The Residential Care Transition Module

住院护理过渡模块

基本信息

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
项目类别：
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&apos 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

项目摘要

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（由申请人提供）：关于家庭照料和收容的新兴研究发现，在亲属入住长期寄宿家庭后，家庭并没有摆脱照料责任，而是继续参与家庭照料。护理活动范围广泛，从日常生活的工具性活动到情感支持，许多研究指出，长期住院护理 (RLTC) 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机构化后增加家庭参与，但没有严格的研究表明这些干预措施可以有效帮助家庭过渡到 RLTC 环境。咨询会议（一对一和家庭会议）针对最近在 RLTC 环境中承认有认知障碍的家庭成员的家庭护理人员。过去 3 个月内的患者将被随机分配到 RCTM [(n = 120)] 或常规护理控制条件 [(n = 120)]。将使用混合方法分析来实现以下目标：具体目标 1)。评估 RCTM 是否能令人惊讶地显着减少家庭成员的主要主观压力和负面心理健康结果；具体目标 2) 确定接受 RCTM 的家庭成员在 12 个月内是否会表现出统计上显着的次要角色压力减少常规护理对照组；具体目标 3) 确定与常规护理对照组的家庭成员相比，RCTM 家庭成员的住院护理压力是否显着下降；以及具体目标 4) 描述机制在 12 个月的评估结束时，通过“嵌入”定性成分（30 次半结构化访谈）来评估 RCTM 在高成功和低成功条件下的行动。拟议的项目将通过评估所设计的非社会心理干预来填补重要的临床和研究空白。针对 RLTC 安置后的家庭，确定 RCTM 是否以及如何帮助家庭更好地应对认知障碍亲属的寄宿护理过渡。