A Person-Centered Environmental and Sensory Intervention for Nursing Home Residents with Dementia who Exhibit Persistent Vocalizations

针对表现出持续发声的痴呆症疗养院居民的以人为本的环境和感官干预

• 批准号: 10456225
• 负责人: JUSTINE SUZETTE SEFCIK
• 金额: $ 15.37万
• 依托单位: DREXEL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10456225
• 关键词: Address; Adverse drug effect; Agitation; Antipsychotic Agents; Attention; Behavior; Behavior Therapy; Behavioral Symptoms; Chemicals; Clinical Trials; Data; Dementia; Development; Distress; Doctor of Philosophy; Elements; Environment; Environmental Monitoring; Equipment; Exhibits; Family member; Foundations; Frequencies; Future; Goals; Heart Rate; Home environment; Hour; Human Resources; Image; Intervention; Intervention Studies; Interview; Measurement; Measures; Mentored Patient-Oriented Research Career Development Award; Mentorship; Mission; Modeling; Moods; Nature; Nursing Homes; Participant; Pennsylvania; Perception; Persons; Pharmaceutical Preparations; Phase I Clinical Trials; Physiological; Play; Psyche structure; Public Health; Quality of life; Research; Research Personnel; Research Proposals; Resources; Role; Sensory; Stress; Suggestion; Surveys; Technology; Testing; Therapeutic; Time; Training; United States Centers for Medicare and Medicaid Services; United States National Institutes of Health; Universities; Work; Wrist; base; biobehavioral measurement; care providers; cost; cost effective; design; effectiveness evaluation; exhaustion; experience; feasibility testing; improved; innovation; intervention delivery; member; nature center; novel; nursing intervention; person centered; post intervention; prevent; psychological symptom; restraint; sensor; skills; sound; symptom management; theories; uptake; vocalization

Project Summary/Abstract This K23 application describes the background and experience of the applicant, Justine S. Sefcik, PhD, RN. It details her plan to acquire the training necessary to achieve her long-term goal to be an independent investigator developing and testing adaptive, non-pharmacological environmental and sensory interventions involving technology to reduce persistent vocalizations (PVs), a common behavioral and psychological symptom of dementia. PVs refer to vocal sounds or inappropriate use of words which are repetitive, persistent, and are upsetting to persons exhibiting them or to others in the same environment. There are known profound negative effects to persons residing in nursing homes (NH) living with dementia and exhibiting PVs, including physical exhaustion, reduced quality of life, and some NH staff using inappropriate interventions (e.g., administering chemical restraints). Unmet needs, such as a need for sensory stimulation and engagement in meaningful activities, may be a contributor to PVs, according to the Need-driven Dementia-compromised Behavior model. Innovative non-pharmacological interventions are urgently needed to reduce PVs. This proposal includes a new application of a nature-based intervention that includes the projection of person- centered nature images with the playing of associated nature sounds for NH residents with dementia and PVs. The intervention, Environmental And Sensory Experience (EASE), was designed based on evidence that engaging with nature elements is a meaningful activity, has a calming effect, and contributes to better moods in people with dementia. Participants (n = 32) will wear a wrist sensor collecting heart rate and electrodermal activity (measures of stress) and be observed 30 minutes prior to-, 30 minutes during-, and 30 minutes immediately after the EASE. The research aims are to: 1) Examine the feasibility and preliminary efficacy of EASE to reduce PVs among NH residents; 2) Evaluate the staff perception of the acceptability of EASE within 48 hours post-intervention, and 3) Examine the mechanism of action of EASE. In the short term, this proposal will allow Dr. Sefcik to: 1) build on her dissertation focused on NH residents with dementia and PVs; 2) gain new skills with behavioral intervention research; and 3) obtain NIH Phase 1 clinical trial data to determine preliminary efficacy of the EASE. The specific training objectives within this application include: 1) Develop skills in designing and implementing tailored, person-centered environmental and sensory behavioral interventions for clinical trials; 2) Acquire skills in biobehavioral measurement, analysis, and dissemination of clinical trial research; and 3) Examine the role of technology for environmental and sensory intervention approaches and measurement for clinical trial research. The University of Pennsylvania is a research-intensive environment with rich resources that will facilitate Dr. Sefcik’s development. This proposal aligns with NINR’s strategic mission to build evidence toward successful symptom management and will be foundational for a R- level submission that will build on these study findings and evaluate the effectiveness of the EASE.

