The ACTIVE Intervention to Improve Hospice Caregiver Pain Management

改善临终关怀护理人员疼痛管理的积极干预措施

• 批准号: 8487258
• 负责人: Debra Parker Oliver
• 金额: $ 43.86万
• 依托单位: UNIVERSITY OF MISSOURI-COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-15 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8487258
• 关键词: Address; Adult; Advocate; Affect; Analgesics; Boxing; Caregivers; Caring; Certification; Child; Chronic; Communication; Communities; Costs and Benefits; Data; Decision Making; Direct Costs; Effectiveness; Effectiveness of Interventions; Emotional; Evaluation; Face; Facilities and Administrative Costs; Family; Family member; Foundations; Friends; Fright; Future; Hand; Health; Home environment; Hospice Care; Hospice Programs; Individual; Institute of Medicine (U.S.); Institutes; Intervention; Interview; Length; Licensing; Link; Manuals; Manuscripts; Medicine; Methods; Misinformation; Mission; Names; Nature; Nurses; Outcome; Outcome Measure; Pain; Pain Measurement; Pain Research; Pain management; Palliative Care Nursing; Patient Care; Patient Participation; Patients; Perception; Pharmaceutical Preparations; Physicians; Pilot Projects; Population; Process; Provider; Questionnaires; Randomized; Randomized Controlled Trials; Regimen; Reporting; Research; Sample Size; Services; Severities; Shoulder; Site; Sleep; Social Workers; Spouses; Structure; Technology; Telephone; Terminal Disease; Testing; Theoretical model; Translating; Translations; Wife; caregiver education; cost; cost effective; cost effectiveness; design; empowered; end of life; evidence base; experience; follow-up; group intervention; hospice environment; improved; instrument; interest; intervention effect; loved ones; meetings; member; methionylmethionine; non-compliance; prevent; public health relevance; response; standard care; standard of care

DESCRIPTION (provided by applicant): In congruence with the mission of NINR to promote and improve the health of individuals, families, communities, and populations and in response to the 11 additional institutes supporting the solicitation of proposals to address pain management (PA-07-282) this proposal seeks to test an intervention which will improve the perceptions of pain management by caregivers of hospice patients, resulting in improved pain control for those facing terminal illness. Following encouraging pilot testing the intervention has been named ACTIVE (Assessing Caregivers for Team Intervention through Video Encounters). This project proposes to strengthen hospice care for patients by enabling patient/family participation in hospice interdisciplinary teams through use of a commercially available video technologies. This randomized controlled trial will definitively test the effect of caregiver/patient participation in hospice interdisciplinary team meetings on the caregiver's perception of pain and the effect of changes in perception on reported patient pain. The study aims to 1) test the effectiveness of the ACTIVE intervention, specifically focusing on the changes in caregiver perceptions of pain, the effectiveness of caregiver assessment to identify individuals who will most benefit from the ACTIVE intervention, and the effect of changes in perception on severity of pain reported by the patient, 2) evaluate the cost and benefits and, 3) evaluate the potential for translation of the ACTIVE intervention into routine hospice care. The theoretical model modified from Saltz and Schaefer advocate the assessment of the organizational context, team process, team structure, and outcomes as a foundation for the intervention. This proposal randomizes 544 hospice caregivers into two groups (standard care and intervention) and uses qualitative and quantitative methods in parallel and equal status. The qualitative design includes observations of team meetings, record reviews, and interviews with staff and family members. The quantitative component uses standardized instruments to measure the outcomes of participation. If successful, the ACTIVE intervention can be easily translated into other settings, holding potential to improve pain management for all suffering chronic and terminal pain.

