Reducing Care-Resistant Behaviors During Oral Hygiene in Persons with Dementia
减少痴呆症患者口腔卫生期间的抗护理行为
基本信息
- 批准号:8577243
- 负责人:
- 金额:$ 34.32万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2012
- 资助国家:美国
- 起止时间:2012-11-03 至 2015-02-28
- 项目状态:已结题
- 来源:
- 关键词:Activities of Daily LivingAdmission activityAffectBehaviorBehavioralCaregiver BurdenCaregiversCaringCerebral cortexClinicalClinical ResearchCommunitiesControl GroupsDataDementiaDental HygieneDenturesEducational process of instructingElderlyExhibitsFrightFutureGingivitisGrowthHealthHealth Care CostsHeart DiseasesHeart RateHemorrhageHippocampus (Brain)HospitalsHyperglycemiaIncidenceIndividualInterventionLip structureMeasuresMediationMethodsModelingMucous MembraneNeurobiologyNursesNursing HomesOralOral cavityOral healthOral mucous membrane structureOrganismOutcomePerceptionPersonsPneumoniaPreventionProceduresQualifyingRandomizedResearchResearch PersonnelResistanceResolutionRiskSalivaSalivarySeveritiesStrokeSweatSweatingSwellingSystemic diseaseTechniquesTestingTimeTooth structureToothbrushingTrainingTreatment Efficacybasebehavior measurementclinical carecostdesignexperiencefightingimprovedinnovationintervention effectmembermultilevel analysisnovelpreventpublic health relevanceresearch studyresponsetoothbrushtreatment as usualtrend
项目摘要
DESCRIPTION (provided by applicant): Nursing home (NH) residents with dementia are often dependent on others for mouth care, yet will react with care-resistant behavior (CRB) when receiving assistance. The oral health of these elders deteriorates in the absence of daily oral hygiene, predisposing them to harmful systemic problems such as pneumonia, hyperglycemia, cardiac disease, and cerebral vascular accidents. The purpose of this study is to determine whether CRBs can be reduced, and oral health improved, through the application of an intervention based on the neurobiological principles of threat perception and fear response. When faced with a threat, all organisms react with "flight-fight" responses. These responses are both autonomic (e.g. elevated heart rate, sweating) and behavioral (e.g. moving away, attacking). Persons with dementia have heightened threat perception as a result of neurobiological changes that affect the cerebral cortex, hippocampus, and amygdale.16 These individuals may interpret mouth care as a threatening action by threatening people. The intervention, called Managing Oral Hygiene Using Threat Reduction (MOUTh), combines best mouth care practices with a constellation of behavioral techniques that reduce threat perception and thereby prevent or de-escalate CRB. The primary specific aims of the study are to: 1)Evaluate the efficacy of the MOUTh intervention for reducing CRBs in persons with dementia; 2)Validate the overall efficacy of the MOUTh intervention using nurse-sensitive oral health outcomes--swollen and bleeding gums, cleanliness of the oral cavity, saliva, and integrity of the lips and oral mucosa; and 3)Calculate the cost of the MOUTh intervention. Using a randomized repeated measures design, 80 elders with dementia from 5 different NHs will be randomized at the individual level to the experimental group, which will receive the intervention, or to the control group, which will receive standard mouth care from research team members who receive training in the proper methods for providing mouth care but no training in resistance recognition or prevention/mediation. Oral health assessments and CRB measurements will be obtained during a 7-day observation period and a 21-day intervention period. Individual growth models using multilevel analysis will be used to estimate the efficacy of the intervention for reducing CRBs in persons with dementia, and to estimate the overall efficacy of the intervention using oral health outcomes. Activity-based costing methods will be used to determine the cost of the MOUTh intervention. At the end of this study, the research team anticipates having a proven intervention that prevents and reduces CRB within the context of mouth care. Long-term objectives include testing the effect of the intervention on systemic illnesses among persons with dementia; examining the transferability of this intervention to other activities of daily living; and disseminating threat reduction interventions to NH staff, which may radically change the way care is provided to persons with dementia.
