What Are the Barriers to Performing Nonpharmacological Interventions for Behavioral Symptoms in the Nursing Home?
What Are the Barriers to Performing Nonpharmacological Interventions for Behavioral Symptoms in the Nursing Home?
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DOI：
10.1016/j.jamda.2011.07.006
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发表时间：
2012-05-01
影响因子：
7.6
通讯作者：
Dakheel-Ali, Maha
中科院分区：
文献类型：
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作者：
Cohen-Mansfield, Jiska;Thein, Khin;Dakheel-Ali, Maha
目的：行为症状在痴呆患者中很常见，非药物干预被推荐为第一线治疗。我们描述的障碍，进行非药物干预行为symptoms.Design：一个描述性研究的障碍，干预交付在一个对照trial.Settings：这项研究进行了6个疗养院在马里兰州。参与者：参与者是89激动的养老院居民与dementia。干预：个性化的干预措施开发使用的治疗路线探索激动决策树协议。经过培训的研究助理编写并提供了干预措施。测量指标：干预实施障碍评估、日常生活活动、认知功能、抑郁情绪、疼痛、观察到的躁动和观察到的情绪（具体而言，不愿意参与;居民属性，如无响应），与居民不可用相关的障碍（居民睡觉或吃饭）和外部障碍（员工相关障碍，家庭相关障碍，环境障碍和系统过程变量）。与食物/饮料和1对1社交有关的干预措施被发现障碍最少，而拼图/棋盘游戏和艺术和手工艺活动的障碍数量更高。此外，当成功的干预措施后，可行性期间，我们注意到较少的障碍，大概是因为障碍识别已被用来更好地定制干预措施，以每个参与者和environment.Conclusion：知识的障碍提供了一种工具，通过它来定制干预措施，以预测或规避障碍，从而最大限度地提高干预交付。版权所有（C）2012 -美国医学主任协会，Inc.
Objective: Behavioral symptoms are common in persons with dementia, and nonpharmacological interventions are recommended as the first line of therapy. We describe barriers to conducting nonpharmacological interventions for behavioral symptoms.Design: A descriptive study of barriers to intervention delivery in a controlled trial.Settings: The study was conducted in six nursing homes in Maryland.Participants: Participants were 89 agitated nursing home residents with dementia.Intervention: Personalized interventions were developed using the Treatment Routes for Exploring Agitation decision tree protocol. Trained research assistants prepared and delivered the interventions. Feasibility of the interventions was determined.Measurements: Barriers to Intervention Delivery Assessment, activities of daily living, cognitive functioning, depressed affect, pain, observed agitation, and observed affect.Results: Barriers were observed for the categories of resident barriers (specifically, unwillingness to participate; resident attributes, such as unresponsive), barriers related to resident unavailability (resident asleep or eating), and external barriers (staff-related barriers, family-related barriers, environmental barriers, and system process variables). Interventions pertaining to food/drink and to 1-on-1 socializing were found to have the fewest barriers, whereas higher numbers of barriers occurred with puzzles/board games and arts and crafts activities. Moreover, when successful interventions were presented to participants after the feasibility period, we noted fewer barriers, presumably because barrier identification had been used to better tailor interventions to each participant and to the environment.Conclusion: Knowledge of barriers provides a tool by which to tailor interventions so as to anticipate or circumvent barriers, thereby maximizing intervention delivery. Copyright (C) 2012 - American Medical Directors Association, Inc.