Testing a Restorative Care Nursing Program

测试恢复护理护理计划

• 批准号: 7122978
• 负责人: BARBARA RESNICK
• 金额: $ 63.87万
• 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 2008-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7122978
• 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）：大多数居住在疗养院的老年人在日常生活活动 (ADL) 方面需要一些帮助。造成功能障碍的原因有很多，其中一些护理造成老年人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，重点关注身体功能的恢复和/或维持，并帮助老年人补偿功能损伤，以获得最高水平的功能。恢复性护理非常重视预防身体依赖、缺乏活动和不动等继发性后遗症。尽管有一些关于这些计划好处的轶事报道（Koroknay 等，1995；Orth，1991；Farnham & Moffett，1988），但几乎没有定量证据支持这些计划的广泛使用，也很少有详细描述和开发的计划。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师纳入基于自我效能的干预措施，以改善功能表现、维持或减少挛缩次数、维持或提高肌肉力量、减少跌倒和跌倒相关伤害，并提高长期护理住院医师的生活质量。与居民相关的次要目标侧重于理解居民从事功能活动的机制，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 如何影响护理助理恢复性护理活动的表现、就业状况和工作满意度。 Erickson Life Care Communities 拥有和管理的 8 个长期护理机构的总共 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以接受 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标。测试将在计划实施后的基线、4 个月和 12 个月进行。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现实的模型。最终目标是改变长期护理中当前的护理理念，以关注功能、改善临床结果并告知政策制定者恢复护理计划的有效性。

项目成果

Exploring the factors that influence functional performance among nursing home residents.

探讨影响疗养院居民功能表现的因素。

• DOI: 10.1177/0898264310383157
• 发表时间: 2011
• 期刊: Journal of aging and health
• 影响因子: 2.8
• 作者: Sabol,ValerieK;Resnick,Barbara;Galik,Elizabeth;Gruber-Baldini,AnnL;Morton,PatriciaGonce;Hicks,GregoryE
• 通讯作者: Hicks,GregoryE

Pilot testing of the Restorative Care Intervention: impact on residents.

恢复性护理干预的试点测试：对居民的影响。

• DOI: 10.3928/00989134-20060301-07
• 发表时间: 2006
• 期刊: Journal of gerontological nursing
• 影响因子: 1.3
• 作者: Resnick,Barbara;Simpson,Marjorie;Bercovitz,Anita;Galik,Elizabeth;Gruber-Baldini,Ann;Zimmerman,Sheryl;Magaziner,Jay
• 通讯作者: Magaziner,Jay

Falls and fall-related injuries associated with function-focused care.

跌倒和与跌倒相关的伤害与以功能为中心的护理相关。

• DOI: 10.1177/1054773811420060
• 发表时间: 2012
• 期刊: Clinical nursing research
• 影响因子: 1.7
• 作者: Resnick,Barbara;Galik,Elizabeth;Gruber-Baldini,AnnL;Zimmerman,Sheryl
• 通讯作者: Zimmerman,Sheryl

Anemia and its impact on function in nursing home residents: what do we know?

贫血及其对疗养院居民功能的影响：我们知道什么？

• DOI: 10.1111/j.1745-7599.2009.00471.x
• 发表时间: 2010
• 期刊: Journal of the American Academy of Nurse Practitioners
• 作者: Sabol,ValerieK;Resnick,Barbara;Galik,Elizabeth;Gruber-Baldini,Ann;Morton,PatriciaGonce;Hicks,GregoryE
• 通讯作者: Hicks,GregoryE

Treatment fidelity in nursing home research: the Res-Care Intervention Study.

疗养院研究中的治疗保真度：Res-Care 干预研究。

• DOI: 10.3928/19404921-20090101-09
• 发表时间: 2009
• 期刊: Research in gerontological nursing
• 影响因子: 1.6
• 作者: Resnick,Barbara;Galik,Elizabeth;Pretzer-Aboff,Ingrid;Gruber-Baldini,AnnL;Russ,Karen;Cayo,Jeanne;Zimmerman,Sheryl
• 通讯作者: Zimmerman,Sheryl