The Residential Care Transition Module

住院护理过渡模块

• 批准号: 9103590
• 负责人: JOSEPH E. GAUGLER
• 金额: $ 57.73万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-01 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9103590
• 关键词: Activities of Daily Living; Admission activity; Age-Years; Alzheimer' s Disease; Assisted Living Facilities; Caregivers; Caring; Clinical Research; Communication; Competence; Consultations; Continuity of Patient Care; Control Groups; Counseling; Dementia; Diagnosis; Disease; Elderly; Emotional; Enrollment; Environment; Evaluation; Family; Family Caregiver; Family member; Health Care Costs; Home Nursing Care; Impaired cognition; Individual; Institutionalization; Intervention; Interview; Life; Literature; Long-Term Care; Medicare; Memory; Mental Depression; Mental Health; Methods; Nursing Homes; Outcome; Patients; Perception; Personal Satisfaction; Randomized; Randomized Controlled Trials; Recruitment Activity; Rehabilitation therapy; Reporting; Research; Role; Self Efficacy; Stress; Structure; United States; Visit; care giving burden; caregiver interventions; coping; cost; depressive symptoms; effective intervention; emotional distress; family caregiving; improved; instrumental activity of daily living; prevent; psychoeducation; psychological distress; psychosocial; public health relevance; stressor; success; therapy design; treatment as usual

 DESCRIPTION (provided by applicant): Emerging research on family caregiving and institutionalization has found that families do not disengage from care responsibilities following relatives' admissions to residential long-term care settings. Families instead remain involved in a spectrum of care activities ranging from instrumental activities of daily living to emotional support. Perhaps for these reasons, a number of studies have noted that caregiving stress, depression, or other key outcomes remain stable or sometimes increase following residential long-term care (RLTC) entry for certain types of caregivers. A few interventions have attempted to increase family involvement after institutionalization, but no rigorous studies have demonstrated that these interventions are effective in helping families navigate transitions to RLTC environments. The Residential Care Transition Module (RCTM) provides 6 formal sessions of consultation (one-to-one and family sessions) over a 4-month period to those family caregivers who have recently admitted a relative to a RLTC setting. In this randomized controlled trial, family members who have admitted a cognitively impaired relative to a RLTC setting in the past 3 months will be randomly assigned to the RCTM [(n = 120)] or a usual care control condition [(n = 120)]. A mixed methods analysis will be used to pursue the following aims: Specific Aim 1) Assess whether the RCTM yields statistically significant reductions in family members' primary subjective stress and negative mental health outcomes; Specific Aim 2) Determine whether family members who receive the RCTM will indicate statistically significant decreases in secondary role strains over a 12-month period when compared to usual care controls; Specific Aim 3) Determine whether RCTM family members report statistically significant decreases in residential care stress when compared to family members in the usual care control group; and Specific Aim 4) Delineate the mechanism of action of RCTM under conditions of high and low success by "embedding" qualitative components (30 semi-structured interviews) at the conclusion of the 12-month evaluation. The proposed project will fill an important clinical and research gap by evaluating a psychosocial intervention designed for families following RLTC placement that determines whether and how the RCTM can help families better navigate the residential care transitions of cognitively impaired relatives.

 描述（由申请人提供）：关于家庭收容和机构化的新兴研究发现，在亲属进入长期护理机构后，家庭并没有脱离护理责任。相反，家庭仍然参与一个 护理活动范围从日常生活的工具性活动到情感支持。也许由于这些原因，一些研究已经注意到，在某些类型的照顾者进入长期护理（RLTC）后，工作压力，抑郁或其他关键结果保持稳定或有时会增加。一些干预措施试图增加机构化后的家庭参与，但没有严格的研究表明，这些干预措施是有效的，帮助家庭导航过渡到RLTC环境。 住宿照顾过渡模块（RCTM）在4个月的时间内为那些最近接受了RLTC设置的亲属的家庭照顾者提供6次正式咨询（一对一和家庭会议）。在这项随机对照试验中，在过去3个月内承认相对于RLTC环境存在认知障碍的家庭成员将被随机分配到RCTM [（n = 120）]或常规护理控制条件[（n = 120）]。具体目标1）评估RCTM是否在统计学上显著降低家庭成员的主要主观压力和负面心理健康结果;具体目标2）确定接受RCTM的家庭成员是否在12个月期间与常规护理对照相比在统计学上显著降低次要角色压力;具体目标3）确定与常规护理对照组的家庭成员相比，RCTM家庭成员报告的住院护理压力是否在统计学上显著降低;具体目标4）通过在12个月评估结束时“嵌入”定性成分（30次半结构化访谈），描述RCTM在高成功率和低成功率条件下的作用机制。拟议的项目将通过评估为RLTC安置后的家庭设计的心理社会干预来填补一个重要的临床和研究空白，该干预决定了RCTM是否以及如何帮助家庭更好地导航认知受损亲属的住宿护理过渡。