Testing a Restorative Care Nursing Program

测试恢复护理护理计划

基本信息

批准号：
6941194
负责人：
BARBARA RESNICK
金额：
$ 64.4万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2002
资助国家：
美国
起止时间：
2002-09-27 至 2007-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6941194
关键词：
allied health personnel behavior test behavior therapy body physical activity clinical research functional ability geriatric nursing human old age (65+)human subject interview motivation muscle strength nursing homes nursing intervention quality of life questionnaires

项目摘要

DESCRIPTION (provided by applicant): The majority of older adults living in nursing homes require some assistance with activities of daily living (ADL). There are many causes of functional impairments, among these nursing care that create dependency and lack of motivation on the part of the older adult to perform self-care activities. Restorative care, however, is a philosophy of care that focuses on the restoration and/or maintenance of physical function, and helps the older adult to compensate for functional impairments so that the highest level of function is obtained. Restorative care places an important emphasis on prevention of the secondary sequelae of physical dependence, inactivity, and immobility. Although there are some anecdotal reports of benefits of these programs (Koroknay et al., 1995; Orth, 1991; Farnham & Moffett, 1988), there is little quantitative evidence to support the widespread use of these programs, and few well described and developed programs. The primary aims of this study are to implement an investigator developed two tiered restorative care program, the Nursing Assistants Resident Care Activities Intervention (NARCAI). The NARCAI incorporates self-efficacy based interventions for both nursing assistants and residents to improve functional performance, maintain or decrease the number of contractures, maintain or improve muscle strength, decreased falls and fall related injuries, and improve quality of life in long-term care residents. The secondary aims related to residents focus on understanding the mechanism by which residents engage in functional activities, i.e. the mediating effect of self- efficacy and outcome expectations. The secondary aims related to nursing assistants focus on understanding the mechanism by which nursing assistants change behavior to facilitate restorative care activities, and how the NARCAI impacts nursing assistants performance of restorative care activities, employment status and job satisfaction. A total of 520 residents and 560 nursing assistants in 8 long-term care facilities owned and managed by Erickson Life Care Communities will participate in the study. The facilities will be randomly assigned to receive the NARCAI or routine care. A 2(group) by 3(time) repeated measure analysis of covariance will be done to address both the primary and secondary aims. Testing will be done at baseline, 4 and 12 months following implementation of the program. This study will help determine the effectiveness of restorative care programs and provide a realistic model for how to integrate these programs into all long-term care facilities. The ultimate goal is to alter the current philosophy of care in long-term care to focus on function, improve clinical outcomes, and inform policy makers on the effectiveness of restorative care programs.

描述（由申请人提供）：大多数居住在疗养院中的老年人需要在日常生活活动（ADL）方面提供一些帮助。在这些护理护理中，有许多原因造成功能障碍的原因，这些护理会造成老年人进行自我保健活动的依赖和缺乏动力。然而，恢复性护理是一种护理哲学，侧重于恢复和/或维持身体机能，并帮助老年人补偿功能障碍，从而获得最高水平的功能。恢复性护理对预防身体依赖性，不活动性和不动性的继发性后遗症的重要重视。尽管有一些有关这些计划的好处的轶事报道（Koroknay等，1995; Orth，1991; Farnham＆Moffett，1988），但几乎没有定量证据来支持这些程序的广泛使用，很少有描述和开发的很好的证据程序。这项研究的主要目的是实施一个研究人员制定了两个分层的修复护理计划，即护理助理居民护理活动干预措施（NARCAI）。 NARCAI为护理助理和居民纳入了基于自我效能的干预措施，以提高功能性能，维持或减少缔约国数量，维持或改善肌肉力量，减少跌倒和跌倒相关的伤害，并改善长期护理中的生活质量居民。与居民有关的次要目的专注于理解居民从事功能活动的机制，即自我效能和结果期望的中介作用。与护理助理有关的次要目的专注于理解护理助理改变行为以促进恢复性护理活动的机制，以及Narcai如何影响护理助理的绩效恢复性护理活动，就业状况和工作满意度。在埃里克森生命护理社区拥有和管理的8个长期护理机构中，共有520名居民和560名护理助理将参加这项研究。这些设施将被随机分配以接收Narcai或常规护理。将对协方差的2（时间）重复测量分析进行2（组），以解决主要目标和次要目标。该计划实施后的基线，4和12个月将进行测试。这项研究将有助于确定恢复性护理计划的有效性，并为如何将这些计划整合到所有长期护理设施中提供现实模型。最终目标是改变长期护理中当前的护理哲学，以专注于功能，改善临床结果并为决策者提供恢复性护理计划的有效性。