Elders Marshalling Responsive Care & Enhancing Quality of Life in the Final Years

长者编组响应式护理

• 批准号: 7431694
• 负责人: EVA KAHANA
• 金额: $ 46.39万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-05-25 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7431694
• 关键词: 4 year old; Accounting; Activities of Daily Living; Address; Adult; Advance Directives; Advocate; Affect; African American; Age; Aged, 80 and over; Aging; Appointment; Area; Attitude; Awareness; Buffers; Caregivers; Caring; Categories; Cessation of life; Chronic; Classification; Clinical; Commit; Communities; Complement; Complex; Condition; Cultural Backgrounds; Data; Data Analyses; Decision Making; Demography; Development; Discipline; Discipline of Nursing; Distress; Education; Educational Intervention; Educational Materials; Elderly; Enrollment; Ensure; Ethnic Origin; Event; Family; Fatigue; Female; Frail Elderly; Friends; Funding; Future; Gender; Goals; Growth; Guidelines; Health; Health Personnel; Health Planning; Health Status; Health care facility; Healthcare; Hispanic Americans; Hospice Care; Impairment; Individual; Intervention; Interview; Interviewer; Knowledge; Lead; Life; Life Change Events; Life Experience; Literature; Longitudinal Studies; Maintenance; Marital Status; Marshal; Measures; Medical; Medicine; Minority; Modeling; Nature; Numbers; Nurses; Nursing Research; Nursing Schools; Nutritional; Outcome; Pamphlets; Paper; Participant; Patient Education; Patient-Centered Care; Patients; Perception; Personal Satisfaction; Persons; Physicians; Play; Policies; Population; Principal Investigator; Process; Prospective Studies; Provider; Psychologist; Psychosocial Assessment and Care; Public Health; Publications; Publishing; Quality of Care; Quality of life; Race; Rate; Recruitment Activity; Relative (related person); Reporting; Research; Research Infrastructure; Research Personnel; Resources; Respondent; Risk; Role; Sampling; Sampling Studies; School Nursing; Scientist; Services; Social Network; Social support; Sociology; Source; Spirituality; Staging; Stress; Support System; Survival Analysis; Symptoms; Techniques; Technology; Telephone; Terminally Ill; Testing; Time; Time Study; Training; United States; Week; Well in self; Work; base; caregiving; day; disability; disability burden; end of life; end of life care; experience; follow-up; frailty; functional decline; functional status; health care quality; hospice environment; improved; interest; knowledge base; male; member; men; mortality; multidisciplinary; nursing intervention; older patient; outcome forecast; patient oriented; preference; programs; prospective; psychologic; response; skills; social; sociologist; sound; stressor; theories; therapy design; time use

DESCRIPTION (provided by applicant): As more people live to old age, identifying resources that enable maintenance of good quality of life during the final years of life assumes increasing importance for those committed to enhancing public health. Major gaps exist in our current knowledge of factors that contribute to health care that promotes physical comfort, psychological well-being and meaningfulness during the final years and months of life. We propose and aim to test a conceptual model focused on proactive adaptations by patients and responsiveness of their formal and informal care providers, as playing key roles in enhancing quality of life close to the end of life. We propose a four year longitudinal study of a representative sample of diverse older adults dwelling in three urban settings, to examine quality of life trajectories and their determinants. Annual face-to-face interviews and four and eight month telephone follow-up interviews will be conducted with 900 older adults (age 75+) who are participants in our ongoing NIA funded study of successful aging. Our prospective study will be complemented by interviews with next of kin of respondents who die during the course of this study in order to obtain a retrospective account of the older person's end of life care. At the conclusion of the study, we will be able to describe health, functional status, social support, and quality of life trajectories of respondents who die during the study and those who survive. The proposed study will provide information on the nature of changes in stressors posed by ill health and critical incidents, changes in ameliorative resource use, and in quality of life outcomes for racially diverse older adults. Our conceptual framework and measures we selected will allow us to offer a more holistic view of the intersection of health care and maintenance of the integrity of the person that follow from traditions of nursing research. Findings of the study should yield systematic guidelines for nursing interventions based on patient education and specialized training for nurses and other health care providers that can help promote patient-centered health care.

描述（由申请人提供）：随着越来越多的人活到老年，对于那些致力于加强公共卫生的人来说，确定能够在生命的最后几年维持良好生活质量的资源变得越来越重要。我们目前对促进在生命的最后几年和几个月里促进身体舒适、心理健康和有意义的卫生保健的因素的认识存在重大差距。我们提出并旨在测试一个概念模型，该模型侧重于患者的主动适应和他们的正式和非正式护理提供者的反应，因为它们在提高生命末期的生活质量方面发挥着关键作用。我们建议对居住在三个城市环境中的不同老年人的代表性样本进行为期四年的纵向研究，以检查生活轨迹的质量及其决定因素。我们将对900名老年人（75岁以上）进行年度面对面访谈和4个月和8个月的电话随访访谈，这些老年人是我们正在进行的NIA资助的成功衰老研究的参与者。我们的前瞻性研究将通过采访在研究过程中死亡的受访者的近亲来补充，以获得老年人临终关怀的回顾性记录。在研究结束时，我们将能够描述在研究期间死亡和幸存的受访者的健康，功能状态，社会支持和生活质量轨迹。拟议的研究将提供关于由健康不良和危急事件引起的压力源变化的性质、改善资源使用的变化以及不同种族老年人生活质量结果的信息。我们选择的概念框架和措施将使我们能够从护理研究的传统中，对医疗保健和维护人的完整性的交叉点提供更全面的看法。这项研究的结果应该产生系统化的护理干预指南，该指南建立在对患者的教育和对护士和其他卫生保健提供者的专门培训的基础上，可以帮助促进以患者为中心的卫生保健。