Avatar-Based Decision Support Technology for Surrogate Decision Makers

针对代理决策者的基于阿凡达的决策支持技术

• 批准号: 8433655
• 负责人: Ronald Lee Hickman
• 金额: $ 47.55万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8433655
• 关键词: Accident and Emergency department; Acute; Address; Admission activity; Advance Care Planning; Advocate; Aging; American; Anxiety; Area; Caring; Chronic Care; Complex; Conflict (Psychology); Data; Decision Aid; Decision Making; Decision Support Systems; Deterioration; Development; Distress; Elderly; Electronics; Elements; Evaluation; Face; Family member; Frequencies; Friends; Future; Goals; Health; Health Status; Health Technology; Healthcare; Hospitalization; Hospitals; Impaired cognition; Individual; Intervention; Investigation; Knowledge; Medical; Mental Depression; Nature; Nursing Homes; Outcome; Patient Preferences; Patients; Persons; Phase; Population; Preparation; Probability; Quality of life; Randomized Clinical Trials; Readiness; Regrets; Relative (related person); Research; Resources; Resuscitation; Risk; Role; Self Efficacy; Signal Transduction; Skilled Nursing Facilities; Stress; System; Taxes; Technology; Testing; Time; Training; Uncertainty; Visit; arm; base; clinical practice; design; experience; functional status; loved ones; novel; preference; programs; psychological distress; public health relevance; satisfaction; simulation; surrogate decision maker; treatment as usual; trial comparing

DESCRIPTION (provided by applicant): One of the most burdensome responsibilities faced by any family member is making health care decisions for a loved one who is decisionally impaired. Given the aging of the population and increasing options for treatment of acute illnesses, most Americans will find themselves facing this tremendous challenge of assuming the surrogate decision maker role for a relative or friend. Despite the frequency with which family members face this taxing responsibility, we have yet to identify effective ways to support them in decision making. This project builds on an established decision support framework and the team's prior experience with health technology. We aim to create an interactive, avatar-based, tailored intervention using serious gaming technology to deliver decision support to surrogate decision makers in preparation for post-discharge decisions about a patient's resuscitation and rehospitalization status. The purpose of this study is the development and evaluation of a novel decision support strategy that, if shown to be effective, can be widely disseminated and offered to surrogate decision makers facing the many significant health care decisions required in the acute and chronic care of their cognitively impaired loved one. The project is planned in two phases: Phase 1 will consist of the creation, development, and design of an interactive, avatar-based, individually tailored electronic program that will engage and prepare family members for the role of surrogate decision maker. Phase 2 will be a three-arm, randomized, clinical trial comparing the tailored, avatar-based simulation system, "electronic Surrogate Decision Maker Resources and Tailored Training" (eSMARTT) with a non-tailored passive educational program, "electronic Nursing Home Decision Aid" (eNHDA), and with usual care (UC). By engaging surrogate decision makers as co-designers and evaluators of decision support strategies, this application will generate data that will have a significant impact on clinical practice and the future direction of research in this area.

描述（由申请人提供）：任何家庭成员面临的最繁重的责任之一是为决策受损的亲人做出医疗保健决定。鉴于人口老龄化和急性疾病治疗的选择越来越多，大多数美国人将发现自己面临着为亲戚或朋友承担代理决策者角色的巨大挑战。尽管家庭成员经常面临这种纳税责任，但我们尚未找到有效的方法来支持他们做出决策。该项目建立在一个既定的决策支持框架和该小组先前在卫生技术方面的经验基础上。我们的目标是创建一个互动的，基于化身的，定制的干预使用严重的游戏技术，提供决策支持，以代理决策者准备出院后的决定，病人的复苏和再住院状态。本研究的目的是开发和评估一种新的决策支持策略，如果被证明是有效的，可以广泛传播，并提供给代理决策者面临的许多重大的医疗保健决策所需的急性和慢性护理的认知受损的亲人。该项目计划分为两个阶段：第一阶段将包括创建，开发和设计一个互动的，基于化身的，个性化定制的电子程序，该程序将使家庭成员参与并准备代理决策者的角色。第二阶段将是一项三臂、随机、临床试验，比较定制的、基于化身的模拟系统、“电子代孕决策者资源和定制培训”（eSMARTT）与非定制的被动教育计划、“电子护理之家决策辅助”（eNHDA）和常规护理（UC）。通过让代理决策者作为决策支持策略的共同设计者和评估者，该应用程序将生成对临床实践和该领域未来研究方向产生重大影响的数据。