Testing a Restorative Care Nursing Program

测试恢复护理护理计划

• 批准号: 6562945
• 负责人: BARBARA RESNICK
• 金额: $ 62.57万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-27 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6562945
• 关键词: allied health personnel; behavior test; behavior therapy; body physical activity; clinical research; functional ability; geriatric nursing; human old age (65+); human subject; interview; motivation; muscle strength; nursing homes; nursing intervention; quality of life; questionnaires

DESCRIPTION (provided by applicant): The majority of older adults living in nursing homes require some assistance with activities of daily living (ADL). There are many causes of functional impairments, among these nursing care that create dependency and lack of motivation on the part of the older adult to perform self-care activities. Restorative care, however, is a philosophy of care that focuses on the restoration and/or maintenance of physical function, and helps the older adult to compensate for functional impairments so that the highest level of function is obtained. Restorative care places an important emphasis on prevention of the secondary sequelae of physical dependence, inactivity, and immobility. Although there are some anecdotal reports of benefits of these programs (Koroknay et al., 1995; Orth, 1991; Farnham & Moffett, 1988), there is little quantitative evidence to support the widespread use of these programs, and few well described and developed programs. The primary aims of this study are to implement an investigator developed two tiered restorative care program, the Nursing Assistants Resident Care Activities Intervention (NARCAI). The NARCAI incorporates self-efficacy based interventions for both nursing assistants and residents to improve functional performance, maintain or decrease the number of contractures, maintain or improve muscle strength, decreased falls and fall related injuries, and improve quality of life in long-term care residents. The secondary aims related to residents focus on understanding the mechanism by which residents engage in functional activities, i.e. the mediating effect of self- efficacy and outcome expectations. The secondary aims related to nursing assistants focus on understanding the mechanism by which nursing assistants change behavior to facilitate restorative care activities, and how the NARCAI impacts nursing assistants performance of restorative care activities, employment status and job satisfaction. A total of 520 residents and 560 nursing assistants in 8 long-term care facilities owned and managed by Erickson Life Care Communities will participate in the study. The facilities will be randomly assigned to receive the NARCAI or routine care. A 2(group) by 3(time) repeated measure analysis of covariance will be done to address both the primary and secondary aims. Testing will be done at baseline, 4 and 12 months following implementation of the program. This study will help determine the effectiveness of restorative care programs and provide a realistic model for how to integrate these programs into all long-term care facilities. The ultimate goal is to alter the current philosophy of care in long-term care to focus on function, improve clinical outcomes, and inform policy makers on the effectiveness of restorative care programs.

描述（由申请人提供）：大多数住在养老院的老年人需要一些日常生活活动（ADL）的帮助。功能障碍的原因有很多，其中护理造成老年人的依赖性和缺乏进行自我护理活动的动力。然而，恢复性护理是一种护理理念，其重点是恢复和/或维持身体功能，并帮助老年人弥补功能障碍，以便获得最高水平的功能。恢复性护理非常重视预防身体依赖、不活动和不动等继发后遗症。尽管有一些关于这些计划的好处的轶事报道（Koroknay等人，一九九五年; Orth，1991年; Farnham & Moffett，1988），很少有定量证据支持这些程序的广泛使用，也很少有很好的描述和开发程序。本研究的主要目的是实施一项研究者开发的两级恢复性护理计划，护理助理居民护理活动干预（NARCAI）。NARCAI结合了护理助理和住院医师的自我效能干预措施，以改善功能表现，维持或减少挛缩次数，维持或改善肌肉力量，减少福尔斯和跌倒相关损伤，并改善长期护理住院医师的生活质量。与居民相关的次级目标侧重于理解居民参与功能活动的机制，即自我效能和结果期望的中介作用。与护理助理相关的次要目标侧重于了解护理助理改变行为以促进恢复性护理活动的机制，以及NARCAI如何影响护理助理的恢复性护理活动，就业状况和工作满意度。埃里克森生活护理社区拥有和管理的8个长期护理设施中共有520名居民和560名护理助理将参加这项研究。这些机构将被随机分配接受NARCAI或常规护理。将进行2（组）× 3（时间）重复测量协方差分析，以解决主要和次要目的。将在基线、项目实施后4个月和12个月进行测试。这项研究将有助于确定恢复性护理计划的有效性，并为如何将这些计划纳入所有长期护理设施提供一个现实的模型。最终目标是改变目前长期护理的护理理念，专注于功能，改善临床结果，并告知政策制定者恢复性护理计划的有效性。