Dementia Caregiver Treatment for Nursing Home Transition

描述(由申请人提供)：拟议研究的目标是确定基于电话的心理社会干预(家庭干预：电话跟踪-疗养院；FITT-NH)在从社区过渡到长期护理期间改善非正式痴呆症照顾者调整和照顾者与工作人员互动的效果。这种干预是从理论上衍生出来的，包括教育、积极解决问题和支持技术，以改善过渡期间的应对和适应。FITT-痴呆症随机试点研究(R21 MH62561；首席调查员G.Tremont)的初步发现支持了干预的有效性，与通常的护理相比，干预可以减少护理接受者的感知负担、情景焦虑以及对记忆和行为问题的反应，增加对社区资源的使用，并提高家庭照顾者与健康相关的生活质量。这项拟议的研究是一项为期3个月的随机对照试验，将FITT-NH与标准护理进行比较。治疗战略基于每次接触期间对关键领域的评估(例如，情绪调整、健康、家庭生活、社会支持和照顾者与工作人员的沟通)，以使干预措施个性化，以满足照顾者的需求。在护理接受者进入长期护理机构后，将登记80名非正式的痴呆症护理人员。治疗将提供3个月，并将在基线、治疗后立即和3个月的随访时获得结果测量。主要照顾者的结果是负担、情绪、预期的悲伤、对工作人员与照顾者互动的感知、感知的探视质量以及对设施的满意度。资源利用率是次要结果。研究假设，接受FITT-NH的照顾者将表现出(1)更好的情绪适应(例如，较少的预期悲伤，较少的抑郁和焦虑症状，较少的感知负担，以及更好的与健康相关的生活质量，以及(2)更好的工作人员与照顾者的关系(例如，对工作人员与照顾者的互动更积极的看法，更少的与工作人员的麻烦和分歧，以及更好的访问质量)。这种低成本的干预措施可能对痴呆症照顾者将其家庭成员过渡到长期护理机构的常规护理有用。

DESCRIPTION (provided by applicant): The goal of the proposed study is to determine the efficacy of a telephone-based psychosocial intervention (Family Intervention: Telephone Tracking-Nursing Home; FITT-NH) to improve informal dementia caregiver adjustment and caregiver-staff interactions during the transition from community to long-term care. The intervention is theoretically derived and includes education, active problem-solving, and support techniques to improve coping and adaptation during transitions. Preliminary findings from a randomized pilot study of FITT-Dementia (R21 MH62561; G. Tremont, Principal Investigator), support efficacy of the intervention for reducing perceived burden, situational anxiety, and reaction to memory and behavior problems in the care recipient, increasing use of community resources, and improving health-related quality of life in home caregivers compared to usual care. The proposed study is a randomized, controlled 3-month trial of FITT-NH compared to standard care. Treatment strategies are based on assessment of key areas (e.g., emotional adjustment, health, family life, social support, and caregiver-staff communication) during each contact to individualize the intervention to caregivers' needs. Eighty informal dementia caregivers will be enrolled following admission of the care recipient to a long-term care facility. Treatment will be delivered for 3 months, and outcome measures will be obtained at baseline, immediately following treatment, and at a 3-month follow-up. Primary caregiver outcomes are burden, mood, anticipatory grief, perceptions of staff-caregiver interactions, perceived quality of visitation, and satisfaction with the facility. Resource utilization is a secondary outcome. It is hypothesized that caregivers receiving FITT-NH will demonstrate (1) better emotional adjustment (e.g., less anticipatory grief, fewer depressive and anxiety symptoms, less perceived burden, and better health-related quality of life, and (2) better staff-caregiver relationships (e.g., more positive perceptions of staff-caregiver interactions, fewer hassles and disagreements with staff, and better perceived quality of visitations). This low-cost intervention may be useful as part of routine care for dementia caregivers transitioning their family member to long-term care facilities.