Assessing preferences for everyday living in the nursing home: reliability and co

评估疗养院日常生活的偏好：可靠性和合作性

• 批准号: 8294518
• 负责人: Kimberly S VanHaitsma
• 金额: $ 24.45万
• 依托单位: POLISHER RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8294518
• 关键词: Address; Affective; Anxiety; Area; Behavior; Behavioral; Caring; Cognitive; Communities; Complex; Comprehensive Health Care; Dementia; Development; Device or Instrument Development; Elderly; Ensure; Equation; Equipment and supply inventories; Family; Family member; Focus Groups; Foundations; Frail Elderly; Frequencies; Future; Goals; Guidelines; Health; Hordeolum; Impaired cognition; Individual; Interview; Knowledge; Lead; Life; Literature; Logistic Regressions; Logistics; Long-Term Care; Measurement; Measures; Medical; Mental Depression; Methodology; Methods; Modeling; NIH Program Announcements; Nursing Homes; Outcome; Pain; Participant; Patient Self-Report; Personality Traits; Persons; Phase; Population; Proxy; Quality of life; Regulation; Reporting; Research; Sampling; Shapes; Source; Symptoms; Techniques; Testing; Time; United States National Institutes of Health; Work; base; behavioral/social science; care delivery; care preference; design; functional disability; information gathering; innovation; instrument; intervention program; person centered; preference; programs; psychologic; psychosocial; research study; response; social; trend

DESCRIPTION (provided by applicant): Current trends in long-term care, in concert with CMS Quality of Life guidelines, call for a shift in focus to "person-centered care". Evolving conceptualizations of optimal care in the nursing home (NH) are emphasize the need to "know the person" in order to deliver individualized, holistic care. However, incorporating the elder's perspective as a central component in shaping care delivery depends on having a comprehensive and reliable instrument that can gather this information effectively. Currently, no such assessment instrument is available. Knowledge of a resident's everyday life preferences is the foundation on which ongoing individualized care planning is based. Despite this centrality, the reliability of preferences for care has not been assessed in a NH sample. The purpose of this study is to develop a comprehensive, assessment instrument that incorporates NH residents' views of what preference items are most important to them, assess the reliability of preference responses over time, and to examine predictors of changes in resident preferences. In Phase 1 (n=80), this study will use cognitive interviewing techniques to adapt the Preference for Everyday Living Inventory (PELI), originally designed for community dwelling elders, to ensure its applicability to frail residents in NHs, including those with mild to moderate cognitive impairment. In addition, Phase 1 will test the one week reliability of the instrument and cull unreliable items. Using this newly adapted instrument, Phase 2 (n=300) will address which preferences are most and least important to residents and the reliability of preferences over a three month period for NH residents. Multivariate and logistic regression, as well as structural equations models will be used to examine relationships between reliability in preference responses and hypothesized predictor variables suggested from preliminary studies by this research team and the literature. Focus group participants (n=40) will enable us to examine sources of changes in preference responses from the resident's perspective. We will also examine exploratory hypotheses related to examine concordance between family proxy and resident preference responses. The completion of the proposed project will lead to the submission of an R01 proposal testing the PELI embedded in an intervention program designed to ameliorate behavioral and affective disturbances in persons with dementia residing in NHs. The primary specific aims are: 1) Adapt PELI to frail elders residing in NHs using cognitive interviewing (CI) techniques; examine one week test-retest reliability; and cull unreliable items; 2) Identify the most and least significant areas of everyday preferences from the perspective of NH residents, both with and without cognitive impairment; 3) Quantitatively assess the reliability of preference responses of NH residents over a 3-month period and test hypothesized relationships between predictors and resident changes in preference responses; and 4) Qualitatively examine response reliability issues from residents' perspective. Exploratory aim: Examine the concordance between resident-rated preferences and family member proxy ratings of resident preferences.

