Montessori Assessment in Restorative Nursing in Dementia

描述(申请人提供)：这项研究的目的是开发和测试一种新的评估工具，供疗养院工作人员使用，目的是更有效地实施恢复性护理，并为患有中到重度痴呆症的疗养院居民制定活动计划。在长期护理中评估中度至重度痴呆症患者的能力对于制定护理计划至关重要，特别是如果这些计划侧重于康复而不仅仅是姑息治疗的话。然而，很少有评估工具提供信息来指导希望为这些居民制定干预措施的护理提供者。这项研究将开发和测试迈尔斯-梅诺拉公园/蒙台梭利评估系统(MMP/MAS)。这项研究将分三个阶段进行：(1)实地测试在小规模示范项目中显示出希望的MMP/MAS的“阿尔法版本”，以确定其可靠性和效度；(2)创建MMP/MAS的“测试版”，完善其管理和评分，在研究人员和护理人员之间建立评价者之间的可靠性，并制定将MMP/MAS评估与住院医生的恢复性护理计划和护理计划联系起来的协议；(3)使用实验护理单元和对照护理单元，以治疗忠诚度、长期护理住院患者的多重结果测量、工作人员满意度、继续实施的意愿和改进建议来检验3个养老院护理人员实施MMP/MAS的效果。在这项研究结束时，MMP/MAS将达到可以在大规模、多地点有效性研究中实施的点。这项未来的研究将确定，在大量设施中提供护理服务的工作人员是否可以为患有中重度痴呆症的长期护理居民制定更有效的护理计划、恢复性护理和活动规划，从而提高这一人群的生活质量。

DESCRIPTION (provided by applicant): The purpose of this study is to develop and test a new assessment tool to be used by nursing home staff with the goal of more effectively implementing restorative nursing and activities programming with nursing home residents with moderate to advanced dementia. The ability to assess persons with moderate to advanced dementia in long-term care is critical for developing plans of care, especially if such plans are to focus on rehabilitative rather than mere palliative care. Yet few assessment instruments provide information that guides care providers who wish to develop interventions for these residents. This study will develop and test the Myers-Menorah Park/Montessori-Based Assessment System (MMP/MAS). The study will be conducted in three phases: (1) field testing the "alpha version" of the MMP/MAS, which has shown promise in a small-scale demonstration project, to determine its reliability and validity; (2) creating the MMP/MAS "beta version", refining its administration and scoring, establishing inter-rater reliability between research staff and nursing staff, and developing protocols for linking the MMP/MAS assessments to restorative nursing programs and plans of care for residents; and (3) testing the effects of implementation of the MMP/MAS by nursing staff in three nursing homes, using experimental and control nursing units, with measures of treatment fidelity, multiple outcome measures on long-term care residents, and measures of staff satisfaction, willingness to continue implementation of MMP/MAS, and recommendations for improving it. At the end of this study, the MMP/MAS will have reached the point where it can be implemented in a large-scale, multi-site effectiveness study. This future study will determine if the utilization of the MMP/MAS by care-delivering staff at a large number of facilities can produce more effective plans of care, restorative nursing, and activities programming for long-term care residents with moderate to advanced dementia, thus leading to improved quality of life for this population.