An Assistive Wardrobe to Support Dressing Independence

描述(申请人提供)：穿衣是一项复杂的任务，包括许多步骤，从能够到达衣服存放的地方，能够接触到它们，能够将它们脱下/离开存储位置，管理衣服以准备穿上，穿上和重新调整。它需要力量和耐力，可能会受到活动程度、负重状态、平衡、活动范围和视力差的影响。许多老年人，从社区之家到老年公寓和平显住房，再到辅助生活和疗养院，都需要或至少得到穿衣方面的帮助。在第一阶段，开发了一个原型辅助衣柜单元，并对居住在各种住房环境中的26名老年人进行了测试。该单元是专门为解决这些居民所经历的物理和安全问题而设计的。第一阶段的结果强烈表明，原型辅助衣柜单元增加了居民获取衣服的能力，更容易和更安全(p&lt；.003)。在第二阶段，辅助衣柜单元将得到改进，包括为认知障碍者提供支持。有两种干预措施的重复测量设计(单独的衣柜和带有恢复性训练计划的衣柜)将评估辅助衣柜系统对45-50名有一系列身体和认知缺陷的老年人正常日常着装的影响。有4个假设：#1辅助衣柜系统将增强获取衣物的独立性和安全性；#2居民使用辅助衣柜系统时将比使用传统衣柜时独立完成更多的更衣过程；#3工作人员在使用辅助衣柜时花费更少的时间和提供更少的帮助来帮助居民取出衣服和穿衣；#4居民使用辅助衣柜参加为期6天的恢复性换衣计划后，结果将更加强烈。预期结果将对居民和设施都是积极的。功能能力的丧失，如着装独立性，与自我价值和幸福感的下降有关，因此，保持或提高着装独立性可能会增加自我价值感。此外，鉴于目前和预期的未来人员编制短缺，特别是在CNA/STNA一级，在不损害居民安全的情况下提高效率的环境假肢将变得越来越重要。

DESCRIPTION (provided by applicant): Dressing is a complex task with many steps, ranging from being able to get to where the clothes are stored, being able to reach them, being able to get them off/out of the storage location, managing clothing in preparation for donning, donning and readjusting. It requires strength and stamina and may be impacted by degree of mobility, weight-bearing status, balance, range of motion, and poor vision. Many older adults, in settings ranging from homes in the community to senior apartments and HUD housing to assisted living and nursing homes require, or at least receive, assistance with dressing. In Phase I, a prototype assistive wardrobe unit was developed and tested with 26 elders living in a range of housing settings. The unit was designed to specifically address physical and safety concerns experienced by these residents. Results from Phase I strongly indicate that the prototype assistive wardrobe unit increased residents' ability to access their clothing, with greater ease and safety (p< .003). In Phase II, the assistive wardrobe unit will be refined to include supports for people with cognitive impairment. A repeated measure design with two interventions (wardrobe alone, and wardrobe with restorative training program) will assess the impact of the assistive wardrobe system on the normal daily dressing routine of 45-50 elders with a range of physical and cognitive deficits. There are 4 hypotheses: #1 The assistive wardrobe system will enhance independence and safety in accessing clothes; #2 Residents will complete more of the dressing process independently when using the assistive wardrobe system than when using their traditional wardrobe; #3 Staff will spend less time and provide less assistance to residents in getting their clothes out and getting dressed when using the assistive wardrobe; #4 Results will be stronger after residents participate in a six-day restorative dressing program using the wardrobe. The expected outcomes will be positive both for residents and facilities. Loss of functional abilities, such as dressing independence, is linked to decreases in self worth and well-being, therefore maintenance or improvements in dressing independence may increase sense of self-worth. Further, given the current and expected future shortages in staffing, especially at the CNA/STNA level, environmental prostheses that increase efficiency without compromising resident safety will be increasingly important.