描述(由申请人提供):患有痴呆症的疗养院 (NH) 居民通常依赖他人进行口腔护理,但在接受援助时会出现抗护理行为 (CRB)。由于缺乏日常口腔卫生,这些老年人的口腔健康状况恶化,容易出现肺炎、高血糖、心脏病和脑血管意外等有害的全身问题。本研究的目的是确定是否可以通过应用基于威胁感知和恐惧反应的神经生物学原理的干预措施来减少 CRB 并改善口腔健康。当面临威胁时,所有生物体都会做出“逃跑-战斗”反应。这些反应既是自主反应(例如心率升高、出汗)又是行为反应(例如离开、攻击)。由于影响大脑皮层、海马体和杏仁核的神经生物学变化,痴呆症患者的威胁感知能力增强。16这些人可能会将口腔护理视为威胁他人的威胁行为。这项名为“利用减少威胁管理口腔卫生”(MOUTh) 的干预措施将最佳口腔护理实践与一系列行为技术相结合,减少威胁感知,从而预防或降低 CRB。该研究的主要具体目标是: 1) 评估 MOUTh 干预对于减少痴呆症患者 CRB 的功效; 2)使用护士敏感的口腔健康结果(牙龈肿胀和出血、口腔清洁度、唾液以及嘴唇和口腔粘膜的完整性)验证口腔干预的总体效果; 3) 计算 MOUTh 干预的成本。采用随机重复测量设计,来自 5 个不同 NH 的 80 名患有痴呆症的老年人将在个人层面上被随机分配到实验组,该组将接受干预措施,或对照组,该组将接受由研究团队成员提供的标准口腔护理。接受提供口腔护理的正确方法的培训,但没有接受抵抗识别或预防/调解的培训。口腔健康评估和 CRB 测量将在 7 天的观察期和 21 天的干预期内获得。使用多水平分析的个体生长模型将用于估计减少痴呆症患者 CRB 的干预措施的功效,并使用口腔健康结果估计干预措施的总体功效。将使用基于活动的成本计算方法来确定 MOUTh 干预的成本。在这项研究结束时,研究小组预计将有一种行之有效的干预措施,可以在口腔护理的背景下预防和减少 CRB。长期目标包括测试干预措施对痴呆症患者全身性疾病的影响;检查这种干预措施是否可以转移到其他日常生活活动中;向 NH 工作人员传播减少威胁的干预措施,这可能会从根本上改变向痴呆症患者提供护理的方式。
项目成果
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RITA A JABLONSKI其他文献
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{{ truncateString('RITA A JABLONSKI', 18)}}的其他基金
Testing Dementia Caregiver TeleCoaching to Reduce Episodes of Abuse and Neglect by Recognizing and Managing Care-Resistant Behaviors
测试痴呆症护理人员远程辅导,通过识别和管理抗护理行为来减少虐待和忽视的发生
- 批准号:
10478199 - 财政年份:2021
- 资助金额:
$ 34.32万 - 项目类别:
Testing Dementia Caregiver TeleCoaching to Reduce Episodes of Abuse and Neglect by Recognizing and Managing Care-Resistant Behaviors
测试痴呆症护理人员远程辅导,通过识别和管理抗护理行为来减少虐待和忽视的发生
- 批准号:
10683297 - 财政年份:2021
- 资助金额:
$ 34.32万 - 项目类别:
Testing Dementia Caregiver TeleCoaching to Reduce Episodes of Abuse and Neglect by Recognizing and Managing Care-Resistant Behaviors
测试痴呆症护理人员远程辅导,通过识别和管理抗护理行为来减少虐待和忽视的发生
- 批准号:
10300245 - 财政年份:2021
- 资助金额:
$ 34.32万 - 项目类别:
Reducing Care-Resistant Behaviors During Oral Hygiene in Persons with Dementia
减少痴呆症患者口腔卫生期间的抗护理行为
- 批准号:
8628670 - 财政年份:2012
- 资助金额:
$ 34.32万 - 项目类别:
Reducing Care-Resistant Behaviors During Oral Hygiene in Persons with Dementia
减少痴呆症患者口腔卫生期间的抗护理行为
- 批准号:
8081634 - 财政年份:2011
- 资助金额:
$ 34.32万 - 项目类别:
Reducing Care-Resistant Behaviors During Oral Hygiene in Persons with Dementia
减少痴呆症患者口腔卫生期间的抗护理行为
- 批准号:
8250337 - 财政年份:2011
- 资助金额:
$ 34.32万 - 项目类别:
IMPROVING ORAL CARE PROVIDED BY NURSING ASSISTANTS
改善护理助理提供的口腔护理
- 批准号:
6949043 - 财政年份:2004
- 资助金额:
$ 34.32万 - 项目类别:
IMPROVING ORAL CARE PROVIDED BY NURSING ASSISTANTS
改善护理助理提供的口腔护理
- 批准号:
6887177 - 财政年份:2004
- 资助金额:
$ 34.32万 - 项目类别:
ELDER TRANSFER FROM NURSING HOME TO EMERGENCY DEPARTMENT
老年人从疗养院转移到急诊室
- 批准号:
6529351 - 财政年份:2002
- 资助金额:
$ 34.32万 - 项目类别:
ELDER TRANSFER FROM NURSING HOME TO EMERGENCY DEPARTMENT
老年人从疗养院转移到急诊室
- 批准号:
6402007 - 财政年份:2001
- 资助金额:
$ 34.32万 - 项目类别:
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