Changing Talk Online Training (CHATO): A National Trial to Reduce Behavioral Symptoms in Long Term Care Residents with Alzheimer's Disease and Other Dementias

改变谈话在线培训 (CHATO)：一项旨在减少患有阿尔茨海默病和其他痴呆症的长期护理居民行为症状的全国试验

• 批准号: 10307900
• 负责人: KRISTINE N. WILLIAMS
• 金额: $ 15.29万
• 依托单位: UNIVERSITY OF KANSAS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10307900
• 关键词: Address; Administrative Supplement; Alzheimer' s Disease; Antipsychotic Agents; Behavioral; Behavioral Symptoms; COVID-19 mortality; COVID-19 pandemic; Caring; Code; Communication; Communication Barriers; Comprehension; Computer Assisted; Cues; Dangerousness; Delirium; Dementia; Dementia caregivers; Disorientation; E-learning; Education; Educational Intervention; Elderly; Face; Family; Family Caregiver; Focus Groups; Fright; Goals; Home Nursing Care; Hour; Impaired cognition; Infection Control; Intervention; Knowledge; Learning Module; Link; Lipreading; Long-Term Care; Masks; Methods; Modification; Nursing Homes; Nursing Staff; Patients; Persons; Pharmaceutical Preparations; Population; Provider; Quality of Care; Randomized Clinical Trials; Randomized Controlled Trials; Reaction; Regulation; Research; Research Methodology; Resources; Review Literature; SARS-CoV-2 transmission; Sampling; Scheme; Services; Smiling; Symptoms; Testing; Time; Training; Training Activity; Training Programs; Video Recording; Visualization; base; care providers; care recipients; communication behavior; cost; dementia care; dietary; evidence base; experience; improved; infection rate; interest; novel; online delivery; person centered; personal protective equipment; psychological symptom; response; skills; success; web-based intervention

Project Abstract The COVID-19 pandemic has greatly impacted care of persons living with Alzheimer’s disease and other dementias (ADOD) in long-term service and support settings. Notably, nursing home residents, including an estimated 50% or more who experience dementia, have extremely high rates of infection and comprise a predominant number of deaths from COVID-19. New infection control precautions, regulations, and surveillance have been implemented to reduce these overwhelming effects on older adults in nursing home (NH) care. Central to infection control precautions is the use of personal protective equipment (PPE). Although a necessary and critical aspect of reducing COVID-19 transmission in NHs, secondary effects of PPE on communication, behavioral and psychological symptoms of dementia (BPSD), and other aspects of care for persons with dementia remain to be addressed. As PPE presents additional challenges to communication, interventions to optimize communication while using PPE have the potential to improve dementia care by reducing negative reactions by persons with ADOD and supporting nursing staff by identifying person-centered best practices. Our research team is currently conducting a randomized clinical trial (R01 AG069171-06A1), to test an online communication training program “Changing Talk Online” (CHATO). This staff educational intervention includes three evidence-based training modules that have resulted in improved communication and reduced BPSD in NHs. The CHATO pragmatic randomized controlled trial will test the effects of CHATO on BPSD and on use of psychotropic medication for residents with dementia in 120 NHs nationwide. In addition, we will test strategies to engage staff and maximize CHATO effects and evaluate cost and sustainability for widespread dissemination. The overall goal is to provide ready access and support to NH staff to improve communication that subsequently reduces BPSD and the need for psychoactive medications inappropriately and dangerously used to control these symptoms. This administrative supplement (CHAT-PPE) will expand the scope of our R01 study to: (1) identify evidence- based best practices for communication while using PPE; and (2) create and test a brief training module for nursing staff to be used alone or in conjunction with the CHATO training. Strategies for effective communication while wearing PPE are of critical importance across long-term service and support settings that care for older adults with dementia. Our research established evidence of the importance of communication in dementia care, noting that improved communication reduced BPSD and the need for antipsychotic medication use. Our team is uniquely qualified to identify communication best practices and then to develop and test interventions to overcome PPE communication barriers in dementia care. This research meets the NIA objective to develop novel interventions to meet the needs of dementia caregivers and care recipients.

项目摘要 COVID-19的大流行极大地影响了对患有阿尔茨海默氏病和其他的人的护理 长期服务和支持环境中的痴呆症（ADOD）。值得注意的是，护士居民，包括 估计患有痴呆症的人估计有50％或以上的人感染率极高，并且包括 Covid-19的主要死亡人数。新的感染控制预防措施，法规和 已经实施了监视，以减少对护士家中老年人的压倒性影响 （NH）护理。感染控制预防措施的中心是使用个人保护设备（PPE）。虽然 降低NHS中的CoVID-19的必要和关键方面，PPE的次要影响 痴呆症（BPSD）的沟通，行为和心理症状以及护理的其他方面 痴呆症患者仍有待解决。随着PPE对交流提出了其他挑战， 使用PPE的干预措施以优化沟通，有可能通过 通过确定以人为中心 最佳实践。 我们的研究团队目前正在进行一项随机临床试验（R01 AG069171-06A1），以测试在线 沟通培训计划“在线更改谈话”（Chato）。该员工教育干预包括 三个基于证据的培训模块，导致沟通改善并减少了BPSD NHS。 Chato务实的随机对照试验将测试Chato对BPSD的影响并在使用时 全国120 NHS痴呆症居民的精神药物。此外，我们将测试策略 吸引员工并最大化Chato效果以及评估成本和可持续性以进行宽度 传播。总体目标是为NH员工提供现成的访问和支持，以改善沟通 这随后减少了BPSD，并且需要不适当和危险地进行精神活性药物 用于控制这些符号。 这种行政补充（CHAT-PPE）将将我们的R01研究的范围扩大到：（1）确定证据 - 使用PPE时，基于交流的最佳实践； （2）创建并测试一个简短的培训模块 护理人员单独使用或与Chato培训一起使用。有效的策略 穿着PPE时的沟通在长期服务和支持环境中至关重要 照顾老年人患有痴呆症。我们的研究确定了交流重要性的证据 痴呆症护理，指出改善的沟通减少了BPSD，需要抗精神病药物 使用。我们的团队具有独特的资格来确定沟通最佳实践，然后开发和测试 克服痴呆症护理中PPE通信障碍的干预措施。这项研究符合NIA 建立新颖的干预措施以满足痴呆症护理人员和护理人员的需求的目标。