Improving Affect & Behavior in Assisted Living Residents

描述(由申请人提供)：这项提案开发了一项关于减少痴呆症辅助生活(AL)居民的情感和行为障碍的治疗的多地点有效性试验的方案。AL正在迅速成为长期护理中照顾痴呆症老年人的最常见方法之一。这些居民中有一半以上患有痴呆症，相当多的人有情感和行为问题，阻碍了他们的护理和生活质量。尽管如此，在一项多点有效性试验中，还没有经过经验验证的治疗方法来教直接护理人员如何护理这些居民。有巨大的公共卫生需要这样的试验，以减少AL患者痴呆症患者经历的情感和行为障碍。 这项研究将制定一项全面的标准化方案，以实施和评估AL工作人员的干预措施，以减少痴呆症患者的情感和行为问题。该议定书将包括：(1)进行治疗的标准化程序(包括治疗手册和提供治疗所需的所有材料)；(2)评估治疗保真度的方法，包括评估治疗提供、接收和颁布；(3)居民和工作人员成果的标准化衡量；以及(4)基于网络的数据收集和输入的实施程序。 这项建议将分三个阶段实现其目标。首先，三个不同州的站点将合作标准化该协议，以确保它可以跨站点系统和可靠地进行。 第二，将进行可行性试验，以测试该协议。在三个地点，9个助理人员驻地(每个驻地有7-9名工作人员和8-10名驻地工作人员)将接受干预--两个内部讲习班、四个与直接护理人员的现场协商和两个有执照的工作人员会议--并在基线和培训后进行评估。将在每个住所获得治疗保真度措施以及居民和工作人员的结果。住院医生的结果将包括抑郁、焦虑、行为问题和生活质量；工作人员的结果将包括工作满意度、对住院医生问题的反应、技能和离职。最后，这项试验的结果将被用于开发一项关于治疗AL痴呆症患者的情感和行为障碍的多点有效性试验。

DESCRIPTION (provided by applicant): This proposal develops a protocol for a multi-site effectiveness trial on a treatment to reduce affective and behavioral disturbance in Assisted-living (AL) residents with dementia. AL is rapidly becoming one of the most common methods of caring for demented older adults in long-term care. Over half of these residents are demented, and a significant number have affective and behavioral problems impeding their care and quality of life. Despite this, no empirically validated treatments to teach direct care staff how to care for these residents have been evaluated in a multi-site effectiveness trial. There is a tremendous public health need for such a trial to decrease the affective and behavioral disturbance experienced by AL residents with dementia. This study will develop a comprehensive standardized protocol to conduct and evaluate an intervention for AL staff to reduce the affective and behavioral problems of residents with dementia. This protocol will include: (1) a standardized procedure for conducting the treatment (including treatment manual and all materials necessary for treatment delivery); (2) methods for evaluating treatment fidelity, including assessment of treatment delivery, receipt, and enactment; (3) standardized measures of resident and staff outcomes, and (4) implementation procedures for web-based data collection and entry. This proposal will accomplish its goals in 3 phases. First, sites in three different states will collaborate to standardize the protocol to insure that it can be conducted systematically and reliably across sites. Second, a feasibility trial will be conducted to test the protocol. Across the three sites, 9 AL residences (each with 7-9 staff and 8-10 residents) will receive the intervention - two in-house workshops, four on-site consultations with direct care staff and two licensed staff sessions - and be assessed at baseline and post training. Treatment fidelity measures and resident and staff outcomes will be obtained at each residence. Resident outcomes will include depression, anxiety, behavioral problems and quality of life; staff outcomes will include job satisfaction, reaction to resident problems, skill, and turnover. Finally, the results of this trial will be used to develop a multi-site effectiveness trial on treatment to reduce affective and behavioral disturbance in AL residents with dementia.