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Engaging Hospitalized Patients and Family Caregivers to Identify and Prevent Delirium Superimposed on Dementia: An Intervention Mapping Approach.

让住院患者和家庭护理人员参与识别和预防痴呆症叠加的谵妄：一种干预映射方法。

基本信息

批准号：
10642332
负责人：
Blair Pollitt Golden
金额：
$ 17.25万
依托单位：
UNIVERSITY OF WISCONSIN-MADISON
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-06-15 至 2028-02-29
项目状态：
未结题

项目摘要

PROJECT SUMMARY/ABSTRACT This career development proposal will provide Blair Golden, MD MS, a physician-scientist at The University of Wisconsin-Madison School of Medicine and Public Health, with the training required for success as an independent investigator researching interventions to improve the delivery of patient- and family-centered care for hospitalized adults with Alzheimer's Disease and Alzheimer's Disease Related Dementias (AD/ADRD). Nearly half of all hospitalized patients with AD/ADRD develop delirium superimposed on dementia (DSD), which is associated with significant morbidity and mortality. DSD also leads to adverse impacts for family caregivers, compounding pre-existing caregiver stresses and negative impacts on wellbeing. Despite its substantial burden, DSD remains under-detected and poorly managed in hospitalized patients due in part to under-developed approaches for assessing pre-existing impairment and other individual characteristics that are critical to delivering tailored prevention strategies. Evidence-based programs for delirium have emphasized the role of family engagement in recognition and management, but approaches to proactively engaging family members and patients with AD/ADRD in DSD detection and prevention remain underdeveloped. The overarching goal of this K23 proposal is to establish patient and family caregiver-centered communication and engagement practices capable of proactively addressing information needs and soliciting participation in DSD identification and prevention that are feasible and scalable. Understanding family and patient communication and information needs regarding DSD could not only improve the delivery of patient and family-centered care, but also potentially reduce family and patient suffering and improve DSD identification and prevention. As a junior faculty member at an institution with extensive infrastructure to support early-stage investigators, Dr. Golden is in an optimal environment to complete the proposed research project and pursue advanced training. Her career development plan includes formal coursework, intensive mentorship, and experiential training in 1) mixed methods, survey, and intervention mapping approaches 2) delirium assessment and prevention 3) research engagement and clinical care of patients with AD/ADRD and 4) pragmatic clinical trial design. To ensure success, she has identified expert mentors in these disciplines with outstanding track records in training independent investigators and secured protected time for this work. This award addresses a significant clinical dilemma and serious gap in AD/ADRD and delirium research while affording the education and mentored research experience critical to prepare Dr. Golden to lead an independent research program.

项目总结/摘要这个职业发展建议将提供布莱尔黄金，医学博士和硕士，在大学的物理学家，科学家，威斯康星-麦迪逊医学与公共卫生学院，与成功所需的培训，作为一个独立调查员研究干预措施，以改善以患者和家庭为中心的护理服务阿尔茨海默病和阿尔茨海默病相关痴呆（AD/ADRD）的住院成人。近一半的AD/ADRD住院患者发生谵妄叠加痴呆（DSD），其与显著的发病率和死亡率相关。渠务署亦会对家庭带来负面影响照顾者，加剧了先前存在的照顾者压力和对福祉的负面影响。尽管尽管存在巨大负担，但DSD在住院患者中仍然未被发现且管理不善，部分原因是评估预先存在的减值和其他个别特征的方法发展不足，对提供有针对性的预防战略至关重要。针对谵妄的循证医学项目强调，家庭参与在承认和管理中的作用，但积极主动地让家庭参与的方法在DSD的检测和预防方面，成员和AD/ADRD患者仍然不发达。的 K23提案的总体目标是建立以患者和家属为中心的沟通，能够主动满足信息需求并征求参与DSD的参与实践这是可行和可扩展的。了解家庭和患者沟通关于DSD的信息需求不仅可以改善以患者和家庭为中心的护理的提供，而且还潜在地减少家庭和患者的痛苦并改善DSD的识别和预防。作为作为一个拥有广泛基础设施以支持早期研究人员的机构的初级教员，高登是在一个最佳的环境，以完成拟议的研究项目，并追求先进的培训。她的职业发展计划包括正式的课程，密集的指导，和经验培训1）混合方法、调查和干预绘图方法2）谵妄评估和预防3） AD/ADRD患者的研究参与和临床护理以及4）务实的临床试验设计。到为了确保成功，她已经确定了这些学科的专家导师，他们在培训方面有着出色的记录。独立的调查人员，并确保这项工作的时间受到保护。该奖项旨在解决一个重大的临床 AD/ADRD和谵妄研究的困境和严重差距，同时提供教育和指导研究经验的关键准备金博士领导一个独立的研究计划。