The Residential Care Transition Module

住院护理过渡模块

• 批准号: 9275911
• 负责人: JOSEPH E. GAUGLER
• 金额: $ 50.98万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-01 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9275911
• 关键词: Activities of Daily Living; Admission activity; Age-Years; Alzheimer' s Disease; Assisted Living Facilities; Bereavement; Caregivers; Caring; Chronic; Clinical Research; Communication; Competence; Consultations; Continuity of Patient Care; Control Groups; Counseling; Dementia; Diagnosis; Disease; Elderly; Emotional; Enrollment; Environment; Evaluation; Event; Family; Family Caregiver; Family member; Health; Home Nursing Care; Impaired cognition; Impairment; Individual; Institutionalization; Intervention; Interview; Life; Literature; Long-Term Care; Medicare; Memory; Mental Depression; Mental Health; Methods; Nursing Homes; Outcome; Patients; Perception; Pharmacology; Randomized; Randomized Controlled Trials; Recruitment Activity; Rehabilitation therapy; Reporting; Research; Role; Self Efficacy; Stress; Structure; United States; Visit; care giving burden; caregiver interventions; coping; cost; depressive symptoms; effective intervention; emotional distress; family caregiving; improved; instrumental activity of daily living; prevent; psychoeducation; psychological distress; psychosocial; public health relevance; stressor; success; therapy design; treatment as usual

 DESCRIPTION (provided by applicant): Emerging research on family caregiving and institutionalization has found that families do not disengage from care responsibilities following relatives' admissions to residential long-term care settings. Families instead remain involved in a spectrum of care activities ranging from instrumental activities of daily living to emotional support. Perhaps for these reasons, a number of studies have noted that caregiving stress, depression, or other key outcomes remain stable or sometimes increase following residential long-term care (RLTC) entry for certain types of caregivers. A few interventions have attempted to increase family involvement after institutionalization, but no rigorous studies have demonstrated that these interventions are effective in helping families navigate transitions to RLTC environments. The Residential Care Transition Module (RCTM) provides 6 formal sessions of consultation (one-to-one and family sessions) over a 4-month period to those family caregivers who have recently admitted a relative to a RLTC setting. In this randomized controlled trial, family members who have admitted a cognitively impaired relative to a RLTC setting in the past 3 months will be randomly assigned to the RCTM [(n = 120)] or a usual care control condition [(n = 120)]. A mixed methods analysis will be used to pursue the following aims: Specific Aim 1) Assess whether the RCTM yields statistically significant reductions in family members' primary subjective stress and negative mental health outcomes; Specific Aim 2) Determine whether family members who receive the RCTM will indicate statistically significant decreases in secondary role strains over a 12-month period when compared to usual care controls; Specific Aim 3) Determine whether RCTM family members report statistically significant decreases in residential care stress when compared to family members in the usual care control group; and Specific Aim 4) Delineate the mechanism of action of RCTM under conditions of high and low success by "embedding" qualitative components (30 semi-structured interviews) at the conclusion of the 12-month evaluation. The proposed project will fill an important clinical and research gap by evaluating a psychosocial intervention designed for families following RLTC placement that determines whether and how the RCTM can help families better navigate the residential care transitions of cognitively impaired relatives.

 描述（由应用程序提供）：关于家庭护理和制度化的新兴研究发现，在亲戚对居民的长期护理环境的招生之后，家庭不会脱离护理责任。而是家庭仍然参与 从日常生活的乐器活动到情感支持的一系列护理活动。也许由于这些原因，许多研究指出，在居民长期护理（RLTC）进入某些类型的护理人员之后，护理压力，抑郁或其他关键结果保持稳定或有时会增加。一些干预措施试图在制度化后增加家庭参与，但没有严格的研究表明，这些干预措施有效地帮助家庭导航过渡到RLTC环境。住宅护理过渡模块（RCTM）在为期4个月的时间内提供了6次正式的咨询（一对一和家庭会议），向那些最近承认与RLTC环境相关的家庭护理人员。在这项随机对照试验中，在过去三个月中，相对于RLTC设置的认知受损的家庭成员将随机分配给RCTM [（n = 120）]或通常的护理控制条件[（n = 120）]。混合方法分析将用于追求以下目的：具体目的1）评估RCTM是否会在家庭成员的主要主观压力和负面心理健康结果中产生统计学上的显着减少；具体目的2）确定接受RCTM的家庭成员是否表明与常规护理对照相比，在12个月内，次要角色菌株的统计显着降低；具体目的3）确定RCTM家庭成员是否报告了与通常的护理对照组的家庭成员相比，居民护理压力的统计学意义下降；和具体目的4）在12个月评估的结论中，通过“嵌入”定性组件（30个半结构化访谈）来描述RCTM在高成功和低成功条件下的作用机理。拟议的项目将通过评估为RLTC安置后设计的心理社会干预措施来填补重要的临床和研究差距，该干预措施决定了RLTC安置后，该干预措施决定了RCTM是否以及如何帮助家庭对居民的认知障碍相关物的护理过渡进行导航。