Dementia Caregiver Treatment for Nursing Home Transition

疗养院过渡期间的痴呆症护理人员治疗

• 批准号: 6905309
• 负责人: JENNIFER D DAVIS
• 金额: $ 6.74万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6905309
• 关键词: anxiety; behavioral /social science research tag; caregivers; clinical research; clinical trials; coping; dementia; depression; extended care facility; family structure /dynamics; grief; health services research tag; human subject; human therapy evaluation; interview; mental health counseling; nursing homes; outcomes research; patient care personnel relations; problem solving; psychological adaptation; psychological stressor; quality of life; social adjustment; social change; social support network; telemedicine

DESCRIPTION (provided by applicant): The goal of the proposed study is to determine the efficacy of a telephone-based psychosocial intervention (Family Intervention: Telephone Tracking-Nursing Home; FITT-NH) to improve informal dementia caregiver adjustment and caregiver-staff interactions during the transition from community to long-term care. The intervention is theoretically derived and includes education, active problem-solving, and support techniques to improve coping and adaptation during transitions. Preliminary findings from a randomized pilot study of FITT-Dementia (R21 MH62561; G. Tremont, Principal Investigator), support efficacy of the intervention for reducing perceived burden, situational anxiety, and reaction to memory and behavior problems in the care recipient, increasing use of community resources, and improving health-related quality of life in home caregivers compared to usual care. The proposed study is a randomized, controlled 3-month trial of FITT-NH compared to standard care. Treatment strategies are based on assessment of key areas (e.g., emotional adjustment, health, family life, social support, and caregiver-staff communication) during each contact to individualize the intervention to caregivers' needs. Eighty informal dementia caregivers will be enrolled following admission of the care recipient to a long-term care facility. Treatment will be delivered for 3 months, and outcome measures will be obtained at baseline, immediately following treatment, and at a 3-month follow-up. Primary caregiver outcomes are burden, mood, anticipatory grief, perceptions of staff-caregiver interactions, perceived quality of visitation, and satisfaction with the facility. Resource utilization is a secondary outcome. It is hypothesized that caregivers receiving FITT-NH will demonstrate (1) better emotional adjustment (e.g., less anticipatory grief, fewer depressive and anxiety symptoms, less perceived burden, and better health-related quality of life, and (2) better staff-caregiver relationships (e.g., more positive perceptions of staff-caregiver interactions, fewer hassles and disagreements with staff, and better perceived quality of visitations). This low-cost intervention may be useful as part of routine care for dementia caregivers transitioning their family member to long-term care facilities.

描述（由申请人提供）：拟议研究的目标是确定基于电话的心理社会干预（家庭干预：电话跟踪-养老院；FITT-NH）在从社区护理过渡到长期护理期间改善非正式痴呆症护理人员适应和护理人员与工作人员互动的功效。干预是从理论上衍生出来的，包括教育、积极解决问题和支持技术，以改善过渡期间的应对和适应。一项针对fitt -痴呆（R21 MH62561； G. Tremont，首席研究员）的随机试点研究的初步发现，与常规护理相比，支持干预在减轻护理对象感知负担、情境焦虑、对记忆和行为问题的反应、增加社区资源的使用以及改善家庭护理人员与健康相关的生活质量方面的有效性。拟议的研究是一项为期3个月的随机对照试验，将FITT-NH与标准治疗进行比较。治疗策略基于每次接触期间对关键领域（如情绪调整、健康、家庭生活、社会支持和护理人员-工作人员沟通）的评估，以便根据护理人员的需要进行个性化干预。80名非正式的痴呆症护理人员将在接受护理者进入长期护理机构后登记。治疗将持续3个月，并将在基线、治疗后立即和3个月随访时获得结果测量。照顾者的主要结果是负担、情绪、预期悲伤、工作人员与照顾者互动的感知、探视的感知质量和对设施的满意度。资源利用是次要的结果。假设接受FITT-NH的护理人员将表现出(1)更好的情绪调整（例如，更少的预期悲伤，更少的抑郁和焦虑症状，更少的感知负担，以及更好的健康相关生活质量），以及(2)更好的工作人员-护理人员关系（例如，更积极地感知工作人员-护理人员互动，更少的争吵和分歧，以及更好的感知探视质量）。这种低成本的干预措施可能是痴呆护理人员将其家庭成员转移到长期护理机构的常规护理的一部分。