Assessment Protocol to Identify Environmental Barriers to Communication

描述（由申请人提供）：与痴呆症患者的无效沟通是长期护理机构中的一个重要问题，对居民的功能能力和生活质量产生负面影响。它还会影响员工的压力和负担，从而导致更高的流动率和更差的护理质量。环境是影响沟通质量的关键因素，特别是对于因痴呆症而导致沟通能力受损的个人而言。设计不良的沟通环境会对许多群体产生负面影响：痴呆症患者、直接护理人员和护士、治疗师、家庭成员和设施管理员/所有者。沟通工具包将是唯一的综合性资源，为语言病理学家（slp）、职业治疗师（OTs）、物理治疗师（PTs）、护理人员和管理部门提供有关如何评估和修改长期护理环境的信息，从而支持痴呆症患者的沟通技能，提高他们的生活质量。这个SBIR项目的具体目标是：1)通过纳入额外的住宅护理环境区域（如餐厅和活动空间）来扩展通信工具包。2)根据第一阶段的结果和咨询小组的全面评估来完善和修订沟通工具包。3)通过在更大的专业人员样本中测量意识、效用和影响方面的积极结果来证明沟通工具包的有效性。这一样本将包括与slp合作实施沟通干预的其他职业（如职业治疗师、物理治疗师和护士）。通信工具包包括通信环境资源指南和评估工具，以及用于评估环境如何支持有效通信的声光仪表。一旦扩大并得到咨询小组的批准，传播工具包将在两波数据收集中进行评估，至少有90名卫生专业人员参与。将通过以下变化来评估传播工具包的有效性：将通过知识的变化来评估对环境干预措施的认识；信息的效用将通过行为的改变来评估；将通过实施干预措施来评估传播工具包的影响；通信工具包的可用性将通过对通信工具包的评估来评估。公共卫生相关性：很大一部分生活在长期护理环境中的个人经历沟通问题，通常源于痴呆症，这损害了他们充分参与护理和保持高质量生活的能力。虽然有确凿的经验证据表明，适当的环境干预可以改善沟通，但评估有效沟通的障碍和促进因素并不是正常临床实践的一部分。沟通工具包将通过提供可纳入功能维护计划、恢复计划、护理人员培训和直接治疗干预的解决方案来指导卫生保健专业人员，从而改善沟通缺陷患者的生活。

DESCRIPTION (provided by applicant): Ineffectual communication with people with dementia is a significant problem in long-term care settings that negatively impacts residents' functional abilities and quality of life. It also influences staff stress and burden which can result in higher turnover and poorer quality care. The environment is a key factor affecting the quality of communication, especially for individuals with impaired communication skills as a result of dementia. A poorly designed communication environment has negative consequences for many groups: residents with dementia, direct care staff and nurses, therapists, family members, and facility administrators/owners. The Communication Toolkit will be the only comprehensive resource that provides information to speech-language pathologists (SLPs), occupational therapists (OTs), physical therapist (PTs), nursing staff, and administration about how to assess and modify the long term care environment so that it is supports the communication skills of people with dementia and improves their quality of life. The specific aims of this SBIR project are: 1) To expand the Communication Toolkit by incorporating additional areas of the residential care environment such as the dining room and activity spaces. 2) To refine and revise the Communication Toolkit per results of Phase I and thorough evaluation by the Advisory Panel. 3) To demonstrate the effectiveness of the Communication Toolkit by measuring positive outcomes in awareness, utility and impact in a larger sample of professionals. This sample will include other professions who work with SLPs to implement communication interventions (e.g. occupational therapists, physical therapists, and nurses). The Communication Toolkit includes the Communication Environment Resource Guide and Assessment Instrument, along with sound and light meters to assess how well the environment supports effective communication. Once expanded and approved by the Advisory Panel, the Communication Toolkit will be evaluated in two waves of data collection, with at least 90 health professionals. The efficacy of the Communication Toolkit will be assessed through the following changes: Awareness of environmental interventions will be assessed by change in knowledge; Utility of information will be assessed by change in behavior; Impact of the Communication Toolkit will be assessed by implementation of interventions; Usability of the Communication Toolkit will be assessed by evaluation of the Communication Toolkit. PUBLIC HEALTH RELEVANCE: Significant proportions of individuals living in long-term care settings experience communication problems, often stemming from dementia, which impairs their ability participate fully in their care and maintain a high quality of life. Although there is solid empirical evidence that appropriate environmental interventions can improve communication, assessment of barriers and facilitators to effective communication is not part of normal clinical practice. The Communication Toolkit will guide health care professions by providing solutions that can be incorporated into functional maintenance plans, restorative plans, caregiver training, and direct treatment interventions, improving the lives of individuals with communication deficits.