Correlates among nocturnal agitation, sleep, and urinary incontinence in dementia

痴呆症夜间躁动、睡眠和尿失禁之间的相关性

• 批准号: 8280841
• 负责人: Karen M Rose
• 金额: $ 24.58万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8280841
• 关键词: Agitation; Alzheimer' s Disease; Area; Behavior; Caregiver Burden; Caregivers; Caring; Communities; Cost Savings; Data; Data Analyses; Data Collection; Dementia; Development; Distress; Emotional; Environment; Family Caregiver; Frequencies; Healthcare Systems; Home environment; Impaired cognition; Incontinence; Institutionalization; Interruption; Intervention; Interview; Laboratories; Language; Lead; Life; Love; Measures; Methods; Outcome; Participant; Pattern; Persons; Quality of life; Questionnaires; Reporting; Research; Research Personnel; Resources; Savings; Sleep; Sleep disturbances; Specific qualifier value; Structure; Symptoms; System; Taxes; Technology; Testing; Time; United States; Urinary Incontinence; Wireless Technology; Work; base; bedwetting; boys; coping; cost; design; effective intervention; experience; innovation; loved ones; novel; nursing intervention; programs; psychologic; satisfaction; sensor; sleep onset

DESCRIPTION (provided by applicant): Seventy to ninety percent of all persons with Alzheimer's Disease (AD) receive care in their homes. For the millions of family caregivers for persons with AD in the U.S., nighttime agitation, sleep disturbances, and urinary incontinence in their care recipients add additional burden to these already burdened caregivers. These disturbances are often reported by caregivers as being the "tipping point" for seeking institutional care for their loved ones. While each of these disturbances are recognized independently in persons with AD, no research, to date, has studied the interrelationships of these challenging behaviors in community-dwelling persons. Effective interventions can be developed and tested once these relationships are better understood. We believe that a primary reason for limited research in this area is related to the resource-intensiveness of collecting these data using conventional methods (i.e., direct observations). Wireless, body sensor networks hold promise as innovative, reliable, and valid means to collect these data. Three specific aims will guide this study: (1) examine the feasibility and acceptability of the use of boy sensors in community-dwelling persons with AD and in their family caregivers; (2) describe patterns of nocturnal agitation, sleep continuity and duration, and nighttime urinary incontinence in community-dwelling persons with AD; and (3) examine the relationships among nocturnal agitation, sleep continuity and duration, and nighttime urinary incontinence (timing, frequency) in persons with AD. We will use a single-group, descriptive design with AD participants and their caregivers (N = 50). Data collection will take place over 5 weeknights in participants' home environments. To measure the feasibility and acceptability of these body sensor systems, we will query family caregivers using a semi-structured interview and questionnaire regarding their satisfaction and ease of enactment with the study components (use of body sensors; alarming systems). This will allow for collection of data concerning the immediate experience of the caregiver, while providing the study team with valuable information upon which to make any needed adjustments prior to our conducting a larger scale study. Wireless, body sensor systems will be used with persons with AD in their natural home settings to collect objective data on nighttime agitation (restlessness, physical and verbal agitation), sleep (sleep onset latency, frequency of nighttime awakenings, wake after sleep onset, and total sleep time), and urinary incontinence (timing, frequency). Data analysis will examine the relationships in terms of timing and duration between incontinence and agitation and the subsequent effects on sleep. Results from this study will provide us with the necessary data to develop and test interventions to decrease or eliminate these problematic disturbances in persons with AD, and to influence positively the daily lives of family caregivers. PUBLIC HEALTH RELEVANCE: Family caregivers provide the majority of care in their homes to the 5.5 to 7 million persons with Alzheimer's Disease (AD) in the United States. The distressing symptoms of nighttime agitation, sleep disturbances, and urinary incontinence are difficult for caregivers to manage, and the presence of these oftentimes leads to institutionalization of care recipients. The proposed study may identify the relationship between these symptoms that can be used to develop interventions to assist family caregivers in handling these distressing symptoms, and may lead to significant cost savings and increases in quality of life for persons with AD and their family caregivers, and, ultimately, to decreased institutionalization rates for persons with AD.

描述（由申请人提供）：70%至90%的阿尔茨海默病（AD）患者在家中接受护理。对于美国数百万AD患者的家庭护理人员来说，他们的护理接受者的夜间躁动、睡眠障碍和尿失禁给这些已经负担沉重的护理者增加了额外的负担。照顾者经常报告说，这些干扰是为他们的亲人寻求机构照顾的“临界点”。虽然这些干扰中的每一个在AD患者中都是独立识别的，但迄今为止，还没有研究研究过社区居民中这些具有挑战性的行为之间的相互关系。一旦更好地了解这些关系，就可以制定和测试有效的干预措施。我们认为，这一领域研究有限的一个主要原因与使用传统方法收集这些数据的资源密集型有关（即，直接观察）。无线身体传感器网络有望成为收集这些数据的创新，可靠和有效的手段。三个具体目标将指导这项研究：（1）检查男孩传感器在社区居住的AD患者及其家庭照顾者中使用的可行性和可接受性;（2）描述社区居住的AD患者的夜间躁动、睡眠连续性和持续时间以及夜间尿失禁的模式;和（3）检查夜间躁动，睡眠连续性和持续时间，夜间尿失禁（时间，频率）之间的关系， AD患者。我们将使用单组描述性设计，包括AD参与者及其护理人员（N = 50）。数据收集将在参与者的家庭环境中进行超过5个工作日的晚上。为了衡量这些身体传感器系统的可行性和可接受性，我们将使用半结构化访谈和问卷调查询问家庭护理人员对研究组件（使用身体传感器;报警系统）的满意度和易用性。这将允许收集有关护理人员即时经验的数据，同时为研究团队提供有价值的信息，以便在进行更大规模的研究之前进行任何必要的调整。将在AD患者的自然家庭环境中使用无线身体传感器系统，以收集有关夜间躁动（不安、身体和言语躁动）、睡眠（入睡潜伏期、夜间觉醒频率、入睡后觉醒和总睡眠时间）和尿失禁（时间、频率）的客观数据。数据分析将检查尿失禁和躁动之间的时间和持续时间的关系以及对睡眠的后续影响。这项研究的结果将为我们提供必要的数据，以开发和测试干预措施，以减少或消除AD患者的这些问题性干扰，并积极影响家庭照顾者的日常生活。 公共卫生关系：在美国，家庭照顾者在家中为550万至700万阿尔茨海默病（AD）患者提供大部分护理。夜间躁动、睡眠障碍和尿失禁的令人痛苦的症状对于护理人员来说难以管理，并且这些症状的存在常常导致护理接受者的机构化。拟议的研究可以确定这些症状之间的关系，可以用来制定干预措施，以帮助家庭照顾者处理这些令人痛苦的症状，并可能导致显着的成本节约和提高生活质量的人与AD和他们的家庭照顾者，并最终降低机构化率的人与AD。