The triple challenge of recruiting older adults with dementia and high medical acuity in skilled nursing facilities.
The triple challenge of recruiting older adults with dementia and high medical acuity in skilled nursing facilities.
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DOI：
10.1111/jnu.12042
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发表时间：
2013-12
期刊：
影响因子：
--
通讯作者：
Fick D
中科院分区：
文献类型：
--
作者：
Kolanowski A;Mulhall P;Yevchak A;Hill N;Fick D
描述从经验中挑选的策略，以应对正在进行的痴呆患者谵妄的随机临床试验中的几个招募挑战。痴呆症患者的谵妄在所有文化中都很常见。很少有研究支持对谵妄使用特定的干预措施。招募足够的样本对干预研究结果的有效性至关重要，这些研究是基于证据的实践的基础。本文引用的试验测试了认知刺激解决痴呆患者谵妄的疗效。参与者在进入八个社区技术护理机构（snf）之一时被招募。符合条件的参与者年龄在65岁或以上，居住在社区，并且诊断为痴呆和谵妄。在两年的时间里，在每周的团队会议上确定了招聘挑战和策略。招聘挑战包括外部和内部环境因素以及参与者及其家庭因素。应对这些挑战的策略包括早期的现场评估和与员工、参与者和家庭的强有力的沟通方法。在snf中招募足够的急性痴呆老年人样本可能对研究人员构成挑战，并威胁到研究结果的有效性。介绍了有助于提高未来研究有效性的招聘策略。到2050年，全球将有超过1亿人患有痴呆症，使他们面临更大的谵妄风险。迫切需要提高护理研究质量的招募策略，并由此延伸到snf康复期间老年痴呆患者谵妄的护理和预防。
To describe strategies, culled from experience, for responding to several recruitment challenges in an ongoing randomized clinical trial of delirium in persons with dementia. Delirium in people with dementia is common across all cultures. Little research supports the use of specific interventions for delirium. Recruitment of an adequate sample is critical to the validity of findings from intervention studies that form the foundation for evidence-based practice. The trial referenced in this article tests the efficacy of cognitive stimulation for resolving delirium in people with dementia. Participants are recruited at the time of admission to one of eight community-based skilled nursing facilities (SNFs). Eligible participants are 65 years of age or older and community dwelling, and have a diagnosis of dementia and delirium. Recruitment challenges and strategies were identified during weekly team meetings over a 2-year period. Recruitment challenges include factors in the external and internal environment and the participants and their families. Strategies that address these challenges include early site evaluation and strong communication approaches with staff, participants, and families. The recruitment of an adequate sample of acutely ill older adults with dementia in SNFs can pose a challenge to investigators and threaten the validity of findings. Recruitment strategies that help improve the validity of future studies are described. Worldwide, over 100 million people will have dementia by 2050, placing them at increased risk for delirium. Recruitment strategies that improve the quality of nursing research and, by extension, the care and prevention of delirium in older adults with dementia during rehabilitation in SNFs are greatly needed.
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