Using design thinking approaches to tailor a dyadic behavioral sleep intervention for persons living with dementia and their caregivers

使用设计思维方法为痴呆症患者及其护理人员量身定制二元行为睡眠干预措施

• 批准号: 10302008
• 负责人: Glenna Shemida Brewster
• 金额: $ 18.75万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10302008
• 关键词: Address; Adherence; Adult; Affect; Alzheimer' s disease related dementia; Beds; Behavior Therapy; Behavioral; Caregiver research; Caregivers; Clinical Trials; Cognitive; Cognitive Therapy; Collaborations; Communities; Control Groups; Dementia; Dementia caregivers; Development; Diagnosis; Disease; Effectiveness; Evidence based intervention; Foundations; Future; Goals; Habits; Health; Health Personnel; Human; Individual; Intervention; Intervention Studies; Intervention Trial; Interview; K-Series Research Career Programs; Knowledge; Learning; Literature; Manuscripts; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Modeling; National Institute on Aging; Neurology; Oral; Outcome; Patients; Peer Review; Personhood; Persons; Phase; Polysomnography; Population; Prevalence; Process; Psychology; Public Health; Quality of life; Questionnaires; Randomized; Randomized Controlled Trials; Reporting; Research; Research Project Grants; Residential Treatment; Schedule; Severities; Sleep; Sleep disturbances; Sleeplessness; Stimulus; Structure; Testing; Thinking; Time; Training; United States National Institutes of Health; Veterans; Visualization; Waiting Lists; Work; Writing; acceptability and feasibility; actigraphy; analytical method; behavioral/social science; caregiving; cognitive skill; control trial; dementia care; dementia caregiving; depressive symptoms; design; diaries; effective intervention; experience; falls; group intervention; improved; indexing; innovation; member; memory care; mild cognitive impairment; novel; patient oriented; poor sleep; primary outcome; programs; prototype; psychologic; satisfaction; skills; sleep behavior; sleep onset; sleep quality; social neuroscience; theories; therapy development; university student; virtual

Project Summary Sleep disturbance is prevalent in persons living with mild cognitive impairment or early-stage Alzheimer’s disease and related dementias (PLwCI) as well as their caregivers. This prevalence suggests that sleep disturbance is an interdependent process that synergistically affects both members of the caregiving dyad. Sleep disturbance is associated with poorer health outcomes, including higher depressive symptoms and lower quality of life. Cognitive behavioral therapy for insomnia (CBTI) is effective for improving sleep disturbance in many populations, and support from a partner during CBTI results in more successful outcomes. The interdependence of PLwCI-caregiver sleep disturbance suggests the need for a dyadic intervention. However, there are no structured fully dyadic interventions focused on managing sleep disturbance in PLwCI and their caregivers; moreover, no dyadic interventions have been developed with input from these stakeholders. Aligned with the National Institute of Aging’s Behavioral and Social Science and Neuroscience high-priority dementia caregiver research agenda, the proposed K23 Patient-Oriented Mentored Career Development Award seeks to use design thinking, human-centered approaches within the CBTI framework to tailor a dyadic intervention (T-Dyadic Sleep) for PLwCI and their caregivers. Twenty PLwCI-caregiver dyads and 10 healthcare providers will be interviewed during the tailoring phase. We will then conduct a waitlist randomized control trial (N = 40 dyads) to test the acceptability, feasibility, and preliminary immediate and sustained efficacy (3 months) of T-Dyadic Sleep. The completion of this mentored research project will enable me to acquire foundational knowledge for conducting large-scale intervention trials and fulfill the need for effective dyadic interventions to treat sleep disturbance in PLwCI and caregiver dyads. The interdisciplinary training plan and goals developed for this K23 award will fill a critical gap in my current skill set. Building on my training as a clinician with expertise in sleep and dementia caregiving, I will develop proficiency in 1) design thinking approaches, 2) dyadic theories, concepts, and analytic methods, 3) identification and diagnosis of dementia- related disorders, including a focus on how these disorders relate to sleep disturbance, and 4) scientific writing, oral presentations, manuscript development, and peer review. I have assembled an excellent team of mentors (Drs. Hepburn, Barton, Lyons and Lah) and a collaborator (Dr. Gehrman). The K23 award will provide me with the necessary foundation to build a successful and independent program of research related to sleep, dementia, and caregiving. My program of research aligns well with NIA’s Strategic Directions for Research to understand and develop interventions to address the needs of patients living with Alzheimer’s disease and related dementias as well as the needs of their caregivers, and to engage persons living with dementia and their caregivers as part of research teams.

项目摘要 睡眠障碍在轻度认知障碍或早期阿尔茨海默氏症患者中很普遍 疾病和相关痴呆（PLwCI）以及他们的照顾者。这种普遍性表明睡眠 干扰是一个相互依赖的过程，协同影响两个成员的双胞胎。 睡眠障碍与较差的健康结果相关，包括较高的抑郁症状和较低的 生活质量失眠的认知行为疗法（CBTI）可有效改善睡眠障碍， 在CBTI期间，许多人群和合作伙伴的支持导致更成功的结果。的 PLwCI-照顾者睡眠障碍的相互依赖性表明需要进行二元干预。然而，在这方面， 没有结构化的完全二元干预措施，重点是管理PLwCI的睡眠障碍， 此外，还没有根据这些利益攸关方的投入制定出任何二元干预措施。 与国家老龄化研究所的行为和社会科学以及神经科学高度优先 痴呆症护理人员研究议程，拟议的K23以患者为导向的指导职业发展 Award旨在使用设计思维，在CBTI框架内以人为本的方法， 对PLwCI及其护理人员进行干预（T-Dyadic Sleep）。20个PLwCI-照顾者二人组和10个 在定制阶段，将对医疗保健提供者进行访谈。然后我们将进行一个随机的等待名单， 对照试验（N = 40对），以测试可接受性、可行性和初步的立即和持续 T-Dyadic Sleep的疗效（3个月）。这个指导研究项目的完成将使我能够 获得进行大规模干预试验的基础知识，并满足有效干预的需要。 治疗PLwCI患者和护理者二人组睡眠障碍的二人干预。跨学科培训计划 为K23奖项制定的目标将填补我目前技能的关键空白。在我作为一个 我是一名睡眠和痴呆症诊断方面的专业临床医生，我将熟练掌握设计思维 方法，2）二元理论，概念和分析方法，3）痴呆症的识别和诊断- 相关疾病，包括关注这些疾病与睡眠障碍的关系，以及4）科学写作， 口头报告、手稿开发和同行评审。我召集了一个优秀的导师团队 (Drs.赫普本、巴顿、里昂和拉）和一位合作者（格尔曼博士）。K23奖将为我提供 建立一个成功的和独立的睡眠相关研究项目的必要基础， 痴呆和痴呆我的研究计划与NIA的研究战略方向保持一致， 了解并制定干预措施，以满足阿尔茨海默病患者的需求， 相关痴呆症及其照顾者的需求，并让痴呆症患者和 他们的护理人员作为研究团队的一部分。