Changing Talk Online: Protocol for a cluster pragmatic trial testing communication education to reduce behavioral and psychological symptoms of dementia in nursing home care.
Changing Talk Online: Protocol for a cluster pragmatic trial testing communication education to reduce behavioral and psychological symptoms of dementia in nursing home care.
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DOI：
10.1016/j.cct.2021.106550
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发表时间：
2021-10
影响因子：
2.2
通讯作者：
Kantartjis M
中科院分区：
文献类型：
--
作者：
Williams KN;Coleman CK;Shaw CA;Perkhounkova Y;Hein M;Cramer E;Beachy T;Berkley A;Kantartjis M
老年痴呆症患者的疗养院（NH）护理通常受到痴呆症（BPSD）的行为和心理症状的挑战，如由于认知和沟通变化而发生的攻击，声音爆发，徘徊和退缩。工作人员经常使用“长者语”与NH居民交流，这是一种类似于婴儿谈话的居高临下的语言。居民对老年人说话的反应是BPSD增加，这促使使用精神药物来控制症状。改变谈话（聊天）培训教育工作人员有效，以人为本的沟通策略，并减少老年人说话的工作人员和随后的BPSD居民。本研究将测试适应的在线版本（CHATO）的影响，增加教育的访问和传播到不同的护理环境中的忙碌的工作人员。将对疗养院（N=128）进行分层，然后随机分配至CHATO教育组（n=64）或对照组（n=64）。行为症状（主要结局）和精神药物使用（次要结局）的数据将在教育前后从医疗保险和医疗补助服务中心最小数据集中提取，并将使用广义线性混合模型在组间进行比较。据推测，完成CHATO教育后，居民将减少行为症状和精神药物的使用相比，在控制NHs的居民。此外，将确定与NH参与和干预费用相关的因素。本研究的总体目标是为大规模传播和实施循证非药物CHATO干预做好准备，以减少长期护理机构中痴呆患者的BPSD。
Nursing home (NH) care of persons living with dementia is often made challenging by behavioral and psychological symptoms of dementia (BPSD) such as aggression, vocal outbursts, wandering, and withdrawal that occur due to cognitive and communication changes. Staff frequently communicate to NH residents using “elderspeak” which is patronizing speech similar to baby talk. Residents respond to elderspeak with increased BPSD that prompts use of psychotropic medication to control symptoms. The Changing Talk (CHAT) training educates staff about effective, person-centered communication strategies and reduces elderspeak by staff and subsequent BPSD among residents. This study will test effects of an adapted online version (CHATO) increasing access and dissemination of education to busy staff across diverse care settings. Nursing homes (N=128) will be stratified and then randomized to CHATO education (n=64) or to the control group (n=64). Data on behavioral symptoms (primary outcomes) and psychotropic medication use (secondary outcomes) will be extracted from the Center for Medicare and Medicaid Services Minimum Data Set before and after education and will be compared between the groups using generalized linear mixed modeling. It is hypothesized that after completing the CHATO education residents will have reduced behavioral symptoms and psychotropic medication use compared to residents in control NHs. Additionally, factors related to NH participation and cost of the intervention will be determined. The overall goal of this study is to prepare for large scale dissemination and implementation of the evidence-based nonpharmacological CHATO intervention to reduce BPSD in residents with dementia across long-term care settings.
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DOI：
10.1016/j.jamda.2020.01.103
发表时间：
2020-08
影响因子：
7.6
作者：
Bakerjian D;Bettega K;Cachu AM;Azzis L;Taylor S
通讯作者：
Taylor S
影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
影响因子：
2
作者：
DAWSON, JD
通讯作者：
DAWSON, JD
影响因子：
1.9
作者：
Kemper, S;Ferrell, P;Billington, C
通讯作者：
Billington, C
影响因子：
1.6
作者：
McConnell, Eleanor S.;Corazzini, Kirsten N.;Champagne, Mary T.
通讯作者：
Champagne, Mary T.