A PRESCRIPTION FOR ENHANCING RESIDENT QUALITY OF LIFE

提高居民生活质量的良方

• 批准号: 7189105
• 负责人: ANN M KOLANOWSKI
• 金额: $ 29.76万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-05-01 至 2009-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7189105
• 关键词: Accounting; Address; Adverse effects; Affect; Agitation; Attention; Behavior; Behavior Therapy; Behavioral; Caring; Classification; Cognitive; Data; Dementia; Effectiveness; Emotional; Enrollment; Exhibits; Goals; Health; Homes for the Aged; Individual; Intervention; Measures; Methods; Modeling; Moods; Nursing Homes; Outcome; Pattern; Personality; Persons; Pharmacological Treatment; Physical Function; Physical activity; Quality of life; Randomized; Randomized Clinical Trials; Reporting; Research; Research Personnel; Resources; Risk; Sedation procedure; Social isolation; Testing; Therapeutic; Time; Week; Work; base; cognitive function; cost effective; design; driving behavior; experience; functional decline; improved; interest; positive mood; prescription document; prescription procedure; programs; restraint; skills

DESCRIPTION (provided by applicant): The majority of the 1.5 million individuals who reside in our nation's nursing homes are elderly persons with dementias that place them at risk for poor health outcomes and diminished quality of life. Need driven behaviors, such as agitation and passivity, are exhibited by 90% of residents with dementia, and account for many poor health outcomes, including poor emotional functioning, decline in physical functioning, use of restraint, social isolation and increased risk of abuse. In the Need-driven Dementia compromised Behavior model (NDB) these behaviors are conceptualized as preserved remnants of earlier behavioral patterns that are triggered by unmet needs. Recreational activities tailored to the skill level and interests of residents hold promise as management strategies for agitation and passivity, but there has been no systematic examination of the treatment components (skill level and interest) that are hypothesized to result in therapeutic outcomes. Until recently, no theoretical framework that addressed nursing home residents' needs related to skill level and interests was available. The primary aim of this study is to test the efficacy of recreational activities derived from the NDB model in reducing agitation and passivity and improving engagement, affect and mood in nursing home residents with dementia. These recreational activities will be individually tailored to match the resident's skill level (cognitive ability and physical functioning) and interests (personality). The NDB-derived activities meet needs by addressing three important causes of need-driven behaviors: impaired cognitive ability, impaired physical functioning and premorbid personality. This study will be a randomized clinical trial with repeated measures, in which 140 residents will be randomly assigned to one of four groups for a 3-week intervention. Measures of agitation and passivity, engagement, affect and mood will be taken before and after interventions. It is hypothesized that residents who receive the NDB-derived intervention will exhibit significantly less agitation, less passivity, greater engagement, more positive affect and more positive mood than residents who receive the match to skill only, match to interest only, or control intervention. This study holds promise for improving quality of life for nursing home residents with dementia by using theoretically based activities to respond to their needs.

描述（由申请人提供）：居住在我国疗养院的 150 万人中，大多数是患有痴呆症的老年人，这使他们面临健康状况不佳和生活质量下降的风险。 90% 的痴呆症居民表现出需求驱动的行为，例如烦躁和被动，并导致许多不良的健康结果，包括情绪功能差、身体功能下降、使用约束、社会孤立和虐待风险增加。在需求驱动型痴呆症受损行为模型（NDB）中，这些行为被概念化为由未满足的需求触发的早期行为模式的保留残余。 根据居民的技能水平和兴趣量身定制的娱乐活动有望作为躁动和被动的管理策略，但尚未对假设可产生治疗结果的治疗成分（技能水平和兴趣）进行系统检查。直到最近，还没有解决疗养院居民与技能水平和兴趣相关的需求的理论框架。本研究的主要目的是测试源自 NDB 模型的娱乐活动在减少痴呆症疗养院居民的烦躁和被动性以及改善参与度、情感和情绪方面的功效。这些娱乐活动将根据居民的技能水平（认知能力和身体机能）和兴趣（个性）进行单独定制。 NDB 衍生活动通过解决需求驱动行为的三个重要原因来满足需求：认知能力受损、身体功能受损和病前人格。这项研究将是一项重复测量的随机临床试验，其中 140 名居民将被随机分配到四组中的一组，进行为期 3 周的干预。在干预之前和之后将测量激动和被动、参与、情感和情绪。据假设，与仅接受技能匹配、仅兴趣匹配或控制干预的居民相比，接受 NDB 衍生干预的居民将表现出明显更少的躁动、更少的被动性、更大的参与度、更积极的影响和更积极的情绪。这项研究有望通过基于理论的活动来满足患有痴呆症的疗养院居民的需求，从而改善他们的生活质量。