Resident-to-Resident Elder Mistreatment Intervention for Dementia Care in Assisted Living

辅助生活中痴呆症护理中居民对居民虐待老人的干预措施

• 批准号: 10221564
• 负责人: MARK STEVEN LACHS
• 金额: $ 68.69万
• 依托单位: HEBREW HOME FOR THE AGED AT RIVERDALE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10221564
• 关键词: Accidents; Activities of Daily Living; Address; Affective; Aggressive behavior; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; Area; Assisted Living Facilities; Awareness; Behavior; Behavior Disorders; Behavioral; Caring; Characteristics; Cluster randomized trial; Data; Data Reporting; Dementia; Discipline of Nursing; Disease; Distress; Doctor of Philosophy; Educational Intervention; Elder Abuse; Elderly; Experimental Designs; Focus Groups; Frequencies; Geriatrics; Gerontology; Goals; Impaired cognition; Individual; Injury; Intervention; Interview; Knowledge; Living Arrangement; Long-Term Care; Measurement; Measures; Mediating; Methodology; Minority; Movement; Nursing Homes; Outcome; Personal Satisfaction; Persons; Positioning Attribute; Prevalence Study; Problem behavior; Process; Professional Role; Public Health; Publishing; Quality of Care; Quality of life; Randomized; Reporting; Research; Risk; Role; Safety; Services; Source; Support System; Testing; Time; Training; Treatment Effectiveness; Vulnerable Populations; care systems; case finding; community setting; comorbidity; compare effectiveness; comparison group; dementia care; falls; group intervention; improved; informant; innovation; intervention program; multidisciplinary; pragmatic trial; prevent; prospective; psychologic; psychological distress; rapid growth; residence; response; social; staff intervention; statistics; treatment as usual; trend

This application proposes a cluster randomized trial to evaluate an innovative staff intervention targeting resident-to-resident elder mistreatment (R-REM) in 6 intervention and 6 control assisted living residences (ALRs). Data will be collected at baseline, 6- and 12-months. We define R-REM as negative and aggressive physical, sexual, or verbal interactions between residents, that in a community setting would likely be construed as unwelcome and have high potential to cause physical and/or psychological distress. R-REM is a serious behavioral problem that has a negative impact on the quality-of-life and physical well-being of residents with and without Alzheimer’s disease and related dementias living in congregate settings. The applicant team is uniquely positioned to conduct this project because of its expertise, multidisciplinary composition, and its previous successful collaborative efforts. Aim 1 (A1). Enhance staff knowledge of R-REM Aim 2 (A2). Enhance staff recognition, reporting and care planning related to R-REM Aim 3 (A3). Evaluate the impact of the staff intervention on resident falls, accidents and injuries and on quality of life using a prospective experimental design that derives information from five sources: (1) Resident interviews (2) Staff informants (3) Observational data (4) Chart and (5) Incident/accident report data. Primary Hypothesis: The frequency of falls, accidents and injuries will decrease in the intervention group, relative to the comparison group after implementation of the training intervention. Secondary Hypotheses: 1. Resident quality-of-life as measured by affective state will improve in the intervention group, relative to the comparison group after implementation of the training intervention. 2. Resident behavior problems will decline in the intervention group, relative to the comparison group after implementation of the training intervention. Resident behaviors will mediate the relationship between the intervention and the falls/accidents/injuries outcome. R-REM has been identified as an important problem in long-term care settings, and our earlier studies identified significant behavioral problems in these settings. However, to our knowledge no interventions targeted at staff have been proposed or tested. The proposed trial is thus timely and innovative. The results are likely applicable to the over 1.2 million residents of AL facilities. With the expected rapid growth in ALRs, and the growing trend to include residents with significant care needs and dementia-related behaviors, the project will serve an important role in improving the quality of care provided by staff.

本申请提出了一个集群随机试验，以评估一个创新的工作人员干预， 在6个干预和6个对照辅助生活住宅中的居民对居民的老年虐待（R-REM） （ALRs）。将在基线、6个月和12个月时收集数据。我们将R-REM定义为消极和积极的 在社区环境中，居民之间的身体，性或语言互动可能是 被认为是不受欢迎的，并且具有引起身体和/或心理痛苦的高可能性。R-REM是一种 严重的行为问题，对居民的生活质量和身体健康产生负面影响 患有或不患有阿尔茨海默氏症和相关痴呆症的人生活在一起。申请人团队 由于其专业知识、多学科组成以及 以往的成功合作。 目标1（A1）。提高工作人员对R-REM的认识 目标2（A2）。加强工作人员对R-REM的认识、报告和护理规划 目标3（A3）。评估员工干预对住院医师福尔斯、事故和伤害以及质量的影响 使用前瞻性实验设计，从五个来源获得信息：（1）居民 访谈（2）工作人员线人（3）观察数据（4）图表和（5）事件/事故报告数据。 主要假设：干预后，福尔斯、事故和伤害的发生率将降低 组，相对于实施培训干预后的对照组。 次要假设：1。居民的生活质量，衡量情感状态将改善， 干预组，相对于对照组实施培训干预后。 2.相对于对照组，干预组的居民行为问题将下降 在实施培训干预后。居民的行为会起到中介作用 干预和福尔斯/事故/伤害结果之间的关系。 R-REM已被确定为长期护理环境中的一个重要问题，我们早期的研究 在这些环境中发现了严重的行为问题。然而，据我们所知， 针对工作人员提出或测试了。因此，拟议的审判是及时和创新的。结果 可能适用于AL设施的120多万居民。随着预期的应收账款快速增长， 以及越来越多的趋势，包括居民有重大的护理需求和痴呆症相关的行为， 该项目将在提高工作人员提供的护理质量方面发挥重要作用。