Gender differences in Well-being, Behavior, and Interventions in Hospitalized Persons with Alzheimer disease and Related Dementias (ADRD). In response to PA-18-591

阿尔茨海默病和相关痴呆症 (ADRD) 住院患者的幸福感、行为和干预措施存在性别差异。

• 批准号: 10092371
• 负责人: Marie Boltz
• 金额: $ 10.16万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10092371
• 关键词: Accounting; Acute; Administrative Supplement; Admission activity; Affect; Aggressive behavior; Agitation; Alzheimer' s Disease; Alzheimer' s disease diagnosis; Alzheimer' s disease related dementia; Anxiety; Area; Back; Behavior; Behavior Therapy; Behavioral; Behavioral Symptoms; Care given by nurses; Caregiver Burden; Caring; Cessation of life; Clinical; Communities; Consumption; Data; Data Sources; Decision Making; Delusions; Dementia; Desire for food; Development; Disease; Disinhibition; Distress; Documentation; Eating; Education; Elderly; Environment; Euphoria; Evaluation; Family; Family Caregiver; Female; Gender; Goals; Hallucinations; Hospitalization; Hospitals; Impaired cognition; Individual; Institutionalization; Intervention; Intrinsic factor; Kale - dietary; Long-Term Care; Mental Depression; Modeling; Moods; Nursing Staff; Outcome; Patient Self-Report; Patients; Personal Satisfaction; Persons; Pharmaceutical Preparations; Pharmacology; Physical aggression; Psychotic Disorders; Research; Resources; Sex Bias; Strategic Planning; Testing; Time; United States; United States National Institutes of Health; Well in self; Woman; Women' s Health; Work; acute care; associated symptom; base; behavioral outcome; care delivery; dementia care; depressive symptoms; dysphoria; efficacy testing; emotional distress; experience; functional disability; functional outcomes; gender difference; improved; male; men; motor behavior; person centered; premature; psychological symptom; randomized trial; response; sex; standard of care; symposium; treatment response

ABSTRACT Approximately three-quarters of hospitalized persons with Alzheimer’s disease and related disorders (ADRD) experience behavioral and psychological symptoms of dementia (BPSD). In hospitalized patients BPSD is associated with accelerated and lasting functional and cognitive impairment, increased resource consumption, institutionalization, caregiver burden, and premature death. The current standard of care is to use person- centered behavioral approaches when responding to BPSD rather than psychoactive medications which are frequently ineffective and often cause complications. An understanding of the factors influencing the individual’s clinical presentation, needs, and response to treatment guides these approaches, including intrinsic factors such as gender. Given that about two-thirds of persons with a diagnosis of Alzheimer’s dementia are women, there is surprisingly little rigorous work on gender differences in the expression of BPSD, and even less on staff response to BPSD by patient gender. The minimal research that has been done in this area has been largely conducted in long term care and suggests that BPSD in men are more likely to be identified and managed. Lack of identification and management of BPSD in women can result in emotional distress, a decrease in the quality of interactions they have with staff., and increased complications. The purpose of this supplement, entitled, Gender differences in Well-being, Behavior, and Related Interventions in Hospitalized Persons with Alzheimer disease and Related Dementias (ADRD), is to utilize our ongoing study testing the efficacy of Family -centered Function focused Care (Fam-FFC) versus Education Only (EO) in 438 patients in three hospitals (two units each) to examine gender differences in how nursing staff identify and manage behavioral and psychological symptoms associated with dementia (BPSD) among men and women during hospitalization. In Fam-FFC nurses purposefully engage family CGs in the assessment, decision-making, care delivery and evaluation of function-focused care during hospitalization and the 60-day post-acute period in order to improve behavioral and functional outcomes. We aim to use baseline data from this study and some additional data to answer the aims of this supplement as follows: Aim 1: Test for gender differences in staff identification and management of BPSD; Aim 2: Test for gender differences in quality of staff/patient interactions and patient emotional wellbeing; Aim 3: Explore formal nursing staff experiences with the identification, documentation and management of BPSD among women and men. This study is aligned with the Trans-NIH Strategic Plan for Women’s Health Research goal of leveraging data sources to consider sex and gender influences that enhance research for the health of women. Our long-term goal is to improve the care delivered to the estimated 3.2 million U.S. women living with ADRD during periods of acute illness requiring hospitalization.

摘要 大约四分之三的阿尔茨海默病和相关疾病（ADRD）住院患者 患有痴呆症的行为和心理症状（BPSD）。在住院患者中，BPSD为 与加速和持久的功能和认知障碍，增加资源消耗， 机构化，照顾者负担和过早死亡。目前的护理标准是使用人- 当对BPSD而不是精神活性药物有反应时， 经常无效，并经常引起并发症。了解影响因素， 个体的临床表现、需求和对治疗的反应指导这些方法，包括内在的 性别等因素。考虑到大约三分之二被诊断患有阿尔茨海默氏痴呆症的人 在女性中，关于BPSD表达的性别差异的严格工作很少，甚至 按患者性别划分的工作人员对BPSD的反应较少。在这个领域所做的最少的研究 主要是在长期护理中进行的，并表明男性BPSD更容易被识别， 管理。缺乏对女性BPSD的识别和管理可能导致情绪困扰， 他们与员工互动的质量下降，增加了并发症。这样做的目的 副刊，题目为：住院患者的幸福感、行为和相关干预措施的性别差异 阿尔茨海默病和相关痴呆症（ADRD）患者将利用我们正在进行的研究测试 以家庭为中心的功能集中护理（Fam-FFC）与单纯教育（EO）在438例 三家医院（每家两个单位）检查护理人员如何识别和管理方面的性别差异 与痴呆相关的行为和心理症状（BPSD）在男性和女性中， 住院在Fam-FFC中，护士有目的地让家庭CG参与评估，决策，护理 在住院期间和急性期后60天内提供和评价以功能为中心的护理， 以改善行为和功能结果。我们的目标是使用本研究的基线数据和一些 目标1：检验工作人员中的性别差异 BPSD识别和管理;目标2：检验工作人员/患者质量的性别差异 互动和病人的情绪健康;目标3：探索正式的护理人员的经验， 确定、记录和管理妇女和男子中BPSD。这项研究与 跨国家卫生研究院妇女健康研究战略计划的目标是利用数据来源考虑性别 和性别影响，加强对妇女健康的研究。我们的长远目标是改善 估计有320万美国妇女在急性疾病期间患有ADRD， 需要住院治疗。