Person-centered approaches for understanding suicidal ideation and behaviors among nursing home residents

以人为本的方法了解疗养院居民的自杀意念和行为

基本信息

批准号：
10163269
负责人：
Kate L Lapane
金额：
$ 46.81万
依托单位：
UNIV OF MASSACHUSETTS MED SCH WORCESTER
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-01 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10163269
关键词：
Address Admission activity Adult Advisory Committees Age Caring Certification Characteristics Clinical Clinical assessments Complex Data Data Set Data Sources Databases Discipline of Nursing Distal Distress Eligibility Determination Epidemiology Event Feeling suicidal Frail Elderly Goals Health Health care facility Healthcare Healthcare Systems Impaired cognition Individual Injury Intervention Joints Knowledge Length of Stay Link Long-Term Care Medical Medicare Medicare Part A Mental disorders Methods Mining Modeling National Institute of Mental Health Nursing Homes Outcome Pain Patients Pattern Population Prevalence Prevention Research Prevention strategy Provider Questionnaires Reporting Research Risk Risk Factors Sampling Sentinel Site Subgroup Suicide Suicide attempt Suicide prevention Supervision Surveys System Vulnerable Populations Work clinically relevant comorbid depression design experience health care settings high risk human old age (65+)ideation improved instrument large datasets neglect novel nursing home length of stay person centered personalized medicine protective factors secondary analysis severe mental illness suicidal behavior suicidal morbidity suicidal risk

项目摘要

PROJECT SUMMARY/ABSTRACT The national Zero Suicide initiative considers all suicide deaths in healthcare settings to be preventable. Research about suicide in nursing homes is necessary given residents’ elevated risk for suicide, the growing importance of this setting as the population ages, and the lack of research on this topic. We propose leveraging our integrated nursing home database of the Minimum Data Set (MDS) 3.0, Medicare eligibility and claims (Part A, B & D) and the Certification and Survey Provider Enhanced Reporting system to examine suicidal ideation and attempts among nursing home residents. Doing so will provide a rare opportunity to use resident- and facility-level data to examine transdiagnostic patterns of risk and protective factors for suicide- related outcomes among a vulnerable population. No national studies have attempted to characterize patterns of risk and protective factors for suicidal ideation and suicide attempts among nursing home residents. The specific aims are to: 1) estimate the prevalence of ideation and attempts during the nursing home stay; 2) identify resident and facility characteristics associated with ideation and attempts; 3) identify and describe distinct subgroups of latent suicide risk among nursing home residents at admission; 4) examine changes in residents’ latent suicide risk throughout the nursing home stay; and 5) identify predictors of change in suicide risk throughout the nursing home stay. Multilevel latent variable models will allow us to identify subgroups of suicide risk and characterize the trajectories of patterns of suicide risk factors and outcomes throughout the nursing home stay. The proposed research responds to the call for research on trajectories of suicide risk to inform how and when to intervene (NIMH Strategic Priority 2) as well as the National Action Alliance for Suicide Prevention Research Prioritization Task Force call for the use of existing data sources such as MDS 3.0 to understand suicide risk in healthcare settings. The proposed work will provide knowledge necessary to ultimately help improve efforts to identify nursing home residents at high risk for suicide and inform tailored suicide prevention efforts in this healthcare setting. The results will also inform future research efforts aimed at improving methods of understanding individuals’ suicide risk throughout lengths of stays in nursing facilities.

项目摘要/摘要国家零自杀计划认为医疗保健环境中的所有自杀死亡是可以预防的。鉴于居民自杀的风险升高，需要在护士屋中自杀的研究，随着人口年龄的增长以及对该主题的缺乏研究，这种环境的重要性。我们建议利用最低数据集（MDS）3.0，Medicare资格和索赔（A部分，B＆D）以及认证和调查提供商增强报告系统以检查护士家庭居民的自杀想法和尝试。这样做将提供难得的使用机会居民和设施级别的数据，以检查自杀的风险和保护因素的转诊模式脆弱人群之间的相关结果。没有国家研究试图表征模式护士居民自杀思想和自杀企图的风险和保护因素。这具体目的是：1）估计护士住宿期间的构想和尝试的流行； 2）确定与思想和尝试相关的居民和设施特征； 3）识别并描述入院时，护士居民的潜在自杀风险的独特亚组； 4）检查变化居民在整个护士住宿期间的潜在自杀风险； 5）确定自杀变化的预测指标在整个护士住宿中冒险。多级潜在变量模型将使我们能够识别自杀风险并表征整个自杀风险因素和结果模式的轨迹护士住宿。拟议的研究回应了对自杀风险轨迹进行研究的呼吁告知如何以及何时干预（NIMH战略重点2）以及自杀的国家行动联盟预防研究优先级工作组要求使用现有数据源，例如MDS 3.0 了解医疗机构中的自杀风险。拟议的工作将为您提供必要的知识最终有助于提高努力，以确定自杀风险高风险的护士家庭居民，并告知量身定制的护士居民在这种医疗保健环境中的自杀预防工作。结果还将告知未来的研究工作改善在护理设施中停留的整个长度上，了解个人自杀风险的方法。