Testing a Restorative Care Nursing Program

测试恢复护理护理计划

• 批准号: 6752755
• 负责人: BARBARA RESNICK
• 金额: $ 62.69万
• 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/6752755
• 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在日常生活能力(ADL)方面需要一些帮助。导致功能障碍的原因有很多，其中包括造成老年人依赖和缺乏动力进行自我护理活动的护理。然而，恢复性护理是一种护理理念，侧重于身体功能的恢复和/或维持，并帮助老年人弥补功能障碍，从而获得最高水平的功能。恢复性护理将重点放在预防身体依赖、不活动和静止的继发性后遗症上。尽管有一些关于这些计划的益处的轶事报道(Koroknay等人，1995；Orth，1991；Farnham&Moffett，1988)，但几乎没有定量的证据支持这些计划的广泛使用，也很少有好的描述和开发的计划。本研究的主要目的是实施研究者开发的两级恢复性护理计划，即护理助理住院护理活动干预(NARCAI)。NARCAI为护理助理和住院医生提供了基于自我效能的干预措施，以改善护理助理和住院医生的功能表现，维持或减少痉挛的数量，维持或改善肌肉力量，减少跌倒和跌倒相关伤害，并提高长期护理住院医生的生活质量。与居民相关的次要目标侧重于了解居民参与功能性活动的机制，即自我效能感和结果期望的中介效应。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如何影响护理助理在恢复性护理活动中的表现、就业状况和工作满意度。埃里克森生命护理社区拥有和管理的8个长期护理机构的520名居民和560名护理助理将参与这项研究。这些设施将被随机分配到接受NARAI或常规护理的地方。将对协方差进行2(组)乘3(时间)的重复测量分析，以解决主要目标和次要目标。测试将在计划实施后的4个月和12个月的基线上进行。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整合到所有长期护理设施中提供一个现实的模式。最终目标是改变目前长期护理中的护理理念，将重点放在功能上，改善临床结果，并向政策制定者通报恢复性护理计划的有效性。