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The MARQUE project: Managing Agitation and Raising QUality of Life. A project to improve quality of life in people with moderate or severe dementia

MARQUE 项目：管理焦虑和提高生活质量。

基本信息

批准号：
ES/L001780/1
负责人：
Gillian Livingston
金额：
$ 433.91万
依托单位：
University College London
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2014
资助国家：
英国
起止时间：
2014 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=ES%2FL001780%2F1
关键词：
MARQUE project Managing Agitation Raising

项目摘要

In the UK about 820,000 people live with dementia with numbers increasing rapidly as the population ages. The Government's "Challenge on Dementia" aims to drive improvements in health and care, create dementia friendly communities and improve research.Responding to this challenge, our MARQUE programme "Managing Agitation and Raising Quality of Life", aims to increase knowledge about dementia, agitation and personhood. We will use the programme to:-develop our theoretical knowledge of dementia, agitation, how people with dementia and their carers experience these and their relationship to citizenship and personhood.-reduce agitation in people with moderate and severe dementia and thus increase quality of life, through the known link between agitation and quality of life. -mentor existing and train new researchers, to build a legacy of trained dementia researchers.Agitation is common, occurring in about 50% of people with moderate or severe dementia every month, is distressing for them and for those around them. The symptoms include restlessness, pacing, shouting or even verbal or physical aggression and signify unmet need. The person with dementia may be in pain, hungry, thirsty, needing comfort or bored but unable to know or explain this. Our group (including Shirley Nurock, an Alzheimer's Society carer) has completed a funded literature review on interventions to reduce agitation. Our vision is to build on this evidence, advancing knowledge, including how to effectively implement findings to improve quality of life for those with dementia.It is a bold and ambitious proposal by a multi-professional team, our family carer partners and participating national and international groups. The team, who have previously worked together successfully, comprise social sciences, medicine, nursing and psychology. A DeNDRoN PPI focus group advised on and approved our proposal. We are partnered by Alzheimer's Society who are leading PPI, care home groups and voluntary and parliamentary groups.The research will involve observing and interviewing a wide range of people with dementia and those who care for them at home, in care homes and in hospitals (including end of life) in order to better understand how agitation is currently managed, barriers to good practice and how care could be improved.We will use this information (with our literature review findings) to develop, test and implement a manual to train staff about how best to reduce agitation and improve quality of life in care homes. It will be tested in a randomised controlled trial in 14 care homes. Our vision is to make this as central to care as good eating and hygiene.Our programme at home will lead to a pilot home intervention, including massage, found to be effective in our review. In addition, we will further develop another manual, to improve people with dementia's end of life for, including "terminal agitation" (comprising restlessness, anxiety, sleeplessness and shortness of breath around the time of dying). This manual will be piloted in four nursing homes (and a control home) and staff, family and residents asked whether it is helpful, practical and feasible.Our programme lasts 5 years but we expect carers and people with dementia to start to benefit from 2 years as we begin testing. It will improve our understanding of current practice and the challenges for family and paid carers. We will have programmes to put into practice across the UK to help manage agitation, including at home, in care homes and at the end of life. We will know what works, is cost effective and how to implement. This will improve quality of life for people with dementia and their carers wherever they live and will help guide research and practice. Our partners will then work with us to ensure national publicity and implementation. This will include incorporation into care home and hospital inductions and feedback to Care Quality Commission as a potential new care standard.

