Follow-Through of Palliative Care after Nursing Home Admission

入住疗养院后姑息治疗的后续工作

• 批准号: 8717368
• 负责人: Joan Gleba Carpenter
• 金额: $ 4.27万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8717368
• 关键词: Address; Adherence; Admission activity; Advance Care Planning; Age-Years; Aging; Area; Care given by nurses; Caring; Categories; Clinical Practice Guideline; Code; Communication; Complex; Consult; Continuing Education; Data; Data Analyses; Data Collection; Development; Discipline of Nursing; Elderly; Family; Fellowship; Goals; Grant; Health Services Research; Healthcare; Home Nursing Care; Hospital Nursing; Hospital Planning; Hospitalization; Hospitals; Individual; Inpatients; Interview; Life; Measures; Medical; Medicare; Methods; National Institute of Nursing Research; Nurses; Nursing Homes; Outcome; Pain; Pain management; Palliative Care; Participant; Patients; Perception; Psychosocial Assessment and Care; Public Opinion; Qualitative Research; Quality of Care; Quality of life; RQ2; Recommendation; Recruitment Activity; Rehabilitation Nursing; Rehabilitation therapy; Reporting; Research; Research Methodology; Research Personnel; Research Project Grants; Research Training; Science; Scientist; Skilled Nursing Facilities; Statutes and Laws; Strategic Planning; Structure; Surveys; Symptoms; Terminal Disease; Training; base; care delivery; career; cost; experience; health care quality; hospice environment; hospital readmission; improved; interdisciplinary approach; interest; palliative; person centered; preference; programs; psychosocial; public health relevance; skills; symptom management

DESCRIPTION (provided by applicant): The long term objective of this research training grant is to prepare the applicant as a nurse scientist in aging and palliative care research. The goal of the fellowship is to obtain competency in qualitative research methods, data collection and analysis, and dissemination of findings. Public opinion research about palliative care reveals that 62% of US healthcare consumers over 65 years of age want access to palliative care if they have a serious illness. Eighty-five percent of residents in nursing homes are over the age of 65. Despite being promoted as an effective method to deliver high quality care to nursing home residents with serious life limiting illness, palliative care is not widely available. This could rsult in unintended emphasis on aggressive rehabilitation over palliative goal oriented care, little acknowledgement of patient's values and preferences for palliative care, and missed opportunities for symptom management including psychosocial and spiritual support. There is limited research that follows patients after a hospital-based palliative care consult and subsequent discharge to a nursing home without hospice support. This research will improve understanding of factors and conditions of care delivery in nursing homes after receiving a palliative care consult during hospitalization and measure patient perceptions of care. The specific aims of this qualitative descriptive study are to: Aim 1) Describe the continuity of patients palliative care plan from the hospital to the nursing home, and Aim 2) Describe the experience of patients admitted to the nursing home following discharge from a hospital with a palliative care consult. Up to thirty participants will be recruited from an inpatient hospital palliative care program with discharge planned to one of two nursing homes for post-hospital care without hospice support. Semi-structured interviews, and chart reviews will be conducted. Iterative data coding and analysis will identify categories and themes to develop a rich description of the experience and outcomes of patients admitted to the nursing home after discharge from a hospital with a palliative care consult. In congruence with the National Institute of Nursing Research, this project seeks improve understanding of outcomes for individuals with serious life limiting illness across care settings and positively impact the quality of life for peple living with serious complex life-limiting illness in nursing homes.

描述（由申请人提供）：本研究培训赠款的长期目标是为申请人做好准备，成为衰老和姑息治疗研究的护士科学家。目标 奖学金是获得定性研究方法，数据收集和分析以及发现的能力。关于姑息治疗的公众舆论研究表明，65岁以上的美国医疗保健消费者中，有62％的人希望获得姑息治疗，如果他们患有严重疾病。 85％的疗养院居民超过65岁。尽管被促进了一种有效的方法，可以为患有严重生命的疾病的养老院居民提供高质量的护理，但姑息治疗并未得到广泛的可用。这可能会意想不到的重点是积极的康复，而不是姑息目标的护理，对患者的价值观几乎没有承认和姑息治疗的偏好，以及错过的症状管理机会，包括心理社会和精神上的支持。在没有临终关怀的没有临终关怀的情况下，在医院的姑息治疗咨询并随后出院后，患者进行了有限的研究。这项研究将在住院期间接受姑息治疗咨询并衡量患者对护理的看法后，在接受姑息治疗后，对疗养院中护理服务的因素和条件的理解。这项定性描述性研究的具体目的是：目标1）描述从医院到疗养院的患者姑息治疗计划的连续性，而AIM 2）描述从医院出院后接受姑息护理咨询后送达疗养院的患者的经验。将在一个住院医院的姑息治疗计划中招募多达30名参与者，并计划出院给两个疗养院中的一家，以供医院后护理，而无需临终关怀。将进行半结构化访谈和图表审查。迭代数据编码和分析将确定类别和主题，以对从医院出院后通过姑息治疗咨询出院后对养老院的经验和结果进行丰富的描述。与国家研究所的一致 在护理研究中，该项目正在寻求改善对严重生命的人的成果的理解，从而在跨护理环境中限制了疾病，并对疗养院中严重的复杂生命障碍疾病生活的生活质量产生积极影响。