Gender differences in Well-being, Behavior, and Interventions in Hospitalized Persons with Alzheimer disease and Related Dementias (ADRD). In response to PA-18-591

阿尔茨海默病和相关痴呆症 (ADRD) 住院患者的幸福感、行为和干预措施存在性别差异。

• 批准号: 10092371
• 负责人: Marie Boltz
• 金额: $ 10.16万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10092371
• 关键词: Accounting; Acute; Administrative Supplement; Admission activity; Affect; Aggressive behavior; Agitation; Alzheimer' s Disease; Alzheimer' s disease diagnosis; Alzheimer' s disease related dementia; Anxiety; Area; Back; Behavior; Behavior Therapy; Behavioral; Behavioral Symptoms; Care given by nurses; Caregiver Burden; Caring; Cessation of life; Clinical; Communities; Consumption; Data; Data Sources; Decision Making; Delusions; Dementia; Desire for food; Development; Disease; Disinhibition; Distress; Documentation; Eating; Education; Elderly; Environment; Euphoria; Evaluation; Family; Family Caregiver; Female; Gender; Goals; Hallucinations; Hospitalization; Hospitals; Impaired cognition; Individual; Institutionalization; Intervention; Intrinsic factor; Kale - dietary; Long-Term Care; Mental Depression; Modeling; Moods; Nursing Staff; Outcome; Patient Self-Report; Patients; Personal Satisfaction; Persons; Pharmaceutical Preparations; Pharmacology; Physical aggression; Psychotic Disorders; Research; Resources; Sex Bias; Strategic Planning; Testing; Time; United States; United States National Institutes of Health; Well in self; Woman; Women' s Health; Work; acute care; associated symptom; base; behavioral outcome; care delivery; dementia care; depressive symptoms; dysphoria; efficacy testing; emotional distress; experience; functional disability; functional outcomes; gender difference; improved; male; men; motor behavior; person centered; premature; psychological symptom; randomized trial; response; sex; standard of care; symposium; treatment response

ABSTRACT Approximately three-quarters of hospitalized persons with Alzheimer’s disease and related disorders (ADRD) experience behavioral and psychological symptoms of dementia (BPSD). In hospitalized patients BPSD is associated with accelerated and lasting functional and cognitive impairment, increased resource consumption, institutionalization, caregiver burden, and premature death. The current standard of care is to use person- centered behavioral approaches when responding to BPSD rather than psychoactive medications which are frequently ineffective and often cause complications. An understanding of the factors influencing the individual’s clinical presentation, needs, and response to treatment guides these approaches, including intrinsic factors such as gender. Given that about two-thirds of persons with a diagnosis of Alzheimer’s dementia are women, there is surprisingly little rigorous work on gender differences in the expression of BPSD, and even less on staff response to BPSD by patient gender. The minimal research that has been done in this area has been largely conducted in long term care and suggests that BPSD in men are more likely to be identified and managed. Lack of identification and management of BPSD in women can result in emotional distress, a decrease in the quality of interactions they have with staff., and increased complications. The purpose of this supplement, entitled, Gender differences in Well-being, Behavior, and Related Interventions in Hospitalized Persons with Alzheimer disease and Related Dementias (ADRD), is to utilize our ongoing study testing the efficacy of Family -centered Function focused Care (Fam-FFC) versus Education Only (EO) in 438 patients in three hospitals (two units each) to examine gender differences in how nursing staff identify and manage behavioral and psychological symptoms associated with dementia (BPSD) among men and women during hospitalization. In Fam-FFC nurses purposefully engage family CGs in the assessment, decision-making, care delivery and evaluation of function-focused care during hospitalization and the 60-day post-acute period in order to improve behavioral and functional outcomes. We aim to use baseline data from this study and some additional data to answer the aims of this supplement as follows: Aim 1: Test for gender differences in staff identification and management of BPSD; Aim 2: Test for gender differences in quality of staff/patient interactions and patient emotional wellbeing; Aim 3: Explore formal nursing staff experiences with the identification, documentation and management of BPSD among women and men. This study is aligned with the Trans-NIH Strategic Plan for Women’s Health Research goal of leveraging data sources to consider sex and gender influences that enhance research for the health of women. Our long-term goal is to improve the care delivered to the estimated 3.2 million U.S. women living with ADRD during periods of acute illness requiring hospitalization.

抽象的 大约四分之三的阿尔茨海默氏病和相关疾病的住院医师（ADRD） 经历痴呆症（BPSD）的行为和心理症状。在住院的患者中，bpsd是 与加速和持久的功能和认知障碍相关，资源消耗增加， 制度化，照顾者伯恩和过早死亡。当前的护理标准是使用人员 - 响应BPSD而不是精神活性药物时，采用的居中行为方法是 经常无效，经常引起并发症。对影响因素的理解 个人的临床表现，需求和对治疗指南的反应，包括内在的方法 性别等因素。鉴于大约三分之二的患有阿尔茨海默氏症痴呆症的人是 女性，关于BPSD的性别差异，甚至 患者性别对员工对BPSD的反应少。在这一领域进行的最低研​​究 我们在很大程度上是在长期护理中进行的，并建议男性的BPSD更有可能被识别出来，并且 管理。女性中BPSD缺乏识别和管理可能会导致情绪困扰，这是一个 他们与员工的互动质量的降低，并增加并发症。这个目的 补充，题为“福祉，行为和相关干预措施的性别差异” 患有阿尔茨海默氏病和相关痴呆症（ADRD）的人是利用我们正在进行的研究测试 在438名患者中，以家庭功能为重点的护理（FAM -FFC）与教育（EO）的效率 三家医院（每个单位）在护士工作人员如何识别和管理方面检查性别差异 在男女中，与痴呆症（BPSD）相关的行为和心理症状在 住院。在FAM-FFC护士中，有目的地让家庭CG参与评估，决策，护理 住院期间以功能为中心的护理和60天的急性后期的交付和评估 为了改善行为和功能结果。我们的目的是使用本研究的基线数据和一些 其他数据以回答此补充的目的如下：目标1：测试员工的性别差异 BPSD的识别和管理；目标2：测试员工/患者质量质量的性别差异 互动和患者的情感健康； AIM 3：探索正式护士工作人员与 男女BPSD的识别，文档和管理。这项研究与 妇女健康研究的Trans-NIH战略计划，利用数据来源考虑性行为 性别影响增强对妇女健康的研究。我们的长期目标是改善 在急性疾病期间，估计有320万美国妇女的美国妇女提供护理 需要住院。