Supporting Family Caregivers with Technology for Dementia Home Care (FamTechCare)

通过痴呆症家庭护理技术支持家庭护理人员 (FamTechCare)

• 批准号: 8606108
• 负责人: KRISTINE N. WILLIAMS
• 金额: $ 50.46万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-03-04 至 2018-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8606108
• 关键词: Address; Adoption; Affect; Age; Aging; Alzheimer' s Disease; Americas; Attention; Behavior; Behavioral; Caregiver Burden; Caregivers; Caring; Characteristics; Clinical Trials; Clinics and Hospitals; Code; Communication; Computer software; Control Groups; Data; Dementia; Diagnosis; Drug usage; Equipment and supply inventories; Family; Family Caregiver; Feedback; Funding; Goals; Health Insurance Portability and Accountability Act; Health Personnel; Healthcare Systems; Home environment; Impaired cognition; Institute of Medicine (U.S.); Institutional Review Boards; Internet; Intervention; Iowa; Kansas; Knowledge; Lead; Link; Managed Care; Memory; Mental Depression; Methods; Mission; Modeling; Monitor; Morbidity - disease rate; Nurses; Nursing Homes; Outcome; Pattern; Persons; Population; Problem behavior; Procedures; Protocols documentation; Psychotropic Drugs; Public Health; Randomized; Records; Reporting; Research; Role; Secure; Self Care; Services; Site; Sleep; Stress; Surveys; Technology; Telephone; Testing; Time; Translations; Typology; United States National Institutes of Health; Universities; Video Recording; Videotape; base; behavior observation; caregiving; cost; cost effectiveness; effective intervention; empowered; group intervention; improved; indexing; meetings; mortality; multidisciplinary; new technology; patient home care; public health relevance; response; satisfaction; telehealth; therapy development

DESCRIPTION (provided by applicant): This clinical trial will test the FamTechCare intervention that uses multidisciplinary professional guidance based on in-home video monitoring to support family caregivers in managing behaviors of persons with dementia (PWD). Families provide the majority of care for PWD at home. However the stress of caregiving is so significant that it increases caregiver morbidity and mortality. Stress is magnified by disruptive behaviors that frequently lead to nursing home placement. In-home video monitoring allows experts to assess behaviors of PWD and to identify antecedents, recommend specific interventions, and subsequently evaluate caregiver outcomes. FamTechCare uses new technology to link family caregivers to experts for guidance in managing disruptive behaviors, supporting continued care at home while reducing the negative effects of caregiving. Caregiver-PWD dyads (N=88) from the University of Iowa Hospital and Clinics and the University of Kansas Alzheimer's Disease Center will be randomly assigned to intervention or control groups. Both groups will record behaviors during daily care for 3 months using a home monitoring unit. Notably, this new technology captures 15 minutes prior to the behavior, thus recording behavior triggers and precursors. Intervention group videos will be auto-uploaded to a HIPAA-secure Internet site for weekly team review with in-home feedback to caregivers in behavior management. The time and attention equivalent control group will receive a weekly phone call from a nurse, but their recorded videos will be held for review and feedback after 3 months. This study builds on the PI's CTSA study that verified feasibility for using in-home monitoring and professional observation of behaviors to guide caregivers in managing care at home. Our team found the video-data essential to identify antecedents, recommend specific interventions, and subsequently evaluate responses. Caregivers were highly satisfied with reductions in disruptive behaviors and their own stress and burden. This study expands the IRB-approved protocols, procedures, HIPAA-secure software interface, and protocols for internet-based team meetings and caregiver feedback. Study aims are to identify interventions, based on in-home observations, to assist caregivers in behavior management. Between-group effects on outcomes, including PWD disruptive behaviors and caregiver burden and other negative outcomes will be compared using linear mixed modeling. We will evaluate ease of use and satisfaction, cost-efficiency, and factors influencing likelihood of translation into practice. Thi is the first study to test new technology for direct observation and immediate feedback to empower families to manage PWD behaviors at home while reducing caregiver stress and morbidity. Technology links caregivers to individualized expert guidance, acknowledging the importance and burden of their role. This study addresses NIH missions and the 2012 National Plan to Address Alzheimer's disease goals, integrating strategies to promote adoption and use of aging services technologies in interventions that will reduce negative caregiver outcomes, a growing public health problem.

描述（由申请人提供）：本临床试验将测试FamTechCare干预，该干预使用基于家庭视频监控的多学科专业指导，以支持家庭护理人员管理痴呆症患者（PWD）的行为。家庭在家中为残疾人提供大部分护理。然而，照顾的压力是如此之大，它增加了照顾者的发病率和死亡率。压力被经常导致养老院安置的破坏性行为放大。家庭视频监控使专家能够评估PWD的行为，并确定前因，建议具体的干预措施，并随后评估护理人员的结果。FamTechCare使用新技术将家庭护理人员与专家联系起来，以指导管理破坏性行为，支持在家中继续护理，同时减少破坏性行为的负面影响。 来自爱荷华州大学医院和诊所以及堪萨斯大学阿尔茨海默病中心的护理人员-PWD二人组（N=88）将被随机分配到干预组或对照组。两组都将使用家庭监护仪记录3个月的日常护理期间的行为。值得注意的是，这项新技术可以在行为发生前15分钟进行捕捉，从而记录行为触发因素和前兆。干预组的视频将自动上传到一个HIPAA安全的互联网网站，每周进行团队审查，并向行为管理方面的护理人员提供家庭反馈。时间和注意力相当的对照组将每周接到护士的电话，但他们录制的视频将在3个月后进行审查和反馈。本研究建立在PI的CTSA研究的基础上，该研究验证了使用家庭监测和专业行为观察指导护理人员管理家庭护理的可行性。我们的团队发现，视频数据对于识别前因、推荐具体干预措施以及随后评估反应至关重要。照顾者对破坏性行为的减少以及他们自己的压力和负担非常满意。 本研究扩展了IRB批准的方案、程序、HIPAA安全软件界面以及基于互联网的团队会议和护理人员反馈的方案。研究的目的是确定干预措施，在家庭观察的基础上，以帮助照顾者的行为管理。将使用线性混合模型比较组间对结局的影响，包括PWD破坏性行为和照顾者负担以及其他负面结局。我们将评估易用性和满意度、成本效益以及影响转化为实践的可能性的因素。这是第一项测试直接观察和即时反馈的新技术的研究，使家庭能够在家中管理PWD行为，同时减少护理人员的压力和发病率。技术将照顾者与个性化的专家指导联系起来，承认他们的作用的重要性和负担。这项研究涉及NIH的任务和2012年国家计划，以解决阿尔茨海默病的目标，整合战略，以促进采用和使用老龄化服务技术的干预措施，将减少负面的照顾者的结果，一个日益严重的公共卫生问题。