描述(由申请人提供)：长期护理的当前趋势，与CMS生活质量指南相一致，呼吁将重点转移到“以人为中心的护理”。在疗养院(NH)不断发展的最佳护理的概念化强调需要“了解人”以便提供个性化的、整体的护理。然而，将老年人的观点作为提供护理服务的核心组成部分，有赖于拥有一种能够有效收集这一信息的全面和可靠的工具。目前，还没有这样的评估工具。了解居民的日常生活偏好是正在进行的个性化护理计划的基础。尽管有这种中心性，但在NH样本中还没有对护理偏好的可靠性进行评估。这项研究的目的是开发一个综合的评估工具，纳入NH居民对他们最重要的偏好项目的看法，评估随着时间推移偏好反应的可靠性，并检验居民偏好变化的预测因素。在第一阶段(n=80)，这项研究将使用认知访谈技术来调整日常生活量表(PELI)的偏好，该量表最初是为社区居住的老年人设计的，以确保其适用于NHS中的虚弱居民，包括那些有轻度到中度认知障碍的人。此外，第一阶段将测试仪器的一周可靠性，并剔除不可靠的项目。使用这一新调整的工具，第二阶段(n=300)将解决哪些偏好对居民最重要和最不重要，以及NH居民在三个月内偏好的可靠性。多变量和Logistic回归，以及结构方程模型将被用来检验偏好反应中的可靠性与本研究小组和文献的初步研究提出的假设预测变量之间的关系。焦点小组参与者(n=40)将使我们能够从居民的角度检查偏好反应的变化来源。我们还将检验与检验家庭代理和居民偏好反应之间的一致性相关的探索性假设。拟议项目的完成将导致提交R01提案，以测试嵌入干预计划的PELI，该干预计划旨在改善居住在NHS的痴呆症患者的行为和情感障碍。主要的具体目标是：1)使用认知访谈(CI)技术使PELI适应于居住在NHS的虚弱老年人；检查一周的重测信度；并剔除不可靠的项目；2)从NH居民的角度识别日常偏好的最显著和最不显著的领域，包括有和没有认知障碍；3)定量评估NH居民在3个月期间偏好反应的可靠性，并检验预测者和居民偏好反应变化之间的假设关系；以及4)从居民的角度定性地检查反应可靠性问题。探索性目标：检验居民评价偏好与家庭成员对居民偏好的代理评价之间的一致性。

项目成果

"A Bone of Contention…": Perceived Barriers and Situational Dependencies to Food Preferences of Nursing Home Residents.

“争论的焦点……”：疗养院居民食物偏好的感知障碍和情境依赖性。

• DOI: 10.1080/21551197.2019.1617220
• 发表时间: 2019
• 期刊: Journal of nutrition in gerontology and geriatrics
• 作者: Goldstein,ChelseaN;Abbott,KatherineM;Bangerter,LaurenR;KottermanRD,LD,Amy;VanHaitsma,Kimberly
• 通讯作者: VanHaitsma,Kimberly

Delivering Person-Centered Care: Important Preferences for Recipients of Long-term Services and Supports.

• DOI: 10.1016/j.jamda.2017.10.005
• 发表时间: 2018-03
• 期刊: Journal of the American Medical Directors Association
• 影响因子: 7.6
• 作者: Abbott KM;Klumpp R;Leser KA;Straker JK;Gannod GC;Van Haitsma K
• 通讯作者: Van Haitsma K

Do Family Proxies Get It Right? Concordance in Reports of Nursing Home Residents' Everyday Preferences.

• DOI: 10.1177/0733464815581485
• 发表时间: 2017-06
• 期刊: Journal of applied gerontology : the official journal of the Southern Gerontological Society
• 作者: Heid AR;Bangerter LR;Abbott KM;Van Haitsma K
• 通讯作者: Van Haitsma K

Using spontaneous commentary of nursing home residents to develop resident-centered measurement tools: A case study.

利用疗养院居民的自发评论来开发以居民为中心的测量工具：案例研究。

• DOI: 10.1016/j.gerinurse.2017.04.003
• 发表时间: 2017
• 期刊: Geriatric nursing (New York, N.Y.)
• 作者: Bangerter,LaurenR;Abbott,Katherine;Heid,Allison;Eshraghi,Karen;VanHaitsma,Kimberly
• 通讯作者: VanHaitsma,Kimberly

The Association Between Preference Satisfaction and Satisfaction with Overall Care for Nursing Home Residents.

• DOI: 10.1080/08959420.2022.2029265
• 发表时间: 2022-09-03
• 期刊: JOURNAL OF AGING & SOCIAL POLICY
• 影响因子: 5.1
• 作者: Madrigal, Caroline;Mogle, Jacqueline;Abbott, Katherine;Mills, Whitney L.;Fick, Donna M.;Scanlon, Dennis;Behrens, Liza;Eshraghi, Karen;VanHaitsma, Kimberly
• 通讯作者: VanHaitsma, Kimberly