Pilot Study: Self Management Groups for Veterans with Dual Sensory Loss

试点研究：双重感觉丧失退伍军人的自我管理小组

• 批准号: 8181321
• 负责人: Mitchel Brant Turbin
• 金额: --
• 依托单位: PORTLAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8181321
• 关键词: Adult; Age; Aging; American; Audiology; Auditory; Behavior; Behavioral; Berry; Blindness; Caring; Chronic; Clinic; Clinical; Clinical Trials; Cognitive; Communication; Computerized Medical Record; Consensus; Consultations; Control Groups; Data; Development; Diagnosis; Disabled Persons; Education; Educational Curriculum; Enrollment; Ensure; Environment; Equipment and supply inventories; Ethnic Origin; Evaluation; Family; Focus Groups; Frustration; Gender; Goals; Group Meetings; Guidelines; Health; Hearing; Hearing Impaired Persons; Hour; Independent Living; Instruction; Intervention; Learning; Literature; Manuals; Measures; Mental Depression; Methodology; Methods; Military Personnel; Modeling; Moods; New York; Optometrist; Oregon; Outcome; Outcome Measure; Outpatients; Participant; Personal Satisfaction; Pilot Projects; Population; Procedures; Provider; Psyche structure; Quality of life; Questionnaires; Randomized; Randomized Clinical Trials; Recruitment Activity; Rehabilitation therapy; Reporting; Research; Research Activity; Research Methodology; Research Training; Risk; Sample Size; Self Efficacy; Self Management; Self-Help Devices; Sensory; Services; Site; Stress; Structure; Technology; Testing; Time; Transportation; Update; Veterans; Vision; Visual impairment; Visually Impaired Persons; Waiting Lists; Work; World Health Organization; Writing; Youth; abstracting; age related; base; blind; clinical efficacy; clinically significant; community reintegration; cost effective; design; disability; efficacy trial; evidence base; experience; follow-up; group intervention; handicapping condition; hearing impairment; improved; instrument; macula; member; novel; peer; psychosocial; skills; social; standard care; symposium; trend

DESCRIPTION (provided by applicant): Project Summary/Abstract The risk that a Veteran will experience concurrent visual and hearing impairments increases with age. Research indicates that as many as 20% of Americans over the age of 70 now experience this dual sensory loss (DSL), up to about 1.9 million people. DSL poses serious problems for people with this diagnosis. Visually impaired people experience difficulties interacting with their environment, but often use their hearing as a way of compensating. Hearing impaired people experience barriers to communication and often use their vision to overcome these obstacles. Those with DSL, therefore, struggle with both managing their environment and communicating with others while lacking some of the compensatory options available to those with a single sensory disability. It is not surprising that adults with DSL often report frustration, few social activities and depression. While providers such as optometrists and audiologists can provide many valuable services to help restore some of the capabilities impeded by sensory loss, studies show functional and psychosocial difficulties often linger, especially with DSL's combined impacts on vision and hearing. We propose a two year pilot study, conducted by the VA National Center for Rehabilitative Auditory Research (NCRAR) in Portland, Oregon, with expert consultation from the VA Center of Excellence for Aging Veterans with Vision Loss (CAVVL) in Atlanta, Georgia and the Helen Keller National Center for Deaf-Blind Youth and Adults (HKNC) in New York. The purpose of this pilot study is to design and conduct a preliminary evaluation of self management groups intended to provide structured education and opportunities for mutual sharing by outpatient military Veterans with DSL. We will carefully investigate the feasibility of our research methodology, intending that, if successful, our methods be used for a full clinical trial to examine the efficacy of DSL self management groups as value added services, useful beyond what Veterans with DSL derive from standard care offered by VA blind/low vision and audiology services. Our national research team will collaborate to produce a working draft of the project manual, containing the self management group curriculum and guidelines for critical logistical procedures for ensuring effective transportation and communication for participants with vision and hearing limitations. Twenty four Veterans with DSL over age 55, of both genders and from varied ethnic origins will be enrolled at the research site in Portland, Oregon. These Veterans will be screened to establish whether their vision, hearing or adaptive technology have deteriorated since last entries in the VA electronic medical record, and if indicated, updated services will be provided by local VA clinics. When clinical rehabilitation is up to date Veterans will be randomly assigned to participate either immediately, or after a wait list period, in self management groups (DSL groups) that meet for six weekly sessions of two hours duration. All Veterans will take baseline questionnaires before beginning DSL group participation to assess their functional and psychosocial adaptation to DSL, and post- tests after DSL group participation. The DSL groups will employ a variety of accomodations to ensure that all Veterans participate fully, with curriculum drawn from the current evidence base on the successful use of self management groups for adults with disabilities and other chronic health issues. The research team will refine the DSL group curriculum and the project procedures throughout the two year period of the project. If our results show the groups have promise and our methodology is effective, we will have a completed Curriculum and Technical Manual and established outcome measures and procedures for conducting a rigorous follow up randomized clinical trial to establish whether this approach will be useful to VA providers nationwide for assisting Veterans with DSL in improving their quality of life.

