A Problem Solving Intervention for Post-ICU Cognitive Impairment in Older Adults
针对老年人 ICU 后认知障碍的问题解决干预措施
基本信息
- 批准号:9914194
- 负责人:
- 金额:$ 15.6万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-04-15 至 2023-03-31
- 项目状态:已结题
- 来源:
- 关键词:Academic Medical CentersAcuteAddressAdherenceAdultAffectiveAgeAlzheimer&aposs DiseaseAlzheimer&aposs disease related dementiaAnxietyBehaviorBlindedBrainCardiovascular systemCellular PhoneChronic DiseaseCognitiveControl GroupsCritical IllnessDataData CollectionDecision MakingDeliriumDementiaDevelopmentDiseaseElderlyElectrolytesEnrollmentEnvironmental Risk FactorGoalsHealthHome environmentHospitalsImpaired cognitionImpairmentInfrastructureIntensive Care UnitsInterventionLinear RegressionsLiquid substanceLungManualsManuscriptsMechanicsMediatingMedicalMental DepressionModelingNational Institute on AgingNeurobehavioral ManifestationsOnline SystemsOutcomeParticipantPatientsPersonal SatisfactionPersonsPilot ProjectsPrevalenceProblem SolvingProcessProtocols documentationQuality of lifeRandomizedRandomized Controlled TrialsRehabilitation therapyResearchResourcesRiskSample SizeScienceSelf EfficacySelf ManagementSeveritiesSocial supportStructureSurvivorsSyndromeTechnologyTelephoneTestingTrainingTraumaTraumatic Brain Injurybaseburden of illnesscognitive changecognitive functioncognitive rehabilitationcomorbiditydementia riskdesigndisabilityeffective interventioneffectiveness testingefficacy studyexperiencefollow-upfunctional declinegroup interventionhealth care service utilizationhealth related quality of lifeintervention effectoperationphysical symptompost interventionprogramspsychological symptomrecruittrial comparing
项目摘要
PROJECT SUMMARY
At 1-year post-ICU discharge, two-thirds of ICU survivors experience cognitive dysfunction at a
severity comparable to that of patients with mild Alzheimer's disease or moderate traumatic
brain injury, regardless of age or pre-morbid chronic illness burden. Despite the prevalence,
significance and persistence of cognitive impairment following critical illness, few interventions
have been tested that help ICU survivors overcome these cognitive changes. The purpose of
this pilot study is to evaluate the feasibility, acceptability and efficacy of a problem solving
intervention, Post Intensive Care Unit Problem Solving (PIC-UPS) in the home setting for
older adult ICU survivors suffering from post-ICU cognitive impairment. This study will employ a
small-scale two-group randomized controlled trial (RCT) comparing the effect of a ten session
intervention with a Control Group (CG) for older adult ICU survivors who have cognitive
impairment at hospital discharge on cognitive function, chronic illness self-management,
affective well-being (anxiety, depression), health care utilization and health related quality of life
(HR-QoL). The components of PIC-UPS include (1) in-person, in-home strategy training
designed to overcome cognitive problems by employing comprehensive structured problem-
solving strategies delivered by trained interventionists and (2) concomitant use of smartphone
technology specifically designed to remind and reinforce in-person training. The study will be
conducted in the adult medical ICUs at a large Midwestern academic medical center with older
adult participants (n=80) recruited prior to home discharge and randomized to either intervention
or control group. Baseline data collection will occur at enrollment. The first session of PIC-UPS
will be delivered after enrollment to those participants randomized to the intervention group n
the hospital setting. Weekly intervention sessions (9) will be conducted by a trained
interventionist and supplemented by telephone reminders to complete daily homework. Follow-
up data collection will be conducted in the home for all participants (intervention and control
group) by a blinded data collector three months post-enrollment. This study will provide data on
processes critical to further hypothesis development and to the successful development of a
large RCT to test the effectiveness of PIC-UPS on cognitive function, chronic illness self-
management, affective well-being (anxiety, depression), health care utilization and HR-QoL in
older adult ICU survivors who suffer cognitive impairment at hospital discharge. In addition, our
pilot will provide infrastructure for a larger trial (e.g., manual of operations, web-based data
collection form), a manuscript describing the pilot study findings, and an R01 application to NIA.
项目摘要
在ICU出院后1年,三分之二的ICU幸存者经历认知功能障碍,
严重程度与轻度阿尔茨海默病或中度创伤性痴呆患者相当
脑损伤,无论年龄或发病前的慢性疾病负担。尽管流行,
严重疾病后认知障碍的显著性和持续性,很少干预
帮助ICU幸存者克服这些认知变化。的目的
本试点研究旨在评估一个问题解决方案的可行性、可接受性和有效性。
干预,重症监护病房后问题解决(PIC-UPS)在家庭环境中,
患有ICU后认知障碍的老年ICU幸存者。本研究将采用
一项小规模两组随机对照试验(RCT),
对有认知障碍的老年ICU幸存者进行对照组(CG)干预
出院时认知功能、慢性病自我管理
情感幸福感(焦虑、抑郁)、卫生保健利用和健康相关生活质量
(HR-QoL)。PIC-UPS的组成部分包括(1)面对面的家庭战略培训
旨在通过采用全面的结构化问题来克服认知问题-
由训练有素的干预人员提供的解决策略,以及(2)同时使用智能手机
专门设计用于提醒和加强面对面培训的技术。本研究将
在中西部一家大型学术医疗中心的成人医疗ICU中进行,
成年受试者(n=80)在出院前招募,并随机接受任一干预
或对照组。基线数据收集将在入组时进行。PIC-UPS第一届会议
将在入组后分发给随机分配至干预组n的受试者
医院设置。每周干预会议(9)将由受过培训的
此外,还采取干预措施,并辅以电话提醒,以完成每日作业。跟着-
所有参与者的数据收集将在家中进行(干预和控制
组)由盲态数据收集器在入组后三个月进行。这项研究将提供数据,
对进一步发展假说和成功发展一个
一项大型随机对照试验,旨在测试PIC-UPS对认知功能、慢性疾病自我治疗、
管理,情感幸福感(焦虑,抑郁),医疗保健利用和HR-QoL
老年ICU幸存者在出院时患有认知障碍。另外我们
试点将为更大的试验提供基础设施(例如,业务手册,网上数据
收集表),描述初步研究结果的手稿,以及向NIA提交的R 01申请。
项目成果
期刊论文数量(4)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Notes on family caregiving in acute and critical care.
急性和重症护理中的家庭护理注意事项。
- DOI:10.1016/j.gerinurse.2015.06.009
- 发表时间:2015
- 期刊:
- 影响因子:0
- 作者:Happ,MaryBeth;Tate,JudithA;Davidson,JudyE
- 通讯作者:Davidson,JudyE
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