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）的有效性，以改善从社区向长期护理过渡期间的非正式痴呆症护理人员调整和护理人员与工作人员的互动。干预是从理论上推导出来的，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。来自FITT-痴呆的随机试点研究的初步发现（R21 MH 62561; G.特雷蒙，主要研究者），支持干预措施的有效性，以减少感知负担，情境焦虑，以及对护理接受者的记忆和行为问题的反应，增加社区资源的使用，并改善与常规护理相比，家庭护理者的健康相关生活质量。拟议的研究是一项FITT-NH与标准治疗相比的随机对照3个月试验。治疗策略基于对关键领域的评估（例如，情绪调整、健康、家庭生活、社会支持和护理人员与工作人员的沟通），以根据护理人员的需求进行个性化干预。80名非正式的痴呆症护理人员将在护理接受者进入长期护理机构后入组。治疗将持续3个月，并在基线、治疗后即刻和3个月随访时获得结局指标。主要照顾者的结果是负担，情绪，预期的悲伤，工作人员-照顾者的互动，感知质量的访问，并与设施的满意度的看法。资源利用是次要结果。假设接受FITT-NH的护理者将表现出（1）更好的情绪调节（例如，更少的预期悲伤，更少的抑郁和焦虑症状，更少的感知负担，以及更好的健康相关生活质量，和（2）更好的工作人员-护理人员关系（例如，对工作人员与照顾者互动的看法更积极，与工作人员的争吵和分歧更少，感觉探视质量更好）。这种低成本的干预可能是有用的，作为常规护理的一部分，痴呆症照顾者将其家庭成员过渡到长期护理设施。

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.