描述（由申请人提供）： 项目摘要/摘要退伍军人将经历并发视力和听力障碍的风险随着年龄的增长而增加。研究表明，多达20%的70岁以上的美国人现在经历这种双重感觉丧失（DSL），高达约190万人。DSL对患有这种诊断的人造成了严重的问题。视力受损的人在与环境互动时会遇到困难，但他们通常会使用听力作为补偿。听力受损的人遇到沟通障碍，并经常使用他们的视觉来克服这些障碍。因此，DSL患者在管理环境和与他人沟通方面都很挣扎，同时缺乏单一感官障碍患者的一些补偿选择。患有DSL的成年人经常报告挫折感，很少社交活动和抑郁症，这并不奇怪。虽然验光师和听力学家等提供者可以提供许多有价值的服务，以帮助恢复因感官丧失而受到阻碍的一些能力，但研究表明，功能和心理社会困难往往挥之不去，特别是DSL对视觉和听觉的综合影响。 我们建议进行一项为期两年的试点研究，由俄勒冈州波特兰的VA国家反射性听觉研究中心（NCRAR）进行，并与格鲁吉亚亚特兰大的VA老年视力丧失退伍军人卓越中心（CAVVL）和纽约的海伦凯勒国家聋哑青年和成人中心（HKNC）进行专家咨询。本试点研究的目的是设计和进行自我管理组的初步评估，旨在提供结构化的教育和机会，由门诊退伍军人与DSL相互分享。我们将仔细研究我们的研究方法的可行性，如果成功的话，我们的方法将用于一项全面的临床试验，以检查DSL自我管理组作为增值服务的有效性，这超出了DSL退伍军人从VA盲/低视力和听力学服务提供的标准护理中获得的有用性。 我们的国家研究小组将合作编写项目手册的工作草案，其中载有自我管理小组的课程和关键后勤程序的指导方针，以确保视力和听力有障碍的参与者的有效交通和通信。将在俄勒冈州波特兰的研究中心招募24名年龄超过55岁的DSL退伍军人，包括性别和不同种族。这些退伍军人将接受筛查，以确定他们的视力，听力或自适应技术是否自VA电子病历中的最后一次输入以来已经恶化，如果有指示，当地VA诊所将提供更新的服务。当临床康复是最新的退伍军人将被随机分配参加立即，或在等待名单期后，在自我管理组（DSL组），满足每周六次会议的两个小时的持续时间。所有退伍军人将在开始DSL组参与之前进行基线问卷调查，以评估他们对DSL的功能和心理社会适应，并在DSL组参与后进行后测试。DSL小组将采用各种各样的住宿，以确保所有退伍军人充分参与，课程从目前的证据基础上成功使用自我管理小组的成年残疾人和其他慢性健康问题。研究小组将在整个项目的两年期间完善DSL组课程和项目程序。 如果我们的结果表明这些团体有希望，我们的方法是有效的，我们将有一个完整的课程和技术手册，并建立了结果的措施和程序，进行严格的后续随机临床试验，以确定这种方法是否将有助于全国范围内的VA提供者帮助退伍军人DSL改善他们的生活质量。