenMeneses,PhD,RN,FAAN

•  ResearchInterest:– Breastcancersurvivorship-dispari1esresearch

– Grewfromclinicalprac1cewithcancersurvivors

”Ihavebeenanursesincedinosaursroamedtheearth”

KarenMeneses,PhD,RN,FAAN

•  Topprofessionalachievements:– Dis1nguishedFacultyLecturer– MaraMogensenMemorialLectureship

•  Adviceaboutpursuingagraduatedegree:–  Justdoit.

“Filipino

nursesarethebest!”

JosephD.Tariman,PhD,RN,ANP-BC,FAAN

•  ResearchInterest:– Shareddecisionmaking– Mul1plemyelomatherapies– Sideeffectsmanagement

•  Whythisarea?– Nurseprac11onerfor15yearsspecializinginmyeloma

– LedresearchteamofmyelomaprogramatNorthwesternUniversity

JosephD.Tariman,PhD,RN,ANP-BC,FAAN

•  Topprofessionalachievements:– 2013:SpeakeratPNAAannualconference– Chair:AnnualMyelomaNursingConferencefor7consecu1veyears

– 2013:PlenaryspeakerforInterna1onalMyelomaNursingconference

•  Adviceaboutpursuingagraduatedegree:“Stop

hesita9ng!Enrollingrad

school.“

DaretoDream

References

•  Elborn,J.S.,Shale,D.J.,&Brijon,J.R.(1991).Cys1cfibrosis:currentsurvivalandpopula1ones1matestotheyear2000.Thorax,46(12),881-885.

•  hjp://www.aacn.nche.edu/dnp/ContrastGrid.pdf•  hjps://www.cff.org/What-is-CF/About-Cys1c-Fibrosis/•  hjps://www.cff.org/Research/About-Our-Research/Research-Milestones/•  hjp://www.nature.com/news/2009/080709/full/460164a.html•  hjps://www.cff.org/About-Us/Assets/2015-Annual-Report.pdf•  hjp://web.a.ebscohost.com.ezproxy3.lhl.uab.edu/ehost/pdfviewer/pdfviewer?

sid=90657e0d-914e-429b-ba90-3d36236b05fd%40sessionmgr4006&vid=2&hid=4209•  hjp://files.eric.ed.gov/fulltext/ED471502.pdf•  hjps://www.cff.org/Life-With-CF/Treatments-and-Therapies/Lung-Transplanta1on/What-to-

Consider-Regarding-a-Lung-Transplant/Weighing-the-Benefits-and-Risks/•  hjp://www.cys1cfibrosis.ca/about-cf/living-with-cys1c-fibrosis/complica1ons•  hjps://www.cff.org/trials/pipeline•  hjp://www.aacn.nche.edu/dnp/dnp-tool-kit-sec1on-1•  MacKenzie,T.,Gifford,A.H.,Sabadosa,K.A.,Quinton,H.B.,Knapp,E.A.,Goss,C.H.,&Marshall,

B.C.(2014).Longevityofpa1entswithcys1cfibrosisin2000to2010andbeyond:survivalanalysisofthecys1cfibrosisfounda1onpa1entregistry.Annalsofinternalmedicine,161(4),233-241.

•  Marx,J.L.(1989).Thecys1cfibrosisgeneisfound.Science,245(4921),923-926.