Negotiation Training to Optimize Caregiver Communication in Alzheimer's Disease

优化阿尔茨海默病护理人员沟通的谈判培训

• 批准号: 10045230
• 负责人: Lee A Lindquist
• 金额: $ 78.48万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10045230
• 关键词: Adult; Advocate; Affect; Age; Alzheimer' s Disease; Ambulatory Care; Anxiety; Area; Back; Businesses; Caregiver Burden; Caregiver well-being; Caregivers; Caring; Clinical Trials; Communication; Communities; Complex; Conflict (Psychology); Custom; Data; Decision Making; Disputes; Educational Intervention; Educational process of instructing; Elderly; Ensure; Exercise; Family Caregiver; Feedback; Frustration; Future; Goals; Health; Health Personnel; Health Professional; Health system; Helicopter; Home environment; Hospitalization; Hospitals; Hour; Insurance; Intervention; Laws; Mediation; Medical Care Team; Medical Students; Moods; Nurses; Online Systems; Outcome; Participant; Patient-Focused Outcomes; Patients; Personal Satisfaction; Pharmaceutical Preparations; Physician Assistants; Physicians; Population; Prevalence; Process; Public Policy; Randomized; Research; Resolution; Schedule; Schools; Stress; Telephone; Testing; Training; Training Programs; Universities; base; design; empowerment; experience; follow-up; health training; improved; innovation; lectures; loved ones; multiphase optimization strategy; pilot trial; post intervention; professor; public health relevance; recruit; retention rate; skills; usability; user centered design; webinar

The goals of this proposal are to adapt and test a negotiation and dispute resolutions (NDR) training program for caregivers of patients with Alzheimer’s disease (AD), who experience conflicts when they act as patient advocates in the health system [Stage 1A and 1B]. Teaching NDR to family caregivers has the potential to improve caregiver communication, wellbeing, mood, and the care of the adult with AD. Alzheimer’s disease (AD) affects more than 5 million older adults nationally, with the prevalence expected to increase as our population ages. An integral driver in the care of older adults with AD is the family caregiver. Our prior research has shown that family caregivers act as patient navigators for their loves ones with AD, often interacting with the health system for a multitude of conflicts (e.g. determining if a test/medication/hospitalization is necessary, responding to insurance denials, billing errors). A reoccurring theme is that family caregivers experience frustration, anxiety, and stress as they deal with these health system conflicts. Whether it is spending hours on the phone trying to get answers from a health care provider’s team or navigating complex insurance hoops, these conflicts contribute to the burden experienced by a family caregiver. Unfortunately, family caregivers are vastly underprepared to effectively negotiate through these conflicts. Northwestern University’s Kellogg School of Business is an innovator in the field of negotiations and dispute resolution training. Previously, we have tailored the negotiations training for health professionals with positive results. We hypothesize that teaching negotiation and dispute resolution tactics to family caregivers of patients with AD will help improve communication, caregiver stress, anxiety, and empowerment. To test this hypothesis, we aim to: Aim 1: Employ a caregiver (user)-centered design approach to modify and tailor a negotiations and dispute resolution (NDR) training intervention to support communication skills of family caregivers of adults with AD. Aim 2: Utilizing Multiphase Optimization Strategy (MOST), conduct a randomized pilot trial of the NDR intervention that targets better communication between caregivers and health teams, using a 2X3 full factorial design, to (2a) determine the feasibility of delivering the intervention, and (2b) derive estimates of the effect of 3 intervention components on changes in patient-centered outcomes at post-intervention and follow-up to inform a future RCT trial. Exploratory Aim 3: Explore if intervention components (lectures/exercises) interact to change communication between caregivers and health care teams at post-intervention and follow-up. The factorial design will enable testing if the effect of a component is moderated by another component, to ensure the optimized intervention retains components that directly or indirectly impact outcomes. We have partnered with community-based family caregivers who will provide feedback for tailoring the NDR and assist with recruiting family caregivers for the study. Our goal is to improve communication of family caregivers of adults with AD with healthcare providers and others through the negotiation and dispute resolution training.

本提案的目标是调整和测试谈判和争议解决（NDR）培训 阿尔茨海默病（AD）患者的护理人员计划，当他们 在卫生系统中担任患者倡导者[阶段1A和1B]。向家庭照顾者教授NDR， 改善护理人员沟通、健康、情绪和成人护理的潜力， AD.阿尔茨海默病（AD）影响着全国500多万老年人，预计患病率 随着人口老龄化而增加。在照顾老年人与AD的一个不可或缺的驱动程序是家庭照顾者。 我们先前的研究表明，家庭照顾者充当患者导航员，为他们的亲人与AD，往往 与健康系统交互以解决多个冲突（例如，确定测试/药物/住院是否 是必要的，应对保险拒绝，计费错误）。一个反复出现的主题是， 在处理这些卫生系统冲突时，他们会感到沮丧、焦虑和压力。无论是消费 在电话上花上几个小时试图从医疗保健提供者的团队那里得到答案或浏览复杂的保险 这些冲突加剧了家庭照顾者的负担。不幸的是， 照顾者在有效地通过这些冲突进行谈判方面准备不足。西北大学 凯洛格商学院是谈判和争议解决培训领域的创新者。在此之前， 我们为保健专业人员量身定制了谈判培训，取得了积极成果。我们假设 向AD患者的家庭照顾者教授谈判和争议解决策略将有助于改善 沟通，照顾者的压力，焦虑和授权。为了验证这一假设，我们的目标是：目标1：雇用 以护理人员（用户）为中心的设计方法，用于修改和定制协商和争议解决（NDR） 培训干预，以支持AD成年人的家庭照顾者的沟通技能。目标2：利用 多阶段优化策略（MOST），对NDR干预进行随机试点试验， 护理人员和卫生团队之间更好的沟通，使用2X 3全因子设计，以（2a）确定 提供干预措施的可行性，以及（2b）对3个干预措施组成部分的效果进行估计 干预后和随访时以患者为中心的结局变化，为未来的RCT试验提供信息。 探索性目标3：探索干预组件（讲座/练习）是否相互作用以改变沟通 在干预后和随访时，护理人员和医疗保健团队之间的关系。析因设计将使 测试一种成分的影响是否受到另一种成分的调节，以确保优化干预 保留直接或间接影响结果的组件。我们与社区家庭合作， 护理人员将为定制NDR提供反馈，并协助招募家庭护理人员 study.我们的目标是改善AD成人的家庭护理人员与医疗保健提供者的沟通， 其他人通过谈判和解决争端的培训。