Reducing Care-Resistant Behaviors During Oral Hygiene in Persons with Dementia

减少痴呆症患者口腔卫生期间的抗护理行为

基本信息

  • 批准号:
    8081634
  • 负责人:
  • 金额:
    $ 36.27万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2011
  • 资助国家:
    美国
  • 起止时间:
    2011-04-01 至 2015-02-28
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): Nursing home (NH) residents with dementia are often dependent on others for mouth care, yet will react with care-resistant behavior (CRB) when receiving assistance. The oral health of these elders deteriorates in the absence of daily oral hygiene, predisposing them to harmful systemic problems such as pneumonia, hyperglycemia, cardiac disease, and cerebral vascular accidents. The purpose of this study is to determine whether CRBs can be reduced, and oral health improved, through the application of an intervention based on the neurobiological principles of threat perception and fear response. When faced with a threat, all organisms react with "flight-fight" responses. These responses are both autonomic (e.g. elevated heart rate, sweating) and behavioral (e.g. moving away, attacking). Persons with dementia have heightened threat perception as a result of neurobiological changes that affect the cerebral cortex, hippocampus, and amygdale.16 These individuals may interpret mouth care as a threatening action by threatening people. The intervention, called Managing Oral Hygiene Using Threat Reduction (MOUTh), combines best mouth care practices with a constellation of behavioral techniques that reduce threat perception and thereby prevent or de-escalate CRB. The primary specific aims of the study are to: 1)Evaluate the efficacy of the MOUTh intervention for reducing CRBs in persons with dementia; 2)Validate the overall efficacy of the MOUTh intervention using nurse-sensitive oral health outcomes--swollen and bleeding gums, cleanliness of the oral cavity, saliva, and integrity of the lips and oral mucosa; and 3)Calculate the cost of the MOUTh intervention. Using a randomized repeated measures design, 80 elders with dementia from 5 different NHs will be randomized at the individual level to the experimental group, which will receive the intervention, or to the control group, which will receive standard mouth care from research team members who receive training in the proper methods for providing mouth care but no training in resistance recognition or prevention/mediation. Oral health assessments and CRB measurements will be obtained during a 7-day observation period and a 21-day intervention period. Individual growth models using multilevel analysis will be used to estimate the efficacy of the intervention for reducing CRBs in persons with dementia, and to estimate the overall efficacy of the intervention using oral health outcomes. Activity-based costing methods will be used to determine the cost of the MOUTh intervention. At the end of this study, the research team anticipates having a proven intervention that prevents and reduces CRB within the context of mouth care. Long-term objectives include testing the effect of the intervention on systemic illnesses among persons with dementia; examining the transferability of this intervention to other activities of daily living; and disseminating threat reduction interventions to NH staff, which may radically change the way care is provided to persons with dementia. PUBLIC HEALTH RELEVANCE: Nursing home residents with dementia may react with fear during mouth care, making it difficult for caregivers to brush teeth or remove dentures. Without daily mouth care, the mouth becomes diseased and places the elder at risk for other illnesses such as pneumonia. This study will examine if a method for providing mouth care in a non-threatening way improves the oral health of nursing home residents with dementia.
描述(由申请人提供):患有痴呆症的疗养院(NH)居民通常取决于其他人的口腔护理,但在获得援助时会以耐心行为(CRB)做出反应。在没有每天口腔卫生的情况下,这些长者的口腔健康会恶化,使他们遭受有害的系统性问题,例如肺炎,高血糖,心脏病和脑血管事故。这项研究的目的是通过基于威胁感知和恐惧反应的神经生物学原则的干预来确定CRB是否可以减少CRB,并改善了口腔健康。面对威胁时,所有生物体都会对“战斗”反应做出反应。这些反应既是自主神经(例如心率升高,出汗)和行为(例如移开,攻击)。由于神经生物学变化影响大脑皮层,海马和杏仁核。16这些人可能会通过威胁人们的威胁行动来将痴呆症的人提高威胁感知。这种干预措施称为使用降低威胁(口)管理口腔卫生的干预措施,将最佳口腔护理实践与一系列行为技术相结合,从而减少威胁感知,从而预防或降低CRB。该研究的主要特定目的是:1)评估口干减少痴呆症患者CRB的功效; 2)使用对护士敏感的口腔健康结果(熟悉和流血的牙龈,口腔清洁度,口腔清洁度,唾液以及嘴唇和口腔粘膜的完整性)来验证口腔干预的总体功效; 3)计算口干预的成本。使用随机重复测量设计,将在单个水平上随机分配来自5个不同NHS的痴呆症的80名长辈,将随机分配给实验组,该小组将接受干预组,或者与对照组,该组将接受研究团队成员的标准口腔护理,这些研究团队将接受以适当的方法进行培训,但在提供力能的培训中,但在不提供力能的培训中,在抵抗力识别或预防/调解方面不接受培训。在7天的观察期和21天的干预期内,将获得口腔健康评估和CRB测量。使用多层次分析的个体增长模型将用于估计干预措施减少痴呆症患者的CRB的功效,并估算使用口腔健康结果的干预措施的总体疗效。基于活动的成本核算方法将用于确定口干的成本。在这项研究结束时,研究小组预计进行了经过验证的干预措施,可防止和减少口腔护理背景下的CRB。长期目标包括测试干预对痴呆症患者全身性疾病的影响;检查这种干预措施向其他日常生活活动的转移性;并向NH员工提供减少威胁的干预措施,这可能会从根本上改变给患有痴呆症患者的护理方式。 公共卫生相关性:患有痴呆症的疗养院居民可能会在口腔护理期间恐惧地反应,从而使护理人员难以刷牙或去除牙齿。没有日常口腔护理,口腔就会患病,使长者有其他疾病(例如肺炎)的风险。这项研究将检查以非威胁性方式提供口腔护理的方法是否可以改善患有痴呆症的疗养院居民的口腔健康。

