A mixed methods observational study of persistent vocalizations in nursing home residents with moderate to severe dementia

中度至重度痴呆疗养院居民持续发声的混合方法观察研究

• 批准号: 9108167
• 负责人: JUSTINE SUZETTE SEFCIK
• 金额: $ 1.67万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-01 至 2016-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9108167
• 关键词: Acceleration; Achievement; Address; Administrator; Adverse effects; Aggressive behavior; Award; Behavior; Behavioral Symptoms; Caregiver Burden; Characteristics; Clinical; Competence; Complex; Data; Data Sources; Delirium; Dementia; Development; Distress; Early identification; Elderly; Employee; Ensure; Environment; Exhibits; Family; Family member; Formal caregiver; Foundations; Frequencies; Future; Heart Rate; Hunger; Impairment; Individual National Research Service Award; Intervention; Knowledge; Lead; Light; Long-Term Care; Long-Term Care Nursing; Measurement; Measures; Mentors; Methods; Mission; Modeling; National Institute of Nursing Research; National Research Service Awards; Noise; Nurses; Nursing Homes; Nursing Staff; Observational Study; Pain; Participant; Persons; Physical environment; Physiological; Pilot Projects; Positioning Attribute; Prevalence; Quality of life; Reading; Registered nurse; Research; Research Personnel; Research Project Grants; Research Training; Respiration; Risk; Scientist; Sedation procedure; Sensory; Social Environment; Speed; Stress; Stroke; Symptoms; System; Testing; Training; Translating; Video Recording; Vulnerable Populations; Work; base; cognitive function; design; driving behavior; exercise physiologist; exhaustion; experience; improved; informal caregiver; innovation; member; physical state; prevent; programs; psychosocial; public health relevance; response; skills; social; sound; symptom management; therapy development; vocalization

 DESCRIPTION (provided by applicant): The purpose of this individual National Research Service Award (NRSA) application is to provide the applicant with essential research training to become an independent investigator focusing on behavioral symptoms of dementia, more specifically persistent vocalizations (PVs) (otherwise known as disruptive vocalizations or problematic vocalizations). This NRSA will ensure that the applicant achieves competence in the methodological and analytical skills to conduct ethically sound research with the vulnerable population of older adults with dementia. From her clinical experience as a Registered Nurse in nursing homes (NH), the applicant has first-hand knowledge of how distressing PVs are for other residents, staff, and visitors including family members and how PVs decrease the quality of life for the NH resident(s) with PVs themselves. Prevalence rates among NH residents with dementia and PVs are as high as 81%. Without a deeper understanding of the underlying cause of PVs, nursing staff are unable to effectively prevent or manage them. The overall purpose of this innovative, mixed methods research project is to use physiological measures and observational data to describe persons with moderate to severe dementia and PVs. Using the Needs-driven Dementia-compromised Behavior model as a framework, the applicant will examine the proximal factors (physiological and psychosocial needs states, physical environment and social environment factors) that lead to PVs. Having a greater understanding of PVs and their causes can enable the development and testing of tailored interventions to reduce them. This is the first known study to investigate potential physiological indictors prior t, during and after a PV episode. These physiological data will be combined with other source data including qualitative analysis of video recordings and field notes, noise decibel readings and 3 observational measurement scales to characterize the period prior to, during, and after PV episodes. The applicant's research training will be guided by a mentoring team including Dr. Mary Ersek, a well-known researcher in long term care and pain in persons with dementia; Dr. Pamela Cacchione, a sensory impairment, delirium and dementia expert; Dr. Cornelia Beck, an expert on dementia and persons with dementia and PVs; and Dr. Joseph Libonati, an exercise physiologist with expertise in the use of the BioHarness System that will be used to collect physiological data. This research addresses the priority of the National Institute of Nursing Research on symptom management because it proposes to investigate PVs to build the evidence toward successful symptom management of this challenging behavioral symptom of dementia. The specific research and methodological approach proposed in this application has wide applicability to many stakeholders, including formal and informal caregivers, residents with dementia and behavioral symptoms, nursing home administrators and other researchers exploring behavioral symptoms.

 描述（由应用程序提供）：本个别国家研究服务奖（NRSA）的目的是为应用程序提供基本的研究培训，以成为关注痴呆症行为症状的独立研究者，更具体地说是持续性发声（PVS）（否则称为颠覆性发声或有问题的发声）。该NRSA将确保在方法论和分析能力中的应用成就能力与痴呆症老年人的脆弱人群进行道德合理的研究。从她作为护士房屋（NH）的注册护士的临床经验中，适用的是第一手了解其他居民，员工和访客的苦恼如何，包括家人在内，以及PVS如何降低NH居民与PVS本身的生活质量。 NH痴呆症和PV居民的患病率高达81％。如果没有更深入地了解PV的根本原因，护士工作人员将无法有效预防或管理它们。这个创新的混合方法研究项目的总体目的是使用身体措施和观察数据来描述中度至重度痴呆症和PV的人。将需求驱动的痴呆症受损行为模型作为框架，适用的将检查导致PVS的代理因素（生理和社会心理需求状态，身体环境和社会环境因素）。对PVS及其原因有更深入的了解可以使量身定制的干预措施的开发和测试以减少它们。这是在PV发作期间和之后研究先前t的潜在生理指标的首次已知研究。这些物理数据将与其他源数据结合使用，包括对视频记录和现场音符的定性分析，噪声分贝读数和3个观测测量量表，以表征PV发作之前，期间和之后的周期。申请人的研究培训将受到一个心理团队的指导，其中包括玛丽·埃塞克（Mary Ersek）博士，他是痴呆症患者的长期护理和疼痛的著名研究人员。 Pamela Cacchione博士，感官障碍，del妄和痴呆症专家； Cornelia Beck博士，痴呆症和痴呆症和PV的人的专家；以及将使用生物学系统专家的运动生理学家Joseph Libonati博士，将用于收集生理数据。这项研究涉及美国国立护理研究所SYM管理研究所的优先事项，因为它提议调查PVS以建立证据以成功地症状管理这一挑战的行为痴呆症的行为症状。本申请中提出的具体研究和方法论方法对许多利益相关者，包括正式和非正式护理人员，痴呆症和行为症状的居民，护士家庭管理员和其他探索行为症状的研究人员。