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

长者编组响应式护理

• 批准号: 7590476
• 负责人: EVA KAHANA
• 金额: $ 45.62万
• 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/7590476
• 关键词: Accounting; Activities of Daily Living; Address; Adult; Affect; African American; Age; Aged, 80 and over; Aging; Buffers; Caring; Cessation of life; Chronic; Classification; Commit; Communities; Complement; Data; Elderly; Ensure; Event; Funding; Goals; Growth; Guidelines; Health; Health Personnel; Healthcare; Hispanic Americans; Individual; Interview; Knowledge; Life; Life Change Events; Longitudinal Studies; Maintenance; Marshal; Measures; Modeling; Nature; Nurses; Nursing Research; Outcome; Participant; Patient Education; Patients; Persons; Play; Prospective Studies; Provider; Public Health; Quality of life; Recruitment Activity; Relative (related person); Reporting; Research; Research Infrastructure; Resources; Respondent; Risk; Role; Sampling; Sampling Studies; Social support; Survival Analysis; Techniques; Telephone; Testing; Time; Training; Well in self; base; disability burden; end of life; end of life care; experience; follow-up; functional status; high risk; men; nursing intervention; patient oriented; prospective; quality of death; response; social; stressor; 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(申请人提供)：随着越来越多的人活到老年，确定能够在生命的最后几年保持良好生活质量的资源对那些致力于提高公共健康的人来说变得越来越重要。在生命的最后几年和最后几个月里，我们对有助于促进身体舒适、心理健康和意义的卫生保健的因素的了解存在重大差距。我们建议并旨在测试一个概念模型，该模型侧重于患者的主动适应以及他们的正式和非正式护理提供者的响应能力，在提高接近生命末期的生活质量方面发挥关键作用。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，以检验生活质量轨迹及其决定因素。每年一次的面对面采访以及四个月和八个月的电话跟踪采访将对900名老年人(75岁以上)进行，他们是我们正在进行的NIA资助的成功老龄化研究的参与者。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，以便获得对老年人生命末期护理的回顾。在研究结束时，我们将能够描述在研究期间死亡的受访者和幸存的受访者的健康、功能状况、社会支持和生活质量轨迹。这项拟议的研究将提供关于不健康和危急事件造成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的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提供一个更全面的视角，了解遵循护理研究传统的卫生保健和维护个人完整性的交叉点。研究结果应根据患者教育和对护士和其他卫生保健提供者的专门培训，为护理干预提供系统的指导方针，以帮助促进以患者为中心的卫生保健。