项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

暂无数据

数据更新时间:2024-06-01

RITA A JABLONSKI的其他基金

Testing Dementia Caregiver TeleCoaching to Reduce Episodes of Abuse and Neglect by Recognizing and Managing Care-Resistant Behaviors
测试痴呆症护理人员远程辅导,通过识别和管理抗护理行为来减少虐待和忽视的发生
  • 批准号:
    10300245
    10300245
  • 财政年份:
    2021
  • 资助金额:
    $ 36.27万
    $ 36.27万
  • 项目类别:
Testing Dementia Caregiver TeleCoaching to Reduce Episodes of Abuse and Neglect by Recognizing and Managing Care-Resistant Behaviors
测试痴呆症护理人员远程辅导,通过识别和管理抗护理行为来减少虐待和忽视的发生
  • 批准号:
    10478199
    10478199
  • 财政年份:
    2021
  • 资助金额:
    $ 36.27万
    $ 36.27万
  • 项目类别:
Testing Dementia Caregiver TeleCoaching to Reduce Episodes of Abuse and Neglect by Recognizing and Managing Care-Resistant Behaviors
测试痴呆症护理人员远程辅导,通过识别和管理抗护理行为来减少虐待和忽视的发生
  • 批准号:
    10683297
    10683297
  • 财政年份:
    2021
  • 资助金额:
    $ 36.27万
    $ 36.27万
  • 项目类别:
Reducing Care-Resistant Behaviors During Oral Hygiene in Persons with Dementia
减少痴呆症患者口腔卫生期间的抗护理行为
  • 批准号:
    8628670
    8628670
  • 财政年份:
    2012
  • 资助金额:
    $ 36.27万
    $ 36.27万
  • 项目类别:
Reducing Care-Resistant Behaviors During Oral Hygiene in Persons with Dementia
减少痴呆症患者口腔卫生期间的抗护理行为
  • 批准号:
    8577243
    8577243
  • 财政年份:
    2012
  • 资助金额:
    $ 36.27万
    $ 36.27万
  • 项目类别:
Reducing Care-Resistant Behaviors During Oral Hygiene in Persons with Dementia
减少痴呆症患者口腔卫生期间的抗护理行为
  • 批准号:
    8250337
    8250337
  • 财政年份:
    2011
  • 资助金额:
    $ 36.27万
    $ 36.27万
  • 项目类别:
IMPROVING ORAL CARE PROVIDED BY NURSING ASSISTANTS
改善护理助理提供的口腔护理
  • 批准号:
    6949043
    6949043
  • 财政年份:
    2004
  • 资助金额:
    $ 36.27万
    $ 36.27万
  • 项目类别:
IMPROVING ORAL CARE PROVIDED BY NURSING ASSISTANTS
改善护理助理提供的口腔护理
  • 批准号:
    6887177
    6887177
  • 财政年份:
    2004
  • 资助金额:
    $ 36.27万
    $ 36.27万
  • 项目类别:
ELDER TRANSFER FROM NURSING HOME TO EMERGENCY DEPARTMENT
老年人从疗养院转移到急诊室
  • 批准号:
    6529351
    6529351
  • 财政年份:
    2002
  • 资助金额:
    $ 36.27万
    $ 36.27万
  • 项目类别:
ELDER TRANSFER FROM NURSING HOME TO EMERGENCY DEPARTMENT
老年人从疗养院转移到急诊室
  • 批准号:
    6402007
    6402007
  • 财政年份:
    2001
  • 资助金额:
    $ 36.27万
    $ 36.27万
  • 项目类别:

相似海外基金

Evaluating the Unmet Needs of Older Adults to Promote Functional Recovery after a Critical Illness (LANTERN)
评估老年人未满足的需求以促进危重疾病后的功能恢复(LANTERN)
  • 批准号:
    10735299
    10735299
  • 财政年份:
    2023
  • 资助金额:
    $ 36.27万
    $ 36.27万
  • 项目类别:
Development of wireless, wearable flow sensors for continuous, long-term tracking of cerebrospinal fluid dynamics in patients with hydrocephalus
开发无线可穿戴流量传感器,用于连续、长期跟踪脑积水患者的脑脊液动力学
  • 批准号:
    10728656
    10728656
  • 财政年份:
    2023
  • 资助金额:
    $ 36.27万
    $ 36.27万
  • 项目类别:
Racial Differences in Hospital-Associated Disability and Acute and Post-Acute Care Physical Therapy Utilization
医院相关残疾以及急性和急性后护理物理治疗利用的种族差异
  • 批准号:
    10785500
    10785500
  • 财政年份:
    2023
  • 资助金额:
    $ 36.27万
    $ 36.27万
  • 项目类别:
Developing and Determining Feasibility of a Novel Upper Extremity Robotic Exoskeleton to Track and Target Unwanted Joint Synergies during Repetitive Task Training in Stroke Survivors
开发并确定新型上肢机器人外骨骼的可行性,以跟踪和瞄准中风幸存者重复任务训练期间不需要的关节协同作用
  • 批准号:
    10805748
    10805748
  • 财政年份:
    2023
  • 资助金额:
    $ 36.27万
    $ 36.27万
  • 项目类别:
Multimodal Guidance towards Precision Rehabilitation to Improve Upper Extremity Function in Stroke Patients
多模式精准康复指导改善中风患者上肢功能
  • 批准号:
    10586179
    10586179
  • 财政年份:
    2022
  • 资助金额:
    $ 36.27万
    $ 36.27万
  • 项目类别: