Using design thinking approaches to tailor a dyadic behavioral sleep intervention for persons living with dementia and their caregivers

使用设计思维方法为痴呆症患者及其护理人员量身定制二元行为睡眠干预措施

• 批准号: 10302008
• 负责人: Glenna Shemida Brewster
• 金额: $ 18.75万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10302008
• 关键词: Address; Adherence; Adult; Affect; Alzheimer' s disease related dementia; Beds; Behavior Therapy; Behavioral; Caregiver research; Caregivers; Clinical Trials; Cognitive; Cognitive Therapy; Collaborations; Communities; Control Groups; Dementia; Dementia caregivers; Development; Diagnosis; Disease; Effectiveness; Evidence based intervention; Foundations; Future; Goals; Habits; Health; Health Personnel; Human; Individual; Intervention; Intervention Studies; Intervention Trial; Interview; K-Series Research Career Programs; Knowledge; Learning; Literature; Manuscripts; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Modeling; National Institute on Aging; Neurology; Oral; Outcome; Patients; Peer Review; Personhood; Persons; Phase; Polysomnography; Population; Prevalence; Process; Psychology; Public Health; Quality of life; Questionnaires; Randomized; Randomized Controlled Trials; Reporting; Research; Research Project Grants; Residential Treatment; Schedule; Severities; Sleep; Sleep disturbances; Sleeplessness; Stimulus; Structure; Testing; Thinking; Time; Training; United States National Institutes of Health; Veterans; Visualization; Waiting Lists; Work; Writing; acceptability and feasibility; actigraphy; analytical method; behavioral/social science; caregiving; cognitive skill; control trial; dementia care; dementia caregiving; depressive symptoms; design; diaries; effective intervention; experience; falls; group intervention; improved; indexing; innovation; member; memory care; mild cognitive impairment; novel; patient oriented; poor sleep; primary outcome; programs; prototype; psychologic; satisfaction; skills; sleep behavior; sleep onset; sleep quality; social neuroscience; theories; therapy development; university student; virtual

Project Summary Sleep disturbance is prevalent in persons living with mild cognitive impairment or early-stage Alzheimer’s disease and related dementias (PLwCI) as well as their caregivers. This prevalence suggests that sleep disturbance is an interdependent process that synergistically affects both members of the caregiving dyad. Sleep disturbance is associated with poorer health outcomes, including higher depressive symptoms and lower quality of life. Cognitive behavioral therapy for insomnia (CBTI) is effective for improving sleep disturbance in many populations, and support from a partner during CBTI results in more successful outcomes. The interdependence of PLwCI-caregiver sleep disturbance suggests the need for a dyadic intervention. However, there are no structured fully dyadic interventions focused on managing sleep disturbance in PLwCI and their caregivers; moreover, no dyadic interventions have been developed with input from these stakeholders. Aligned with the National Institute of Aging’s Behavioral and Social Science and Neuroscience high-priority dementia caregiver research agenda, the proposed K23 Patient-Oriented Mentored Career Development Award seeks to use design thinking, human-centered approaches within the CBTI framework to tailor a dyadic intervention (T-Dyadic Sleep) for PLwCI and their caregivers. Twenty PLwCI-caregiver dyads and 10 healthcare providers will be interviewed during the tailoring phase. We will then conduct a waitlist randomized control trial (N = 40 dyads) to test the acceptability, feasibility, and preliminary immediate and sustained efficacy (3 months) of T-Dyadic Sleep. The completion of this mentored research project will enable me to acquire foundational knowledge for conducting large-scale intervention trials and fulfill the need for effective dyadic interventions to treat sleep disturbance in PLwCI and caregiver dyads. The interdisciplinary training plan and goals developed for this K23 award will fill a critical gap in my current skill set. Building on my training as a clinician with expertise in sleep and dementia caregiving, I will develop proficiency in 1) design thinking approaches, 2) dyadic theories, concepts, and analytic methods, 3) identification and diagnosis of dementia- related disorders, including a focus on how these disorders relate to sleep disturbance, and 4) scientific writing, oral presentations, manuscript development, and peer review. I have assembled an excellent team of mentors (Drs. Hepburn, Barton, Lyons and Lah) and a collaborator (Dr. Gehrman). The K23 award will provide me with the necessary foundation to build a successful and independent program of research related to sleep, dementia, and caregiving. My program of research aligns well with NIA’s Strategic Directions for Research to understand and develop interventions to address the needs of patients living with Alzheimer’s disease and related dementias as well as the needs of their caregivers, and to engage persons living with dementia and their caregivers as part of research teams.

项目摘要 睡眠障碍在患有轻度认知障碍的人或阿尔茨海默氏症早期的患者中普遍存在 疾病和相关痴呆症（PLWCI）及其护理人员。这种流行表明睡眠 干扰是一个相互依存的过程，在协同上影响护理二元成员的两个成员。 睡眠障碍与健康状况较差有关，包括更高的抑郁症状和较低的抑郁症状 生活质量。失眠（CBTI）的认知行为疗法可有效改善睡眠障碍 在CBTI期间，许多人群和合作伙伴的支持都会取得更成功的结果。这 PLWCI-Carevers睡眠障碍的相互依赖性表明需要进行二元干预。然而， 没有结构化的完全二元干预措施专注于管理PLWCI及其睡眠障碍 照顾者；此外，没有这些利益相关者的意见，尚未开发出二元干预措施。 与国家老龄化研究所的行为与社会科学与神经科学高优先级保持一致 痴呆症护理人员研究议程，拟议的K23以患者为导向的职业发展 奖项旨在在CBTI框架内使用以人为中心的方式以人为中心的方法来量身定制二元 PLWCI及其护理人员的干预（T-Dyadic睡眠）。二十个PLWCI养护者二元组和10个 医疗保健提供者将在裁缝阶段接受采访。然后，我们将进行一个随机的候补名单 对照试验（n = 40个二元组），以测试可接受性，可行性和初步的即时和持续 效率（3个月）的T-Dyadic睡眠。这个讨论研究项目的完成将使我能够 获得基础知识，用于进行大规模干预试验并满足有效的需求 PLWCI和护理人员二元组中睡眠障碍的二元干预措施。跨学科培训计划 为该K23奖开发的目标将填补我当前技能的关键空白。以我的培训为基础 临床医生在睡眠和痴呆症护理方面具有专业知识，我将在1）设计思维方面培养熟练程度 方法，2）二元理论，概念和分析方法，3）痴呆症的识别和诊断 相关疾病，包括关注与睡眠障碍有关的疾病以及4）科学写作， 口头演示，手稿开发和同行评审。我组建了一支出色的导师团队 （Hepburn博士，Barton，Lyons和Lah）和合作者（Gehrman博士）。 K23奖将为我提供 建立与睡眠有关的成功研究计划的必要基础， 痴呆和照料。我的研究计划与NIA的战略方向相吻合 了解和制定干预措施，以满足患有阿尔茨海默氏病的患者的需求 相关痴呆症以及照顾者的需求，并与痴呆症患者交战 他们的护理人员是研究团队的一部分。