Supporting Family Caregivers with Technology for Dementia Home Care (FamTechCare)

通过痴呆症家庭护理技术支持家庭护理人员 (FamTechCare)

基本信息

批准号：
8606108
负责人：
KRISTINE N. WILLIAMS
金额：
$ 50.46万
依托单位：
UNIVERSITY OF IOWA
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-03-04 至 2018-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8606108
关键词：
Address Adoption Affect Age Aging Alzheimer&apos s Disease Americas Attention Behavior Behavioral Caregiver Burden Caregivers Caring Characteristics Clinical Trials Clinics and Hospitals Code Communication Computer software Control Groups Data Dementia Diagnosis Drug usage Equipment and supply inventories Family Family Caregiver Feedback Funding Goals Health Insurance Portability and Accountability Act Health Personnel Healthcare Systems Home environment Impaired cognition Institute of Medicine (U.S.)Institutional Review Boards Internet Intervention Iowa Kansas Knowledge Lead Link Managed Care Memory Mental Depression Methods Mission Modeling Monitor Morbidity - disease rate Nurses Nursing Homes Outcome Pattern Persons Population Problem behavior Procedures Protocols documentation Psychotropic Drugs Public Health Randomized Records Reporting Research Role Secure Self Care Services Site Sleep Stress Surveys Technology Telephone Testing Time Translations Typology United States National Institutes of Health Universities Video Recording Videotape base behavior observation caregiving cost cost effectiveness effective intervention empowered group intervention improved indexing meetings mortality multidisciplinary new technology patient home care public health relevance response satisfaction telehealth therapy development

项目摘要

DESCRIPTION (provided by applicant): This clinical trial will test the FamTechCare intervention that uses multidisciplinary professional guidance based on in-home video monitoring to support family caregivers in managing behaviors of persons with dementia (PWD). Families provide the majority of care for PWD at home. However the stress of caregiving is so significant that it increases caregiver morbidity and mortality. Stress is magnified by disruptive behaviors that frequently lead to nursing home placement. In-home video monitoring allows experts to assess behaviors of PWD and to identify antecedents, recommend specific interventions, and subsequently evaluate caregiver outcomes. FamTechCare uses new technology to link family caregivers to experts for guidance in managing disruptive behaviors, supporting continued care at home while reducing the negative effects of caregiving. Caregiver-PWD dyads (N=88) from the University of Iowa Hospital and Clinics and the University of Kansas Alzheimer's Disease Center will be randomly assigned to intervention or control groups. Both groups will record behaviors during daily care for 3 months using a home monitoring unit. Notably, this new technology captures 15 minutes prior to the behavior, thus recording behavior triggers and precursors. Intervention group videos will be auto-uploaded to a HIPAA-secure Internet site for weekly team review with in-home feedback to caregivers in behavior management. The time and attention equivalent control group will receive a weekly phone call from a nurse, but their recorded videos will be held for review and feedback after 3 months. This study builds on the PI's CTSA study that verified feasibility for using in-home monitoring and professional observation of behaviors to guide caregivers in managing care at home. Our team found the video-data essential to identify antecedents, recommend specific interventions, and subsequently evaluate responses. Caregivers were highly satisfied with reductions in disruptive behaviors and their own stress and burden. This study expands the IRB-approved protocols, procedures, HIPAA-secure software interface, and protocols for internet-based team meetings and caregiver feedback. Study aims are to identify interventions, based on in-home observations, to assist caregivers in behavior management. Between-group effects on outcomes, including PWD disruptive behaviors and caregiver burden and other negative outcomes will be compared using linear mixed modeling. We will evaluate ease of use and satisfaction, cost-efficiency, and factors influencing likelihood of translation into practice. Thi is the first study to test new technology for direct observation and immediate feedback to empower families to manage PWD behaviors at home while reducing caregiver stress and morbidity. Technology links caregivers to individualized expert guidance, acknowledging the importance and burden of their role. This study addresses NIH missions and the 2012 National Plan to Address Alzheimer's disease goals, integrating strategies to promote adoption and use of aging services technologies in interventions that will reduce negative caregiver outcomes, a growing public health problem.

描述（由申请人提供）：这项临床试验将测试FamTechcare干预措施，该干预使用基于家庭视频监控的多学科专业指导，以支持家庭护理人员管理患有痴呆症患者（PWD）的人行为。家庭在家中提供大多数PWD的护理。但是，护理的压力是如此明显，以增加护理人员的发病率和死亡率。经常导致疗养院安置的破坏行为会放大压力。在家中的视频监控使专家可以评估PWD的行为并确定先决条件，推荐特定的干预措施，并随后评估护理人员的结果。 FAMTECHCARE使用新技术将家庭护理人员与专家联系起来，以指导管理破坏性行为，支持在家中持续的护理，同时减少护理的负面影响。来自爱荷华大学医院和诊所和堪萨斯大学阿尔茨海默氏病中心的Caregiver-PWD二元组（n = 88）将随机分配给干预或对照组。两组将使用家庭监控单元在每日护理中记录3个月的行为。值得注意的是，这项新技术在行为前15分钟捕获，从而记录行为触发和前体。干预小组视频将自动增加到HIPAA-SECURE互联网站点，以进行每周团队审查，并在家中对护理人员的行为管理反馈。时间和注意力等效的对照组将收到护士的每周电话，但他们的录制视频将在3个月后举行审查和反馈。这项研究基于PI的CTSA研究，该研究验证了使用家庭监测和对行为的专业观察的可行性，以指导护理人员在家管理护理。我们的团队发现视频数据是确定先决条件，推荐特定干预措施并随后评估响应所必需的。护理人员对减少颠覆性行为以及自己的压力和负担非常满意。这项研究扩展了IRB批准的协议，程序，HIPAA-SECURE软件接口以及基于Internet的团队会议和护理人员反馈的协议。研究的目的是根据家庭观察确定干预措施，以帮助护理人员进行行为管理。组间对结果的影响，包括PWD破坏性行为和护理人员负担和其他负面结果，将使用线性混合建模进行比较。我们将评估易用性和满意度，成本效益以及影响转化为实践可能性的因素。这是测试新技术直接观察和立即反馈的第一项研究，以使家庭能够在家中管理PWD行为，同时减少护理人员的压力和发病率。技术将护理人员与个性化的专家指导联系起来，承认其角色的重要性和负担。这项研究旨在解决NIH任务和2012年国家计划，旨在解决阿尔茨海默氏病目标，整合策略，以促进对衰老服务技术的采用和使用在干预措施中，从而减少负面照顾者的结果，这是一个日益增长的公共卫生问题。