PREP--FAMILY BASED CARE FOR FRAIL OLDER PERSONS

准备——为体弱的老年人提供家庭护理

• 批准号: 2854277
• 负责人: PATRICIA G ARCHBOLD
• 金额: $ 104.81万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-15 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2854277
• 关键词: African American; Medicare /Medicaid; behavioral /social science research tag; caregivers; caucasian American; clinical research; clinical trials; extended care; family structure /dynamics; frail elderly; geriatric nursing; health care cost /financing; health care model; health care service evaluation; health care service utilization; health services research tag; health surveys; home health care; human subject; income; longitudinal human study; managed care; psychological stressor; racial /ethnic difference; telecommunications

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determine whether any effects of PREP and EHH on family care variables and health continue after the intervention is withdrawn.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.

家庭护理研究是一项 PREP 的随机对照功效试验，也是一项家庭健康干预措施，旨在增强体弱老年人家庭护理的准备丰富度和可预测性。 PREP 以家庭为重点，分为三个部分：(1) 家人和护士共同解决家庭护理问题；(2) 24 小时 PREP 咨询热线； (3) 护士使用“保持联系”进行后续联系。简短的主要目标（完整目标见第 98 页）是： (1) 描述 PREP 家庭所提供的护理、为解决这些问题而实施的策略以及这些策略的有效性； (2)确定与扩展家庭健康(EHH)和标准家庭健康(SHH)相比，PREP是否显着改善家庭护理变量(例如，护理者[CG]技能、CG角色紧张等)和健康状况，包括被护理者(CR)功能； (3) 确定 PREP 在黑人与白人、低收入家庭与中等收入家庭中的有效性是否存在差异； (4) 确定 EHH 与 SHH 相比是否对家庭护理变量和健康有有益影响； (5) 确定在干预措施撤回后，PREP 和 EHH 对家庭护理变量和健康的影响是否持续。拟议的研究还将解决两个次要目标，即衡量 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。该研究将采用三组设计。样本将包括 360 名老年人，他们符合大型非营利 HMO 熟练家庭护理的 Medicare 标准。样本中将至少包括 60 个黑人家庭和 60 个低收入白人家庭。所有样本将被随机分配到 PREP、EHH 或 SHH。 PREP 将由 PREP 护士在跨学科团队的背景下向家庭提供为期 12 个月的服务。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，将获得与 PREP 相同的资源来提供护理，但不会使用 PREP 的目标和原则。 SHH 将是 HMO 提供的常规家庭医疗保健。将使用六项研究措施和数据源：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费用日历。将获得研究开始前 12 个月和研究后 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方差分析。