Shared Decision Making to Improve Palliative Care in the Nursing Home

共同决策以改善疗养院的姑息治疗

• 批准号: 9355095
• 负责人: Debra Parker Oliver
• 金额: $ 19.21万
• 依托单位: UNIVERSITY OF MISSOURI-COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-30 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9355095
• 关键词: Advance Directives; American; Belief; Caring; Clinical; Communication; Communities; Control Groups; Data Set; Decision Making; Dementia; Education; Elderly; Enrollment; Family; Family Nursing; Family member; Frustration; Geriatric Nursing; Goals; Guilt; Health; Health Personnel; Healthcare; Home Nursing Care; Hospice Care; Individual; Internet; Intervention; Interview; Life; Long-Term Care; Medicare; Mental Depression; Methods; Mission; Nursing Homes; Online Systems; Outcome; Pain; Pain management; Palliative Care; Palliative Care Nursing; Patients; Pilot Projects; Population; Process; Proxy; Qualitative Methods; Quality of Care; Quality of life; Questionnaires; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Research; Skilled Nursing Facilities; Symptoms; Technology; Testing; Translating; United States National Institutes of Health; Validity and Reliability; Video Recording; Work; base; design; end of life; end of life care; expectation; experience; family support; frailty; group intervention; hospice environment; improved; improved outcome; instrument; meetings; palliative; patient home care; person centered; pilot trial; prevent; public health relevance; reduce symptoms; satisfaction; shared decision making; symposium; systematic review; treatment as usual

 DESCRIPTION (provided by applicant): Shared Decision Making to Improve Palliative Care in the Nursing Home Abstract Twenty-eight percent of Americans over the age of 65 die in a nursing home. Research has found the quality of care of end-of-life care in nursing homes to have many challenges. It has also been documented that family members, especially those living at a distance, want to be involved in the care of their resident and family support can be beneficial to residents. Family members' involvement in decision-making in the nursing home setting improves outcomes for residents with life-limiting illnesses. Shared decision-making is a process wherein a healthcare choice is jointly made by a healthcare provider and a resident or resident's proxy (14, 15), often a family member. This proposal seeks to facilitate SDM among family members, residents with life- limiting illnesses (who are not enrolled in hospice), and the nursing home care team. Our overall research question (RQ) asks: To what extent are outcomes for family member and residents with life limiting illnesses associated with SDM via web-conferencing in the nursing home? Our overall hypothesis (H) is that SDM among family members, residents (when possible), and skilled nursing home staff via web- conferencing will improve outcomes for family members and residents with life-limiting illnesses. We propose exploratory mixed methods randomized clinical trial pilot to test the effect of shared decision making using web-based conferencing on the depression and burden of family members and the pain of nursing home residents. We seek to translate our hospice experience with web-conferencing and shared decision making into the nursing home setting with geriatric residents appropriate for palliative care.

 描述（由申请人提供）：改善疗养院姑息治疗的共同决策 摘要 28% 的 65 岁以上美国人在疗养院死亡。 研究发现临终关怀的护理质量。据记载，家庭成员，特别是那些居住在远处的家庭成员，希望参与照顾其居民，而家庭支持可能有利于居民参与决策。在疗养院环境中制作改善患有限制生命疾病的居民的治疗结果 共同决策是一个过程，因此医疗保健选择是由医疗保健提供者和居民或居民代理人 (14, 15)（通常是家庭成员）共同做出的。该提案旨在促进。家庭成员、患有生命限制疾病的居民（未参加临终关怀中心）和疗养院护理团队的 SDM 我们的总体研究问题 (RQ) 询问：家庭成员和患有生命限制疾病的居民的结果有多大。与 SDM 相关的疾病我们的总体假设 (H) 是，通过网络会议在家庭成员、居民（如果可能）和熟练的疗养院工作人员之间进行 SDM 将改善患有致命疾病的家庭成员和居民的治疗结果。我们提出混合方法随机临床试验试点，以测试使用基于网络的会议的共同决策对家庭成员的抑郁和负担以及疗养院居民的痛苦的影响。我们寻求通过网络会议和共享来转化我们的临终关怀经验。决策纳入适合姑息治疗的老年居民的疗养院环境。

项目成果

A Pilot Study of An Intervention to Increase Family Member Involvement in Nursing Home Care Plan Meetings.

• DOI: 10.1177/0733464820946927
• 发表时间: 2021-09
• 期刊: Journal of applied gerontology : the official journal of the Southern Gerontological Society
• 作者: Oliver DP;Rolbiecki AJ;Washington K;Kruse RL;Popejoy L;Smith JB;Demiris G
• 通讯作者: Demiris G