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: 6533860
• 负责人: PATRICIA G ARCHBOLD
• 金额: $ 73.72万
• 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 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6533860
• 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determine whether any effects of PREP and EHH on family care variables and health continue after the intervention is withdrawn.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关于PREP的随机对照疗效试验，是一项旨在增加对虚弱老年人的家庭护理的准备丰富和可预测性的家庭健康干预。Prep以家庭为重点，分为三个部分：(1)家庭和护士共同工作，解决家庭护理问题；(2)24小时准备咨询热线；(3)护士使用Keep-in-Touch进行后续联系。简略的主要目标(第98页的完整目标)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战略，以及这些战略的有效性；(2)确定与扩展家庭健康(EHH)和标准家庭健康(SHH)相比，PREP是否显著改善家庭护理变量(例如，照顾者[CG]技能、CG角色紧张等)。(3)确定PREP在黑人和白人以及低收入和中等收入家庭中是否有不同的效果；(4)确定与SHH相比，EHH是否对家庭护理变量和健康有有利影响；以及(5)确定在停止干预后，PREP和EHH对家庭护理变量和健康是否有任何影响。拟议的研究还将涉及两个次要目标，即衡量预科、EHH和SHH中CRS和CGs的正式和非正式卫生保健服务的使用和成本。这项研究将采用三组设计。样本将包括360名符合联邦医疗保险标准的老年人，他们在一家大型非营利性医疗机构进行熟练的家庭护理。样本中将包括至少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为PREP、EHH或SHH。准备工作将由预备护士在跨学科小组的范围内进行，为期12个月。在EHH中，在构成上与Prep团队相似的家庭健康时间将获得与Prep团队相同的资源，但不会使用Prep的目标和原则。Shh将是HMO提供的常见家庭保健服务。将使用六项研究措施和数据来源：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自动数据系统和家庭费用日历。使用率和成本数据将在研究开始前12个月和研究结束后20个月内获得。分析将包括回归分析、生存分析和重复测量方差分析。