描述（由申请人提供）：与NINR的使命一致，以促进和改善个人，家庭，社区和人口的健康状况，并回应其他支持征求提议以解决疼痛管理的提案的其他机构（PA-07）（PA-07） -282）该提案旨在测试一种干预措施，该干预措施将改善临终关怀患者护理人员对疼痛管理的看法，从而改善面临绝症患者的疼痛控制。在鼓励试点测试之后，干预措施已被命名为主动（通过视频相遇评估团队干预的护理人员）。该项目建议通过使用市售的视频技术来使患者/家庭参与临终关怀跨学科团队，从而加强患者的临终关怀护理。这项随机对照试验将确定测试护理人员/患者参与临终关怀跨学科团队会议对看护人对疼痛的看法以及感知变化对患者疼痛的影响。该研究的目的是1）测试主动干预的有效性，特别关注护理人员对疼痛的看法的变化，看护人评估的有效性，以识别那些将从主动干预中受益最大的个人，以及感知变化对感知变化的影响患者报告的疼痛严重程度，2）评估成本和收益，3）评估将主动干预转化为常规临终关怀护理的潜力。萨尔茨（Saltz）和舍夫（Schaefer）倡导组织环境，团队流程，团队结构和成果的评估作为干预的基础，对理论模型进行了修改。该提议将544个临终关怀者随机分为两组（标准护理和干预），并在并行和平等地位上使用定性和定量方法。定性设计包括观察团队会议，记录评论以及与员工和家人的访谈。定量组件使用标准化工具来衡量参与的结果。如果成功的话，可以轻松地将主动干预转化为其他环境，以改善所有遭受慢性和绝期疼痛的疼痛管理的潜力。

项目成果

Pain management and the African American hospice caregiver: a case report.

• DOI: 10.1177/1049909112469274
• 发表时间: 2013-12
• 期刊: The American journal of hospice & palliative care
• 作者: Baldwin PK;Wittenberg-Lyles E;Kruse RL;Demiris G;Parker Oliver D
• 通讯作者: Parker Oliver D

Exploring oral literacy in communication with hospice caregivers.

探索与临终关怀护理人员沟通中的口语读写能力。

• DOI: 10.1016/j.jpainsymman.2012.11.006
• 发表时间: 2013
• 期刊: Journal of pain and symptom management
• 影响因子: 4.7
• 作者: Wittenberg-Lyles,Elaine;Goldsmith,Joy;Oliver,DebraParker;Demiris,George;Kruse,RobinL;VanStee,Stephanie
• 通讯作者: VanStee,Stephanie

YouTube as a tool for pain management with informal caregivers of cancer patients: a systematic review.

YouTube 作为癌症患者非正式护理人员疼痛管理的工具：系统评价。

• DOI: 10.1016/j.jpainsymman.2014.02.015
• 发表时间: 2014
• 期刊: Journal of pain and symptom management
• 影响因子: 4.7
• 作者: Wittenberg-Lyles,Elaine;ParkerOliver,Debra;Demiris,George;Swarz,Jeff;Rendo,Matthew
• 通讯作者: Rendo,Matthew

Telehealth group interactions in the hospice setting: assessing technical quality across platforms.

临终关怀环境中的远程医疗小组互动：评估跨平台的技术质量。

• DOI: 10.1089/tmj.2012.0185
• 发表时间: 2013
• 期刊: Telemedicine journal and e-health : the official journal of the American Telemedicine Association
• 作者: Demiris,George;ParkerOliver,Debra;Kruse,RobinL;Wittenberg-Lyles,Elaine
• 通讯作者: Wittenberg-Lyles,Elaine

Family caregiver participation in hospice interdisciplinary team meetings: how does it affect the nature and content of communication?

家庭护理人员参与临终关怀跨学科团队会议：它如何影响沟通的性质和内容？

• DOI: 10.1080/10410236.2011.652935
• 发表时间: 2013
• 期刊: Health communication
• 影响因子: 3.9
• 作者: Wittenberg-Lyles,Elaine;Oliver,DebraParker;Kruse,RobinL;Demiris,George;Gage,LAshley;Wagner,Ken
• 通讯作者: Wagner,Ken