End of Life Care in Assisted Living Facilities

辅助生活设施中的临终关怀

• 批准号: 6766252
• 负责人: Juliana C Cartwright
• 金额: $ 7.55万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-30 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6766252
• 关键词: clinical research; computer data analysis; geriatric nursing; health care personnel; hospices; human old age (65+); human subject; interview; nursing care; nursing research; residential care facility; terminal patient care

DESCRIPTION (provided by applicant): The purpose of this study is to address the absence of descriptive knowledge about end-of-life (EOL) care in the fastest growing, yet understudied, congregate residential setting for frail older adults, assisted living facilities (ALF). Nationally it is estimated that death accounts for 28% of the annual turnover in ALF residents. Increasingly, dying ALF residents are enrolled in hospice programs. Despite projections that ALFs will surpass nursing homes in occupancy within several years, and estimates that the current national population of 1 million ALF residents will double by 2020, there is limited information on EOL care and hospice involvement in ALFs. Specifically, this study will examine the perspectives of ALF staff and hospice nurses on: 1) how EOL care is provided for ALF residents and 2) facilitators and barriers to EOL care in ALFs. It addresses the National Institutes of Health initiative "Research on Care at the End-of-Life" (RFA-NR-99-004, 1/20/99) and the Institute of Medicine's call for research on EOL care that informs both how and where people die. A qualitative descriptive design will be used. Face-to-face semi-structured interviews will be conducted with a purposeful sampling of up to 36 ALF and hospice nurses in both rural and urban sites in Oregon. In addition, documents used in EOL care in ALFs will also be analyzed (e.g., flow sheets, protocols). Qualitative content analysis will include the following components: open coding of text data, constant comparative analysis of text data and documents, negative case analysis, theoretical memos, and document trails. Key characteristics of the care activities, similarities and differences in how the activities are performed, and related challenges and barriers will be identified. The end product of this study will be a detailed description of how EOL care happens for ALF residents, from the perspectives of the staffs that provide or supervise this care. The findings in combination with the PIs earlier findings from dying residents and their families will be the basis for developing and testing a model intervention aimed at improving EOL care in ALFs in a subsequent R01 study.

描述（由申请人提供）：本研究的目的是解决缺乏描述性知识的生命末期（EOL）护理在增长最快，但研究不足，聚集居住环境的体弱老年人，辅助生活设施（ALF）。在全国范围内，估计死亡占ALF居民年营业额的28%。 越来越多垂死的ALF居民参加临终关怀计划。尽管预测ALF将在几年内超过养老院的入住率，并估计到2020年，目前全国100万ALF居民的人口将翻一番，但关于ALF中的EOL护理和临终关怀的信息有限。 具体而言，本研究将探讨ALF工作人员和临终关怀护士的观点：1）如何为ALF居民提供终末期护理和2）ALF终末期护理的促进者和障碍。它解决了美国国立卫生研究院的倡议“研究护理在生命的尽头”（RFA-NR-99-004，1/20/99）和医学研究所的呼吁，研究临终关怀，告知人们如何和在哪里死亡。 将采用定性描述性设计。面对面的半结构化访谈将进行有目的的抽样多达36 ALF和临终关怀护士在农村和城市的网站在俄勒冈州。此外，还将分析ALF中EOL护理中使用的文件（例如，流程图、方案）。定性内容分析将包括以下组成部分：文本数据的开放编码，文本数据和文档的持续比较分析，负面案例分析，理论备忘录和文档跟踪。将确定护理活动的主要特点、开展活动方式的相似性和差异以及相关的挑战和障碍。这项研究的最终产品将是一个详细的描述如何发生的终末期护理ALF居民，从工作人员的角度提供或监督这种护理。这些发现与来自垂死居民及其家人的PI早期发现相结合，将成为开发和测试一种模型干预的基础，该模型干预旨在改善随后的R 01研究中ALF的EOL护理。