项目摘要/摘要 该K23应用程序描述了应用程序的背景和经验，Justine S. Sefcik，PhD，RN。它 详细介绍她获得必要的培训的计划，以实现自己的长期目标，以成为独立 研究人员开发和测试适应性，非药理学环境和感觉干预措施 涉及减少持续发声（PVS）的技术，这是一种常见的行为和心理学 痴呆症的症状。 PV是指重复，持久的单词的声音或不适当使用 并为在同一环境中展示他们或其他人而感到沮丧。有深刻的 对居住在痴呆症和表现出PV的护士住宅（NH）的人（NH）的负面影响，包括 身体上的疲惫，生活质量降低以及一些NH人员使用不适当的干预措施（例如， 管理化学约束）。未满足的需求，例如需要感官刺激和参与 根据需求驱动的痴呆症，有意义的活动可能是PVS的贡献 行为模型。迫切需要进行创新的非药理学干预措施来减少PV。这 提案包括基于自然干预的新应用，其中包括人的预测 具有痴呆症和PVS的NH居民的相关自然声音的中心自然图像。 干预，环境和感官体验（轻松）是根据证据设计的 与自然元素互动是一项有意义的活动，具有平静的效果，并有助于更好的情绪 患有痴呆症的人。参与者（n = 32）将佩戴腕部传感器，收集心率和电皮 活性（压力的度量），并在30分钟之前观察到 - 30分钟和30分钟 轻松后立即。研究目的是：1）检查的可行性和初步效率 轻松减少NH居民中的PV； 2）评估员工对轻松可接受性的看法 干预后48小时，3）检查轻松的作用机理。在短期内，该提议 将允许塞夫克克（Sefcik）博士：1）基于她的论文，重点是痴呆症和PVS的NH居民； 2）增益 行为干预研究的新技能； 3）获取NIH阶段1临床试验数据以确定 轻松的初步效率。此应用程序中的特定培训对象包括：1）开发 设计和实施量身定制的，以人为本的环境和感觉行为的技能 临床试验的干预措施； 2）获取有关生物行为测量，分析和传播的技能 临床试验研究； 3）检查技术在环境和感觉干预中的作用 临床试验研究的方法和测量。宾夕法尼亚大学是一项研究密集型 具有丰富资源的环境将促进塞夫克克博士的发展。该提议与Ninr的 战略使命是为成功的症状管理建立证据，并将是R-的基础 级别提交将以这些研究结果为基础并评估轻松效果。

项目成果

Predictors of change over time in satisfaction with outdoor activities ratings among long-term care services and supports recipients.

• DOI: 10.1016/j.gerinurse.2022.03.007
• 发表时间: 2022-05
• 期刊: GERIATRIC NURSING
• 影响因子: 2.7
• 作者: Sefcik, Justine S.;Petrovsky, Darina, V;Huang, Liming;Behrens, Liza L.;Naylor, Mary D.;Hodgson, Nancy A.;Hirschman, Karen B.
• 通讯作者: Hirschman, Karen B.

Tailored Music Listening in Persons With Dementia: A Feasibility Randomized Clinical Trial.

• DOI: 10.1177/15333175231186728
• 发表时间: 2023-01
• 期刊: American journal of Alzheimer's disease and other dementias

When snowball sampling leads to an avalanche of fraudulent participants in qualitative research.

当滚雪球抽样导致定性研究中欺诈参与者雪崩时。

• DOI: 10.1111/opn.12572
• 发表时间: 2023
• 期刊: International journal of older people nursing
• 影响因子: 2.2
• 作者: Sefcik,JustineS;Hathaway,Zachary;DiMaria-Ghalili,RoseAnn
• 通讯作者: DiMaria-Ghalili,RoseAnn

Chronic wounds in persons living with dementia: An integrative review.

• DOI: 10.1111/opn.12447
• 发表时间: 2022-05
• 期刊: INTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING
• 影响因子: 2.2
• 作者: Sefcik, Justine S.;McLaurin, Elease J.;Bass, Ellen J.;DiMaria-Ghalili, Rose Ann
• 通讯作者: DiMaria-Ghalili, Rose Ann

Healthcare Utilization and Advance Care Planning among Older Adults Across Cognitive Levels.

不同认知水平的老年人的医疗保健利用和预先护理计划。

• DOI: 10.1177/07334648231191667
• 发表时间: 2023
• 期刊: Journal of applied gerontology : the official journal of the Southern Gerontological Society
• 作者: Rahemi,Zahra;Malatyali,Ayse;Bacsu,Juanita-DawneR;Sefcik,JustineS;Petrovsky,DarinaV;Baker,ZacharyG;Ma,KrisPuiKwan;Smith,MatthewL;Adams,SwannA
• 通讯作者: Adams,SwannA