Engaging Hospitalized Patients and Family Caregivers to Identify and Prevent Delirium Superimposed on Dementia: An Intervention Mapping Approach.

让住院患者和家庭护理人员参与识别和预防痴呆症叠加的谵妄：一种干预映射方法。

基本信息

批准号：
10642332
负责人：
Blair Pollitt Golden
金额：
$ 17.25万
依托单位：
UNIVERSITY OF WISCONSIN-MADISON
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-06-15 至 2028-02-29
项目状态：
未结题

项目摘要

PROJECT SUMMARY/ABSTRACT This career development proposal will provide Blair Golden, MD MS, a physician-scientist at The University of Wisconsin-Madison School of Medicine and Public Health, with the training required for success as an independent investigator researching interventions to improve the delivery of patient- and family-centered care for hospitalized adults with Alzheimer's Disease and Alzheimer's Disease Related Dementias (AD/ADRD). Nearly half of all hospitalized patients with AD/ADRD develop delirium superimposed on dementia (DSD), which is associated with significant morbidity and mortality. DSD also leads to adverse impacts for family caregivers, compounding pre-existing caregiver stresses and negative impacts on wellbeing. Despite its substantial burden, DSD remains under-detected and poorly managed in hospitalized patients due in part to under-developed approaches for assessing pre-existing impairment and other individual characteristics that are critical to delivering tailored prevention strategies. Evidence-based programs for delirium have emphasized the role of family engagement in recognition and management, but approaches to proactively engaging family members and patients with AD/ADRD in DSD detection and prevention remain underdeveloped. The overarching goal of this K23 proposal is to establish patient and family caregiver-centered communication and engagement practices capable of proactively addressing information needs and soliciting participation in DSD identification and prevention that are feasible and scalable. Understanding family and patient communication and information needs regarding DSD could not only improve the delivery of patient and family-centered care, but also potentially reduce family and patient suffering and improve DSD identification and prevention. As a junior faculty member at an institution with extensive infrastructure to support early-stage investigators, Dr. Golden is in an optimal environment to complete the proposed research project and pursue advanced training. Her career development plan includes formal coursework, intensive mentorship, and experiential training in 1) mixed methods, survey, and intervention mapping approaches 2) delirium assessment and prevention 3) research engagement and clinical care of patients with AD/ADRD and 4) pragmatic clinical trial design. To ensure success, she has identified expert mentors in these disciplines with outstanding track records in training independent investigators and secured protected time for this work. This award addresses a significant clinical dilemma and serious gap in AD/ADRD and delirium research while affording the education and mentored research experience critical to prepare Dr. Golden to lead an independent research program.

项目概要/摘要该职业发展提案将为布莱尔·戈尔登 (Blair Golden) 提供医学博士、理学硕士、英国大学医学科学家威斯康星-麦迪逊医学与公共卫生学院，拥有成功成为一名医生所需的培训独立研究者研究干预措施以改善以患者和家庭为中心的护理的提供适用于患有阿尔茨海默病和阿尔茨海默病相关痴呆症 (AD/ADRD) 的住院成人。近一半的 AD/ADRD 住院患者会出现谵妄并伴有痴呆 (DSD)，这与显着的发病率和死亡率相关。渠务署亦对家庭造成不利影响护理人员，加剧了护理人员原有的压力和对健康的负面影响。尽管其 DSD 造成了巨大的负担，但在住院患者中仍未得到充分检测和管理不善，部分原因是评估先前存在的损伤和其他个人特征的方法尚不成熟对于提供量身定制的预防策略至关重要。针对谵妄的循证计划强调家庭参与在认可和管理中的作用，但积极参与家庭的方法成员和 AD/ADRD 患者在 DSD 检测和预防方面仍不发达。这 K23 提案的总体目标是建立以患者和家庭护理人员为中心的沟通和能够主动满足信息需求并吸引参与 DSD 的参与实践可行且可扩展的识别和预防。了解家人和患者的沟通有关 DSD 的信息需求不仅可以改善以患者和家庭为中心的护理的提供，而且还可能减少家庭和患者的痛苦，并改善 DSD 的识别和预防。作为一个博士是一家拥有广泛基础设施支持早期研究人员的机构的初级教员。 Golden 处于完成拟议研究项目和接受高级培训的最佳环境中。她的职业发展计划包括正式课程、强化指导和体验式培训：1) 混合方法、调查和干预绘图方法 2) 谵妄评估和预防 3) AD/ADRD 患者的研究参与和临床护理以及 4) 实用的临床试验设计。到为了确保成功，她在这些学科中找到了在培训方面拥有出色记录的专家导师独立调查员并为这项工作争取了受保护的时间。该奖项涉及重大临床在提供教育和指导的同时，AD/ADRD 和谵妄研究中的困境和严重差距研究经验对于戈尔登博士领导独立研究项目至关重要。