A PRESCRIPTION FOR ENHANCING RESIDENT QUALITY OF LIFE

提高居民生活质量的良方

• 批准号: 7189105
• 负责人: ANN M KOLANOWSKI
• 金额: $ 29.76万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-05-01 至 2009-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7189105
• 关键词: Accounting; Address; Adverse effects; Affect; Agitation; Attention; Behavior; Behavior Therapy; Behavioral; Caring; Classification; Cognitive; Data; Dementia; Effectiveness; Emotional; Enrollment; Exhibits; Goals; Health; Homes for the Aged; Individual; Intervention; Measures; Methods; Modeling; Moods; Nursing Homes; Outcome; Pattern; Personality; Persons; Pharmacological Treatment; Physical Function; Physical activity; Quality of life; Randomized; Randomized Clinical Trials; Reporting; Research; Research Personnel; Resources; Risk; Sedation procedure; Social isolation; Testing; Therapeutic; Time; Week; Work; base; cognitive function; cost effective; design; driving behavior; experience; functional decline; improved; interest; positive mood; prescription document; prescription procedure; programs; restraint; skills

DESCRIPTION (provided by applicant): The majority of the 1.5 million individuals who reside in our nation's nursing homes are elderly persons with dementias that place them at risk for poor health outcomes and diminished quality of life. Need driven behaviors, such as agitation and passivity, are exhibited by 90% of residents with dementia, and account for many poor health outcomes, including poor emotional functioning, decline in physical functioning, use of restraint, social isolation and increased risk of abuse. In the Need-driven Dementia compromised Behavior model (NDB) these behaviors are conceptualized as preserved remnants of earlier behavioral patterns that are triggered by unmet needs. Recreational activities tailored to the skill level and interests of residents hold promise as management strategies for agitation and passivity, but there has been no systematic examination of the treatment components (skill level and interest) that are hypothesized to result in therapeutic outcomes. Until recently, no theoretical framework that addressed nursing home residents' needs related to skill level and interests was available. The primary aim of this study is to test the efficacy of recreational activities derived from the NDB model in reducing agitation and passivity and improving engagement, affect and mood in nursing home residents with dementia. These recreational activities will be individually tailored to match the resident's skill level (cognitive ability and physical functioning) and interests (personality). The NDB-derived activities meet needs by addressing three important causes of need-driven behaviors: impaired cognitive ability, impaired physical functioning and premorbid personality. This study will be a randomized clinical trial with repeated measures, in which 140 residents will be randomly assigned to one of four groups for a 3-week intervention. Measures of agitation and passivity, engagement, affect and mood will be taken before and after interventions. It is hypothesized that residents who receive the NDB-derived intervention will exhibit significantly less agitation, less passivity, greater engagement, more positive affect and more positive mood than residents who receive the match to skill only, match to interest only, or control intervention. This study holds promise for improving quality of life for nursing home residents with dementia by using theoretically based activities to respond to their needs.

描述（由申请人提供）：居住在我国养老院的150万人中的大多数是患有痴呆症的老年人，这使他们面临健康状况不佳和生活质量下降的风险。90%的痴呆症患者表现出焦虑和被动等需求驱动行为，并导致许多不良的健康结果，包括情绪功能不良，身体功能下降，使用约束，社会孤立和滥用风险增加。在需求驱动型痴呆妥协行为模型（NDB）中，这些行为被概念化为由未满足的需求触发的早期行为模式的保留残余。 休闲活动量身定制的技能水平和居民的利益持有承诺作为管理策略的激动和被动，但一直没有系统的检查治疗组件（技能水平和兴趣），假设导致治疗结果。直到最近，没有理论框架，解决养老院居民的需要有关的技能水平和利益。本研究的主要目的是测试来自NDB模型的娱乐活动在减少躁动和被动，提高参与度，影响和情绪的老年痴呆症疗养院居民的有效性。这些娱乐活动将根据居民的技能水平（认知能力和身体功能）和兴趣（个性）进行个性化定制。NDB衍生活动通过解决需求驱动行为的三个重要原因来满足需求：认知能力受损，身体功能受损和病前人格。这项研究将是一项重复测量的随机临床试验，其中140名居民将被随机分配到四个组中的一个，进行为期3周的干预。在干预前后将采取激动和被动、参与、情感和情绪的措施。假设接受NDB衍生干预的居民将表现出显着更少的激动，更少的被动，更大的参与，更积极的影响和更积极的情绪比接受匹配的居民只技能，只匹配的兴趣，或控制干预。这项研究有望通过使用基于理论的活动来满足老年痴呆症疗养院居民的需求，从而提高他们的生活质量。