Self-management support training for carers of older adults with osteoarthritis and additional conditions living in care homes

在这个奖项结束时，我们的目标是制定一个个性化自我管理支持的培训计划，为在家庭和护理院环境中工作的护理人员提供骨关节炎（OA）和多种长期条件（MLTC）以及生活在这些环境中的人的家人和朋友。具有更高护理需求的老年人是最需要支持的群体，以帮助管理他们的OA以及MLTC，但目前最不可能获得支持。生活在这些环境中的许多患有OA的老年人都有不同程度的认知障碍，这通常被视为在没有护理人员大量支持的情况下自我管理的障碍（例如，无法独立进行锻炼活动）。在这个项目中开发的培训将旨在提高护理人员对个性化自我管理支持模式的理解，这将成为一种“工作方式”。护理人员将发展他们的知识和技能，使他们能够在他们支持个人做出决定和参与护理的方式上做出关键改变。我们希望实现这一目标，使患有关节疼痛和高度复杂健康需求的老年人感到自信和熟练，能够对日常活动做出选择，并为有意义的活动创造更多机会。在此奖项期间，我们将采用分阶段的方法来共同设计自我管理支持培训。这将使用各种方法来吸引利益相关者并寻求他们的支持，以便开发的培训与照顾者，家人和朋友以及生活在护理院或在家庭环境中接受护理的OA和MLTC老年人相关。该方法将涉及能够接触和访问“很少听到”的社区的方法，例如那些有文化，沟通或知识障碍的社区。我们将使用基于经验的协同设计，并将涉及以下步骤：1.利益相关者识别和参与，制定招聘方法，项目品牌，并获得道德同意。2.与OA和MLTC的老年人的照顾者，家人和朋友的访谈，以及与OA和MLTC的老年人的访谈，以帮助我们探索在这些环境中自我管理支持的挑战，并提供潜在障碍和解决方案的指示。3.制作一部电影，将联合收割机从参与者的采访中讲述他们作为护理人员工作的经历，或获得和使用服务以及生活在关节疼痛和其他条件下的经历。4.举办一次由所有利益攸关方参加的初步共同设计会议，以分享经验，这将由以前制作的电影引起。将在小型共同设计研讨会上确定和讨论变革的优先事项。6.开发培训。7.最后一个小组研讨会，与参与者和更广泛的利益相关者一起评估培训。除了这个奖项，我们还希望扩大培训规模，使所有家庭和护理院的所有护理人员都能获得培训，并提高公众，家人和朋友对个性化自我管理支持的认识。我们将通过与Bridges的合作来实现这一目标，Bridges是共同设计自我管理支持培训的专家。共同设计过程将允许与所有利益攸关方一起在现有培训的基础上进行改进，使其适合目的。通过这些伙伴关系，我们将确定维持这种工作方式的方法。我们将发展一个护理人员社区，他们感到知识渊博，技能熟练，有信心整合沟通和战略的关键方式，以实现更大的控制，自主权和自我管理，因此这是在他们的服务范围内传播给同事。非盈利模式的桥梁将成为在卫生和社会保健部门传播和采用的工具，我们在以前的项目中使用了这一战略。

At the end of this award our aim is to have developed a training programme in personalised self-management support, for carers working in domiciliary and care home settings with older adults with osteoarthritis (OA) and multiple long term conditions (MLTC's) and family and friends of people living in these settings. Older adults with higher care needs are the group most in need of support to help manage their OA alongside MLTCs but are currently the least likely to be able to access support. Many older adults with OA living within these settings have different degrees of cognitive impairment and this is often seen as a barrier to self-manage without considerable support from carers (e.g. are unable to undertake exercise activity independently). The training developed in this project will aim to increase carers understanding of a model of personalised self-management support that becomes a 'way of working'. Carers will develop their knowledge and skills to empower them to make key changes in the way they support individuals to make decisions and be involved in their care. We want to achieve this so that older adults with joint pain and high and complex health needs feel confident and skilled to make the choices about everyday activities and create more opportunities for meaningful activity.During this award we will used a staged approach to co-design of the self-management support training. This will use a variety of methods to engage and seek support from stakeholders so that the training developed is relevant to carers, family and friends, and older adults with OA and MLTC's living in care homes or receiving care in domiciliary settings. The approach will involve methods that enable reach and access to 'seldom heard' communities such as those with cultural, communication or knowledge barriers.We will use Experienced-Based Co-design, and will involve the following steps:1. Stakeholder identification and engagement, develop recruitment methods, project branding, and gaining ethical consent. 2. Interviews with carers, family and friends of older adults with OA and MLTC's and interviews with older adults with OA and MLTC's, to help us explore the challenges of self-management support across these settings and provide an indication of potential barriers and solutions. 3. Create a film that will combine narratives from the interviews from participants about their experiences of working as a carer, or accessing and using services and living with joint pain and additional conditions. 4. Host an initial co-design meeting of all stakeholders to share experiences, which will be prompted by the film developed previously. Priorities for change will be identified and discussed in small co-design workshops. 6. Develop training.7. Final full group workshop to evaluate the training with co-design participants and wider stakeholders.Beyond this award we want to scale up the training so that it is available to all carers in all domiciliary and care home settings, and raises awareness of personalised self-management support amongst members of the public, family and friends. We will achieve this though our established collaboration with Bridges, who are experts in co-design of self-management support training. The co-design process will allow for building on and refining existing training with all stakeholders so that it is fit for purpose. Through these partnerships we will identify ways to sustain this way of working. We will grow a community of carers that feel knowledgeable, skilled and confident to integrate key ways of communicating and strategies to enable greater control, autonomy and self-management, so this is spread to colleagues within their services. Bridges not for profit model will be a vehicle for spread and adoption across health and social care sectors and we utilised this strategy in previous projects.