Changing Talk Online Training (CHATO): A National Trial to Reduce Behavioral Symptoms in Long Term Care Residents with Alzheimer's Disease and Other Dementias

项目摘要 新冠肺炎大流行极大地影响了对阿尔茨海默病和其他疾病患者的护理 长期服务和支持环境中的痴呆症(ADOD)。值得注意的是，养老院居民，包括一名 据估计，50%或更多的人患有痴呆症，感染率极高，包括 新冠肺炎导致的主要死亡人数。新的感染控制预防措施、法规和 已经实施了监测，以减少这些对养老院老年人的压倒性影响 (Nh)关怀。感染控制预防的核心是使用个人防护装备(PPE)。虽然 作为减少国民健康保险中新冠肺炎传播的必要和关键方面，个人防护装备对 沟通、痴呆症的行为和心理症状(BPSD)以及其他方面的护理 痴呆症患者仍有待解决。由于个人防护设备给通信带来了额外的挑战， 在使用PPE的同时优化沟通的干预措施有可能通过以下方式改善痴呆症的护理 以人为本减少ADOD患者的不良反应及支持护理人员 最佳实践。 我们的研究团队目前正在进行一项随机临床试验(R01 AG069171-06A1)，以测试在线 沟通培训节目《在线改变谈话》(CHATO)。这项员工教育干预包括 三个循证培训模块，改善了沟通，减少了#年的业务流程缺陷 国民健康保险制度。Chato实用型随机对照试验将测试Chato对BPSD的影响以及对 在全国120个国家医疗服务体系中为痴呆症患者提供精神药物。此外，我们还将测试策略 吸引员工，最大限度地发挥查托效应，评估成本和可持续发展 传播。总体目标是为NH工作人员提供随时可用的访问和支持，以改善沟通 这随后降低了bpsd和对精神活性药物的需求，这是不适当和危险的。 用来控制这些症状。 本行政副刊(Chat-PPE)将扩大我们R01研究的范围，以：(1)确定证据- 基于使用PPE时的沟通最佳实践；以及(2)创建并测试一个简短的培训模块，用于 护理人员单独使用或与Chato培训结合使用。有效的战略 佩戴个人防护装备时的沟通在长期服务和支持环境中至关重要， 照顾患有痴呆症的老年人。我们的研究证实了沟通的重要性 痴呆症护理，注意到改善的沟通减少了BPSD和抗精神病药物的需求 使用。我们的团队是唯一有资格识别通信最佳实践，然后开发和测试 痴呆护理中克服个人防护用品沟通障碍的干预措施。这项研究符合NIA的要求 目的开发新的干预措施以满足痴呆症照顾者和照顾者的需求。

Project Abstract The COVID-19 pandemic has greatly impacted care of persons living with Alzheimer’s disease and other dementias (ADOD) in long-term service and support settings. Notably, nursing home residents, including an estimated 50% or more who experience dementia, have extremely high rates of infection and comprise a predominant number of deaths from COVID-19. New infection control precautions, regulations, and surveillance have been implemented to reduce these overwhelming effects on older adults in nursing home (NH) care. Central to infection control precautions is the use of personal protective equipment (PPE). Although a necessary and critical aspect of reducing COVID-19 transmission in NHs, secondary effects of PPE on communication, behavioral and psychological symptoms of dementia (BPSD), and other aspects of care for persons with dementia remain to be addressed. As PPE presents additional challenges to communication, interventions to optimize communication while using PPE have the potential to improve dementia care by reducing negative reactions by persons with ADOD and supporting nursing staff by identifying person-centered best practices. Our research team is currently conducting a randomized clinical trial (R01 AG069171-06A1), to test an online communication training program “Changing Talk Online” (CHATO). This staff educational intervention includes three evidence-based training modules that have resulted in improved communication and reduced BPSD in NHs. The CHATO pragmatic randomized controlled trial will test the effects of CHATO on BPSD and on use of psychotropic medication for residents with dementia in 120 NHs nationwide. In addition, we will test strategies to engage staff and maximize CHATO effects and evaluate cost and sustainability for widespread dissemination. The overall goal is to provide ready access and support to NH staff to improve communication that subsequently reduces BPSD and the need for psychoactive medications inappropriately and dangerously used to control these symptoms. This administrative supplement (CHAT-PPE) will expand the scope of our R01 study to: (1) identify evidence- based best practices for communication while using PPE; and (2) create and test a brief training module for nursing staff to be used alone or in conjunction with the CHATO training. Strategies for effective communication while wearing PPE are of critical importance across long-term service and support settings that care for older adults with dementia. Our research established evidence of the importance of communication in dementia care, noting that improved communication reduced BPSD and the need for antipsychotic medication use. Our team is uniquely qualified to identify communication best practices and then to develop and test interventions to overcome PPE communication barriers in dementia care. This research meets the NIA objective to develop novel interventions to meet the needs of dementia caregivers and care recipients.