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评估针对日本体弱老年门诊患者的更新版预防性家访计划的质量和效果:一项随机对照试验的研究方案

Assessing the quality and effectiveness of an updated preventive home visit programme for ambulatory frail older Japanese people: research protocol for a randomized controlled trial.

作者信息

Kono Ayumi, Izumi Kyoko, Kanaya Yukiko, Tsumura Chieko, Rubenstein Laurence Z

机构信息

School of Nursing, Osaka City University, Japan.

出版信息

J Adv Nurs. 2014 Oct;70(10):2363-72. doi: 10.1111/jan.12390. Epub 2014 Mar 24.

Abstract

AIM

To describe the programme and research protocol of our updated preventive home visit programme for ambulatory frail older adults in the Japanese Long-Term Care Insurance system.

BACKGROUND

Our previous trials have shown that the nature of recommendations during preventive home visits is a key issue. The present programme has updated our previous one by including a unique structured assessment with treatment recommendations tied to an ongoing programme for quality assurance.

DESIGN

A randomized, controlled trial.

METHODS

Eligible participants (n = 360) will be randomly assigned to home visit (n = 179) and control (n = 181) groups in three suburban municipalities. Nurses provide recommendations based on structured assessments to participants in visit group every 3 months from September 2011-October 2013. The primary outcomes are parameters related to quality of life, including activities of daily living, instrumental activities of daily living, depression, cognitive capacity, daily-life satisfaction and self-efficacy for health promotion; these are collected by mail at baseline, 12 and 24 months. The secondary outcome is long-term care use over the study period. To evaluate the visit process, we are qualitatively analysing documentation data from the assessment sheet and chart.

CONCLUSION

This study is collecting and analysing evidence regarding the process and outcomes of preventive home visits based on structured care-need assessments.

TRIAL REGISTRATION

The study protocol was registered for the UMIN clinical registry approved by ICMJE (No. UMIN000006463, October 04, 2011).

摘要

目的

描述日本长期护理保险系统中针对体弱老年人的更新版预防性家访计划的方案和研究协议。

背景

我们之前的试验表明,预防性家访期间的建议性质是一个关键问题。本计划通过纳入独特的结构化评估并将治疗建议与持续的质量保证计划相结合,对我们之前的计划进行了更新。

设计

一项随机对照试验。

方法

符合条件的参与者(n = 360)将被随机分配到三个郊区市的家访组(n = 179)和对照组(n = 181)。从2011年9月至2013年10月,护士每3个月根据结构化评估为家访组的参与者提供建议。主要结局是与生活质量相关的参数,包括日常生活活动、工具性日常生活活动、抑郁、认知能力、生活满意度和健康促进自我效能感;这些在基线、12个月和24个月时通过邮件收集。次要结局是研究期间的长期护理使用情况。为了评估家访过程,我们正在对评估表和图表中的文档数据进行定性分析。

结论

本研究正在收集和分析基于结构化护理需求评估的预防性家访过程和结局的证据。

试验注册

该研究方案已在ICMJE批准的UMIN临床注册中心注册(编号UMIN000006463,2011年10月4日)。

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