PREP--FAMILY BASED CARE FOR FRAIL OLDER PERSONS

家庭护理研究是PREP的随机对照有效性试验，是一种家庭健康干预措施，旨在增加体弱老年人家庭护理的准备程度和可预测性。PREP以其家庭为重点，分为三个部分：（1）家庭和护士共同努力解决家庭护理问题，（2）24小时PREP咨询热线;（3）护士使用Keep-in-Touch进行后续联系。缩写的主要目标（完整目标见第98页）是：（1）描述PREP家庭确定的护理问题，为解决这些问题而实施的策略，以及策略的有效性;（2）确定与扩展家庭健康（EHH）和标准家庭健康（SHH）相比，PREP是否显著改善了家庭护理变量（例如，照顾者[CG]技能，CG角色紧张等）和健康状况，包括护理接受者（CR）功能;（3）确定PREP是否在黑人与白色和低收入与中等收入家庭中具有差异有效性;（4）确定EHH与SHH相比是否对家庭护理变量和健康具有有益影响;（5）确定PREP和EHH对家庭护理变量和健康的任何影响在干预措施撤销后是否继续。拟议的研究还将解决与测量PREP、EHH和SHH中CR和CG的正式和非正式医疗保健服务的使用和成本相关的两个次要目标。本研究将采用3组设计。样本将包括360名符合大型非营利性HMO熟练家庭护理医疗保险标准的老年人。至少有60个黑人和60个低收入白色家庭将被纳入样本。所有样本将随机分配至PREP、EHH或SHH。PREP将由PREP护士在一个跨学科团队的背景下提供给家庭，为期12个月。在EHH中，与PREP团队组成相当的家庭健康时间将获得与PREP团队相同的资源，以提供护理，但不会使用PREP的目标和原则。SHH将是HMO提供的常规家庭健康护理。六个研究措施和数据来源将被使用：家庭护理清单，家庭护理质量量表，家庭健康日记，KPNW家庭健康自动化临床信息系统（DOCPLUSR），KPNW自动化数据系统和家庭日历。将获得研究入组前12个月和研究入组后20个月的利用率和成本数据。分析将包括回归、生存分析和重复测量ANOVA。

The Family Care Study is a randomized controlled efficacy trial of PREP, and a home health intervention designed to increased Preparedness Enrichment, and Predictability in family care for frail elders. PREP is distinguished by its family focus and has three parts: (1) the family and nurse working together of family care issues, (2) 24-hour PREP Advice Line; and (3) follow-up contact by the nurse using Keep-in-Touch. The abbreviated primary aims (full aims on page 98) are to: (1) describe the care issued identified by PREP families, the strategies implemented to resolve these issues, and the effectiveness of the strategies; (2) determine whether compared to Extended Home Health (EHH) and Standard Home Health (SHH), PREP significantly improves family care variables (e.g., caregiver [CG] skill, CG role strain etc.) And health status, including care receiver (CR) function; (3) determine whether PREP is differentially effective in Black versus White and in low versus middle income families; (4) determine whether EHH, compared to SHH, has beneficial effects on family care variables and health; and (5) determine whether any effects of PREP and EHH on family care variables and health continue after the intervention is withdrawn. The proposed study will also address two secondary aims related to measuring use and cost of formal and informal health care services for CRs and CGs in PREP, EHH, and SHH. The study will use a 3-group design. The sample will include 360 older people who meet Medicare criteria for skilled home care at a large not-for- profit HMO. At least 60 Black and 60 low-income White families will be included in the sample. All samples will be randomized to PREP, EHH, or SHH. PREP will be delivered to families by PREP nurses within the context of an interdisciplinary team for a period of 12 months. In EHH, a home health time comparable in composition to the PREP team will be given the same resources as PREP team will be given the same resources as PREP to deliver care but will not use the goals and principles of PREP. SHH will be the usual home health care provided by the HMO. Six research measures and data sources will be used: The Family Care Inventory, Quality of Family Care Scale, Family Health Diary, KPNW Home Health automated clinical information system (DOCPLUSR), KPNW automated data systems, and the Family Expense Calendar. Utilization and cost data will be obtained for 12 months prior to and 20 months after study entry. Analyses will include regression, survival analysis, and repeated measures ANOVA.