Self-management support training for carers of older adults with osteoarthritis and additional conditions living in care homes

在这个奖项结束时，我们的目标是制定一个个性化自我管理支持的培训计划，为在家庭和疗养院环境中工作的患有骨关节炎(OA)和多种长期疾病(MLTC)的老年人以及生活在这些环境中的人的家人和朋友提供培训。有较高护理需求的老年人是最需要支持的群体，以帮助管理他们的OA和MLTC，但目前获得支持的可能性最小。生活在这些环境中的许多患有骨性关节炎的老年人都有不同程度的认知障碍，这通常被视为在没有照顾者大力支持的情况下进行自我管理的障碍(例如，无法独立进行运动活动)。在这个项目中开发的培训将旨在增加照顾者对个性化自我管理支持模式的理解，这种模式将成为一种“工作方式”。护理者将发展他们的知识和技能，使他们能够在支持个人决策和参与他们的护理方面做出关键改变。我们希望做到这一点，以便有关节疼痛和高度复杂的健康需求的老年人有信心和熟练地做出关于日常活动的选择，并创造更多有意义的活动机会。在这次颁奖期间，我们将使用分阶段的方法来共同设计自我管理支持培训。这将使用各种方法与利益攸关方接触并寻求支持，以便制定的培训适用于护理者、家人和朋友以及患有骨质疏松症和MLTC的老年人，这些老年人住在养老院或在住所环境中接受护理。我们将使用基于经验的协同设计，并将涉及以下步骤：1.确定利益相关者并参与其中，制定招募方法，项目品牌，以及获得伦理上的同意。2.与患有自闭症和失智症的老年人的照顾者、家人和朋友进行访谈，并与患有自闭症和失智症的老年人进行访谈，以帮助我们探索在这些环境中自我管理支持的挑战，并提供潜在障碍和解决方案的指示。3.制作一部电影，将参与者采访中的故事结合在一起，讲述他们作为照顾者的工作经历，或获得和使用服务的经历，以及与关节疼痛和其他疾病生活在一起的经历。4.举办一次所有利益相关者的初始联合设计会议，分享经验，这将受到之前开发的电影的推动。改革的优先事项将在小型联合设计研讨会上确定和讨论。6.开展培训。最后的小组工作坊，与共同设计的参与者和更广泛的利益相关者一起评估培训。除了这个奖项，我们希望扩大培训的规模，使其适用于所有家庭和护理院环境中的所有照顾者，并提高公众、家人和朋友对个性化自我管理支持的意识。我们将通过与布里奇斯建立的合作实现这一点，布里奇斯是自我管理支持培训的共同设计专家。联合设计过程将允许与所有利益攸关方在现有培训的基础上建立和完善现有培训，以使其符合目标。通过这些伙伴关系，我们将找到维持这种工作方式的方法。我们将培养一个有知识、有技能、有信心的照顾者社区，将关键的沟通方式和策略整合在一起，以实现更大的控制、自主和自我管理，从而将这一点传播到他们服务的同事中。不以盈利为目的的桥梁模式将成为在卫生和社会保健部门推广和采用的工具，我们在以前的项目中使用了这一战略。

At the end of this award our aim is to have developed a training programme in personalised self-management support, for carers working in domiciliary and care home settings with older adults with osteoarthritis (OA) and multiple long term conditions (MLTC's) and family and friends of people living in these settings. Older adults with higher care needs are the group most in need of support to help manage their OA alongside MLTCs but are currently the least likely to be able to access support. Many older adults with OA living within these settings have different degrees of cognitive impairment and this is often seen as a barrier to self-manage without considerable support from carers (e.g. are unable to undertake exercise activity independently). The training developed in this project will aim to increase carers understanding of a model of personalised self-management support that becomes a 'way of working'. Carers will develop their knowledge and skills to empower them to make key changes in the way they support individuals to make decisions and be involved in their care. We want to achieve this so that older adults with joint pain and high and complex health needs feel confident and skilled to make the choices about everyday activities and create more opportunities for meaningful activity.During this award we will used a staged approach to co-design of the self-management support training. This will use a variety of methods to engage and seek support from stakeholders so that the training developed is relevant to carers, family and friends, and older adults with OA and MLTC's living in care homes or receiving care in domiciliary settings. The approach will involve methods that enable reach and access to 'seldom heard' communities such as those with cultural, communication or knowledge barriers.We will use Experienced-Based Co-design, and will involve the following steps:1. Stakeholder identification and engagement, develop recruitment methods, project branding, and gaining ethical consent. 2. Interviews with carers, family and friends of older adults with OA and MLTC's and interviews with older adults with OA and MLTC's, to help us explore the challenges of self-management support across these settings and provide an indication of potential barriers and solutions. 3. Create a film that will combine narratives from the interviews from participants about their experiences of working as a carer, or accessing and using services and living with joint pain and additional conditions. 4. Host an initial co-design meeting of all stakeholders to share experiences, which will be prompted by the film developed previously. Priorities for change will be identified and discussed in small co-design workshops. 6. Develop training.7. Final full group workshop to evaluate the training with co-design participants and wider stakeholders.Beyond this award we want to scale up the training so that it is available to all carers in all domiciliary and care home settings, and raises awareness of personalised self-management support amongst members of the public, family and friends. We will achieve this though our established collaboration with Bridges, who are experts in co-design of self-management support training. The co-design process will allow for building on and refining existing training with all stakeholders so that it is fit for purpose. Through these partnerships we will identify ways to sustain this way of working. We will grow a community of carers that feel knowledgeable, skilled and confident to integrate key ways of communicating and strategies to enable greater control, autonomy and self-management, so this is spread to colleagues within their services. Bridges not for profit model will be a vehicle for spread and adoption across health and social care sectors and we utilised this strategy in previous projects.