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测试一种以家庭为中心的干预措施,以促进住院老年人的功能和认知恢复。

Testing a family-centered intervention to promote functional and cognitive recovery in hospitalized older adults.

作者信息

Boltz Marie, Resnick Barbara, Chippendale Tracy, Galvin James

机构信息

William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts.

出版信息

J Am Geriatr Soc. 2014 Dec;62(12):2398-407. doi: 10.1111/jgs.13139. Epub 2014 Dec 8.

Abstract

A comparative trial using a repeated-measures design was designed to evaluate the feasibility and outcomes of the Family-Centered Function-Focused-Care (Fam-FFC) intervention, which is intended to promote functional recovery in hospitalized older adults. A family-centered resource nurse and a facility champion implemented a three-component intervention (environmental assessment and modification, staff education, individual and family education and partnership in care planning with follow-up after hospitalization for an acute illness). Control units were exposed to function-focused-care education only. Ninety-seven dyads of medical patients aged 65 and older and family caregivers (FCGs) were recruited from three medical units of a community teaching hospital. Fifty-three percent of patients were female, 89% were white, 51% were married, and 40% were widowed, and they had a mean age of 80.8 ± 7.5. Seventy-eight percent of FCGs were married, 34% were daughters, 31% were female spouses or partners, and 38% were aged 46 to 65. Patient outcomes included functional outcomes (activities of daily living (ADLs), walking performance, gait, balance) and delirium severity and duration. FCG outcomes included preparedness for caregiving, anxiety, depression, role strain, and mutuality. The intervention group demonstrated less severity and shorter duration of delirium and better ADL and walking performance but not better gait and balance performance than the control group. FCGs who participated in Fam-FFC showed a significant increase in preparedness for caregiving and a decrease in anxiety and depression from admission to 2 months after discharge but no significant differences in strain or quality of the relationship with the care recipient from FCGs in the control group. Fam-FFC is feasible and has the potential to improve outcomes for hospitalized older adults and their caregivers.

摘要

一项采用重复测量设计的对比试验旨在评估以家庭为中心的功能聚焦护理(Fam-FFC)干预措施的可行性和效果,该干预措施旨在促进住院老年人的功能恢复。一名以家庭为中心的资源护士和一名机构倡导者实施了一项包含三个部分的干预措施(环境评估与改造、员工教育、个体及家庭教育以及在急性病住院后的护理计划中建立个体与家庭伙伴关系并进行随访)。对照组仅接受功能聚焦护理教育。从一家社区教学医院的三个医疗科室招募了97对65岁及以上的老年患者及其家庭护理人员(FCG)。53%的患者为女性,89%为白人,51%已婚,40%丧偶,平均年龄为80.8±7.5岁。78%的FCG已婚,34%为女儿,31%为女性配偶或伴侣,38%年龄在46至65岁之间。患者的结局指标包括功能结局(日常生活活动能力(ADL)、行走能力、步态、平衡能力)以及谵妄的严重程度和持续时间。FCG的结局指标包括护理准备情况、焦虑、抑郁、角色压力和相互性。与对照组相比,干预组谵妄的严重程度更低、持续时间更短,ADL和行走能力表现更好,但步态和平衡能力表现并无改善。参与Fam-FFC的FCG从入院到出院后2个月,护理准备情况显著增加,焦虑和抑郁程度降低,但与对照组的FCG相比,在角色压力或与受照顾者关系的质量方面没有显著差异。Fam-FFC是可行的,并且有可能改善住院老年人及其护理人员的结局。

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