Insomnia and Physical Function in Older Veterans During and After CLC Rehabilitation Admission
老年退伍军人 CLC 康复入院期间和之后的失眠和身体功能
基本信息
- 批准号:10746207
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-10-01 至 2025-09-30
- 项目状态:未结题
- 来源:
- 关键词:Active LearningAcuteAddressAdmission activityAgeBedsBehavior TherapyBehavioralCaringCategoriesChronic DiseaseCladribineCognitive TherapyComplexDataData CollectionDevelopmentDrowsinessEducationElderlyEligibility DeterminationEnvironmental Risk FactorEvaluationFatal injuryFocus GroupsFutureGait speedGoalsHealthHealthcare SystemsHomeHospitalizationInjuryInpatientsInterdisciplinary StudyInterventionInterviewInvestigationInvestigator-Initiated ResearchK-Series Research Career ProgramsLeadLeadershipLeftLightLinkLiteratureMeasuresMedicineMentorshipMethodsMonitorNoisePainPatient Self-ReportPatientsPerceptionPhysical FunctionPhysical activityPopulationPost-Traumatic Stress DisordersPreparationProcessProgram ReviewsQuality of lifeQuestionnairesRecoveryRecovery of FunctionRehabilitation CentersRehabilitation OutcomeRehabilitation therapyReportingResearchResearch PersonnelRiskSafetySelf AdministrationSeriesSeveritiesSleepSleep disturbancesSleeplessnessStructureSurvival RateSymptomsTask PerformancesTimeTrainingTreatment outcomeVeteransWorkacceptability and feasibilityactigraphycareercommunity livingdesigndiariesexperiencefall riskfallsfollow up assessmentfollow-uphealth care service utilizationhuman old age (65+)improvedimprovement on sleepinterestmedical complicationpoor sleeppreferenceprogramsrecruitsevere injurysleep quality
项目摘要
Sleep and physical function are highly interdependent in older adult populations (≥65 years old), even
after controlling for underlying health conditions. Poor sleep, as well as complications from acute and chronic
illness, leaves older adults more vulnerable to declines in physical functioning and negative safety
consequences, such as falls leading to severe or fatal injuries. As such, older adults experiencing insomnia
symptoms are at greater risk for hospitalization and subsequent rehabilitation. Insomnia symptoms are complex
and multifactorial (e.g., sleep disturbances, increased daytime sleepiness, poor sleep quality) and are often
unintentionally worsened by rehabilitation admission due to environmental factors (e.g., light, noise) and
behavioral factors (e.g., increased time in bed) in this setting. If left undetected and untreated, insomnia
symptoms can result in poorer treatment outcomes, such as longer rehabilitation stays, slower treatment
progression, and decreased survival rates one-year post-discharge. Despite the comprehensive literature on
sleep in older adults, there is less comprehensive literature on sleep in older Veterans receiving care in VA
inpatient rehabilitation settings after hospitalization, for whom successful functional recovery and transition to
home is critical for quality of life.
We will determine the feasibility of simultaneously evaluating insomnia symptoms and physical function
in older Veterans (N=15) receiving care in a VA subacute rehabilitation unit at admission, discharge, and one
month after discharge. We will evaluate insomnia symptoms measured through self-report questionnaires, sleep
diaries, and actigraphy. Actigraphs are activity monitors worn on the body that record continuous physical
activity, which can be used to approximate sleep variables. We will evaluate physical function through self-report
measures and performances tasks, including chair stands and gait speed. We will ask Veterans their perception
of the importance of sleep and physical function in rehabilitation and their interest in and acceptability of
behavioral sleep interventions through brief semi-structured interviews.
Results will further indicate which approaches are most feasible and acceptable, allowing for a more
focused battery in subsequent studies (RR&D CDA-2). Information from the feasibility component will indicate
the degree to which evaluating sleep and physical function by multiple methods is feasible, informative, and
necessary during and after VA subacute rehabilitation. Information gained will inform a larger-N evaluation for
the purposes of statistically understanding the relationship between these variables and their impact on
rehabilitation outcomes. Information from the acceptability component will inform future studies that will adapt
effective Behavioral Sleep Medicine interventions by understanding when the intervention should be offered
during the care trajectory and how the intervention should be adapted to improve physical function. This will also
inform future focus groups evaluating specific components of a treatment addressing insomnia symptoms to
optimize physical function.
The CDA-1 project closely aligns with the proposed training objective categories: (1) physical function
and recovery; (2) objective measures of sleep; (3) interdisciplinary research team leadership; and (4) career and
professional development. Completion of these objectives through mentorship, education, and experiential
learning, will prepare the applicant for an RR&D CDA-2 application and long-term goal of becoming an
independent VA researcher focused on improving sleep to optimize functional recovery. This CDA-1 project will
provide a critical first step of data collection and candidate training to prepare for a planned program of research
with the goal of improving sleep and physical recovery in Veterans and improving safety and high reliability within
the VA Healthcare System.
甚至在老年人(≥65岁)中,睡眠和身体功能也是高度相互依赖的
项目成果
期刊论文数量(0)
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会议论文数量(0)
专利数量(0)
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