Development and Validation of the Caregiver Hospital Assessment Tool (CHAT)

护理人员医院评估工具 (CHAT) 的开发和验证

• 批准号: 9890544
• 负责人: Beth Fields
• 金额: $ 9.16万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-01 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9890544
• 关键词: Address; Administrator; Admission activity; Aging; Agreement; Applications Grants; Assessment tool; Caregiver Burden; Caregivers; Caring; Clinical; Complex; Data; Development; Discipline of Nursing; Dose; Elderly; Evaluation; Event; Face; Family Caregiver; Feedback; Focus Groups; Future; Glean; Health; Health Personnel; Health Status; Healthcare Systems; Home environment; Hospitalization; Hospitals; Individual; Inpatients; Instruction; Interview; Knowledge; Learning; Life; Link; Medical; Medical Technology; Methodology; Methods; Modeling; Outcome; Patients; Personal Satisfaction; Process; Provider; Psychometrics; Reporting; Research; Research Personnel; Resources; Role; Scientist; Self Care; Series; Specific qualifier value; Structure; Suggestion; Surveys; Therapeutic; Training; Validation; Work; aging population; base; care delivery; caregiving; clinical decision-making; cohort; cost; design; experience; functional independence; functional status; hospital readmission; improved; indexing; loved ones; member; programs; response; routine practice; shared decision making; skills; systematic review; tool

ABSTRACT When older adults are hospitalized due to a major health event, the older adults and our healthcare system rely on an estimated 40 million family caregivers to assist their loved ones with self-care activities and complex medical and nursing tasks after hospitalizations. Despite acknowledgement that family caregivers are critical to patients and our healthcare system, caregivers report dissatisfaction with their identification and needs being met during the hospitalization process. In turn, caregivers feel ill-equipped to assist in tasks when their loved one returns home. Assessment of caregivers’ needs, strengths, and resources during hospital care may be particularly important to inform and target training that will equip them to fulfill the needs of their loved ones at home. We propose to develop the Caregiver Hospital Assessment Tool (CHAT) which will identify family caregivers’ needs and guide providers’ clinical decision making for training during hospital care. As a result of this work, family caregivers can expect to receive recognition and meaningful training during the hospitalization of their loved one with the help of CHAT. CHAT will be developed based on the recommended caregiver assessment framework from the National Center on Caregiving at Family Caregiver Alliance and perspectives from collaborative partners that include family caregivers, leading aging and caregiving scientists, and healthcare providers and systems. Specifically, for Aim 1 we will develop CHAT and assess content validity from a panel of experts using quantitative methodology; for Aim 2 we will evaluate face validity of CHAT items from family caregivers using qualitative methodology; and for Aim 3 we will identify clinical utility and acceptability considerations from key stakeholders to inform further refinement of CHAT. To address these aims, we will use a convergent mixed methods approach. In Aim 1, we will survey family caregivers and leading aging and caregiving scientists to gauge feedback on content, wording, and response format. In Aim 2, we will administer CHAT and complete interviews with family caregivers to learn their perspectives on clarity and appropriateness of CHAT. In Aim 3, we will conduct focus groups with frontline providers and healthcare system administrators to inform the refinement of CHAT, including mechanisms for administering and interpreting CHAT, as well as barriers and facilitators to implementing CHAT into routine practice. Findings from all three aims will be synthesized to help strengthen the overall analysis and generate information to refine CHAT. The development and refinement of CHAT is critical to the next planned grant proposal which will examine dose of CHAT specified training and the effect of CHAT on family caregivers and older adults. We expect the refined and psychometrically grounded CHAT will lead to improved knowledge, skills, and abilities of family caregivers. Family caregivers that are well-prepared have the potential to increase their own well-being but also help improve health outcomes and preventable readmissions for their loved ones.

摘要 当老年人因重大健康事件住院时，老年人和我们的医疗保健系统依赖于 估计有4000万家庭照顾者帮助他们的亲人进行自我照顾活动， 住院后的医疗和护理任务。尽管承认家庭照顾者对儿童的健康至关重要， 患者和我们的医疗保健系统，护理人员报告对他们的识别和需求不满意， 在住院治疗过程中，反过来，照顾者感到装备不良，以协助任务时，他们的亲人 回家在医院护理期间，评估护理人员的需求、优势和资源可能是 特别重要的是，要提供信息和有针对性的培训，使他们能够满足他们所爱的人的需要， 回家我们建议发展照顾者医院评估工具， 护理人员的需求，并指导提供者的临床决策，在医院护理培训。的结果 这项工作，家庭照顾者可以期望在住院期间得到认可和有意义的培训， 他们所爱的人在聊天的帮助下。将根据推荐的护理人员制定CHAT 来自家庭护理者联盟国家护理中心的评估框架和观点 来自合作伙伴，包括家庭护理人员，领先的老龄化和老龄化科学家，以及医疗保健 提供商和系统。具体来说，对于目标1，我们将开发聊天，并从一个小组评估内容的有效性， 专家使用定量方法;对于目标2，我们将评估来自家庭的CHAT项目的表面效度 护理人员使用定性方法;对于目标3，我们将确定临床实用性和可接受性 主要利益攸关方的考虑，为进一步完善CHAT提供信息。为了实现这些目标，我们将使用 一种收敛的混合方法。在目标1中，我们将调查家庭照顾者和老年人， 让科学家评估对内容、措辞和回应格式的反馈。在目标2中，我们将管理 与家庭照顾者聊天并完成访谈，了解他们对清晰度和适当性的看法 的聊天。在目的3方面，我们会与前线医疗服务提供者和医疗系统管理人员进行专题小组讨论， 为CHAT的完善提供信息，包括管理和解释CHAT的机制，以及 将CHAT纳入日常实践的障碍和促进因素。所有三个目标的结果将是 综合分析有助于加强总体分析，并生成信息以完善CHAT。发展 CHAT的改进对于下一个计划的赠款提案至关重要，该提案将检查指定的CHAT剂量 培训和CHAT对家庭照顾者和老年人的影响。我们期待的是精致的， 接地聊天将导致家庭照顾者的知识，技能和能力的提高。家庭照顾者， 准备充分的人有可能增加自己的福祉，但也有助于改善健康结果， 可预防的再入院