Caregiver's Role in Hospitalizing Nursing Home Residents with Advanced Dementia

护理人员在患有晚期痴呆症的疗养院居民住院中的作用

基本信息

批准号：
8848333
负责人：
JANE L GIVENS
金额：
$ 19.82万
依托单位：
HEBREW REHABILITATION CENTER FOR AGED
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：
2014-05-15 至 2016-10-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8848333
关键词：
Accounting Acute Advance Care Planning Advance Directives Adverse event Aging American Benefits and Risks Care given by nurses Caregivers Caring Clinical Clinical Research Communication Continuity of Patient Care Databases Decision Making Dementia Distress Expenditure Family Family member Frequencies Future Geriatric Nursing Geriatrics Goals Health Healthcare Home Nursing Care Hospitalization Hospitals Interdisciplinary Study Intervention Interview Length of Stay Long-Term Care Nursing Medical Medicare Mission Nurses Nursing Homes Pain Patients Perception Personal Satisfaction Physicians Population Procedures Process Provider Proxy Qualitative Methods Qualitative Research Quality of life Recruitment Activity Research Research Methodology Risk Role Sampling Science Skilled Nursing Facilities Structure Telephone Interviews United States National Institutes of Health advanced dementia adverse outcome cohort effective therapy end of life experience improved novel preference prospective psychological distress risk perception satisfaction shared decision making therapy design

Accounting Acute Advance Care Planning Advance Directives Adverse event Aging American Benefits and Risks Care given by nurses Caregivers Caring Clinical Clinical Research Communication Continuity of Patient Care Databases Decision Making Dementia Distress Expenditure Family Family member Frequencies Future Geriatric Nursing Geriatrics Goals Health Healthcare Home Nursing Care Hospitalization Hospitals Interdisciplinary Study Intervention Interview Length of Stay Long-Term Care Nursing Medical Medicare Mission Nurses Nursing Homes Pain Patients Perception Personal Satisfaction Physicians Population Procedures Process Provider Proxy Qualitative Methods Qualitative Research Quality of life Recruitment Activity Research Research Methodology Risk Role Sampling Science Skilled Nursing Facilities Structure Telephone Interviews United States National Institutes of Health advanced dementia adverse outcome cohort effective therapy end of life experience improved novel preference prospective psychological distress risk perception satisfaction shared decision making therapy design

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项目摘要

DESCRIPTION (provided by applicant): The majority of the estimated 5 million Americans with dementia will be cared for in nursing homes (NH), where they will be at risk of hospitalization for the management of acute illnesses. Hospitalizations in this population are costly, may have limited clinical benefit, increase the likelihood of aggressive interventions, and may result in impaired family member well-being. Although health care proxy (HCP) preferences are a major factor in decisions to transfer NH residents to the hospital, there is a fundamental gap in our understanding of their role in decision-making regarding hospitalizations, their perceptions of the risks and benefits of hospitalization, and how the experience of hospitalization influences advance care planning in the post-hospital period. This study will employ an interdisciplinary research team with expertise in geriatric medicine, geriatric nursing science, qualitative research methods and dementia to explore the experience of HCPs in relation to hospitalization of NH residents with advanced dementia. To achieve this objective, we will recruit a prospective cohort of 50 NH residents with advanced dementia who are either transferred to the hospital, or in whom a decision was made not to hospitalize, and use qualitative methods to examine the following: 1. HCP's participation in the decision whether to hospitalize; 2. HCP's perceptions of their own experience and that of the resident during the hospitalization; 3. effect of the hospitalization on advance care planning regarding future hospitalizations; and 4. NH providers (nurses and physicians) perception of HCP's role in decisions concerning hospitalization and advance directives. The project will increase our understanding of how to support and engage HCPs to make well-informed decisions regarding hospitalizations of NH residents with advanced dementia.

描述（由申请人提供）：估计有500万美国人患有痴呆症的美国人中的大多数将在疗养院（NH）中得到照顾，在那里他们将面临住院治疗急性疾病的风险。该人群的住院昂贵，临床益处可能有限，增加了积极干预的可能性，并且可能导致家庭成员福祉受损。尽管医疗保健代理（HCP）的偏好是将NH居民转移到医院的决策的主要因素，但我们对他们在医院的决策中的作用，住院风险和福利的看法以及对住院后的住院治疗计划的理解有根本的差距。这项研究将采用一个跨学科研究团队，具有老年医学，老年护理科学，定性研究方法和痴呆症方面的专业知识，以探索HCP与患有晚期痴呆症的NH居民住院的经验。为了实现这一目标，我们将招募由50名NH居民组成的前瞻性队列，这些NH居民要么被转移到医院，要么决定不住院的决定，并使用定性方法检查以下内容：1。HCP参与决定是否住院的决定； 2。HCP对自己的经验以及住院期间居民的看法； 3。住院对未来住院的预先护理计划的影响；和4。NH提供者（护士和医生）对HCP在有关住院和预先指示的决策中的作用的看法。该项目将提高我们对如何支持和参与HCP的理解，以做出有关NH患有晚期痴呆症的NH居民的明智决定。