在英国，约有82万人患有痴呆症，随着人口老龄化，这一数字迅速增加。政府的“痴呆症挑战”旨在推动健康和护理的改善，创建痴呆症友好社区和改善研究。为了应对这一挑战，我们的品牌计划“管理情绪和提高生活质量”，旨在增加对痴呆症、情绪波动和人格的知识。我们将利用该计划：-发展我们关于痴呆症、激动症、痴呆症患者和他们的照顾者如何经历这些以及他们与公民身份和人格的关系的理论知识。-通过激动症和生活质量之间的已知联系，减少中度和重度痴呆症患者的焦虑症，从而提高生活质量。-指导现有的研究人员并培训新的研究人员，以建立训练有素的痴呆症研究人员的遗产。焦虑症很常见，每月约有50%的中度或重度痴呆症患者发生，这对他们和他们周围的人来说都是令人痛苦的。这些症状包括焦躁不安、步态不稳、大喊大叫，甚至言语或身体攻击，表明需求未得到满足。痴呆症患者可能处于疼痛、饥饿、口渴、需要安慰或无聊，但无法知道或解释这一点。我们的团队(包括阿尔茨海默病协会的照顾者雪莉·诺洛克)已经完成了一项由资金资助的关于减少焦虑的干预措施的文献综述。我们的愿景是建立在这一证据的基础上，促进知识的发展，包括如何有效地实施研究结果，以提高痴呆症患者的生活质量。这是一个由多专业团队、我们的家庭护理合作伙伴以及参与的国内和国际团体提出的大胆而雄心勃勃的建议。该团队此前曾成功合作，包括社会科学、医学、护理和心理学。DeNDRoN PPI焦点小组建议并批准了我们的建议。我们是阿尔茨海默病协会的合作伙伴，他们领导着PPI，护理之家团体以及志愿和议会团体。这项研究将包括观察和采访广泛的痴呆症患者以及在家中、在护理之家和医院(包括生命末期)照顾他们的人，以更好地了解目前如何管理焦虑，良好做法的障碍，以及如何改善护理。我们将利用这些信息(与我们的文献综述结果)来制定、测试和实施一本手册，培训工作人员如何最好地减少焦虑，提高疗养院的生活质量。它将在14家疗养院进行随机对照试验。我们的愿景是使这一点与良好的饮食和卫生一样成为护理的核心。我们的家庭计划将导致试点家庭干预，包括按摩，在我们的审查中被发现是有效的。此外，我们还将进一步开发另一本手册，以改善痴呆症患者的临终状态，包括“临终激动”(包括临终前的躁动、焦虑、失眠和呼吸急促)。这本手册将在四家养老院(和一家对照之家)试行，工作人员、家庭和居民询问它是否有帮助、实用和可行。我们的计划为期5年，但我们预计护理人员和痴呆症患者将从2年后开始受益，因为我们开始测试。这将提高我们对目前的做法以及家庭和付费照顾者面临的挑战的理解。我们将在英国各地实施一些计划，以帮助管理焦虑情绪，包括在家里、疗养院和生命末期。我们将知道什么是有效的，是具有成本效益的，以及如何实施。这将提高痴呆症患者及其照顾者的生活质量，无论他们住在哪里，并将有助于指导研究和实践。然后，我们的合作伙伴将与我们合作，确保全国宣传和实施。这将包括纳入疗养院和医院的诱因，并向护理质量委员会反馈，作为潜在的新护理标准。

项目成果

期刊论文数量（10）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Agitation and quality of life in people with dementia in care homes: Managing Agitation and Raising Quality of Life (MARQUE) cross-sectional study

护理院痴呆症患者的躁动和生活质量：管理躁动和提高生活质量 (MARQUE) 横断面研究

DOI：
发表时间：
2017
期刊：
British Journal of Psychiatry Open
影响因子：
0
作者：
Gill Livingston
通讯作者：
Gill Livingston

Implementation of START (STrAtegies for RelaTives) for dementia carers in the third sector: Widening access to evidence-based interventions.

DOI：
10.1371/journal.pone.0250410
发表时间：
2021
期刊：
PloS one
影响因子：
3.7
作者：
Amador S;Rapaport P;Lang I;Sommerlad A;Mukadam N;Stringer A;Hart N;Nurock S;Livingston G
通讯作者：
Livingston G

Relationship between speaking English as a second language and agitation in people with dementia living in care homes: Results from the MARQUE (Managing Agitation and Raising Quality of life) English national care home survey.