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收集养老院临床试验中痴呆症患者的自我报告研究数据:益处、挑战和最佳实践。

Collecting self-report research data with people with dementia within care home clinical trials: Benefits, challenges and best practice.

机构信息

Oxford Health NHS Foundation Trust, Oxford, UK.

Centre for Dementia Research, Leeds Beckett University, Leeds, UK.

出版信息

Dementia (London). 2021 Jan;20(1):148-160. doi: 10.1177/1471301219871168. Epub 2019 Aug 29.

Abstract

One-third of people with dementia live in care home settings and in order to deliver better evidence-based care, robust research including clinical trials is required. Concerns have been raised by researchers about the capacity of care home residents with dementia to participate in clinical trials. This includes self-report measures, completion of which researchers have suggested may be unreliable or impossible and may cause distress for residents. Many trials, therefore, utilise only proxy completed outcome measures. This is despite evidence that individuals with mild through to advanced dementia can reliably report on outcomes, if appropriate measures and approaches to data collection are used. However, little has been written about best practice in data collection with this group. This study aimed to explore the experiences of researchers working on dementia trials in care homes and identify best practices to assist design of future trials. Thirty-three researchers completed an online, qualitative questionnaire outlining their experiences and the perceived benefits and challenges of data collection with people with dementia. We identified five main benefits: (1) improving the delivery of person-centred care, (2) hearing the voice of people with dementia, (3) residents spending time with researchers, (4) improving researcher understanding, and (5) having an evidence base from multiple sources. We also identified five main challenges: (1) effective communication, (2) fluctuating capacity, (3) causing distress to residents, (4) time pressures, and (5) staff availability. Researchers also made suggestions about how these can be overcome. We recommend that the challenges identified could be overcome using appropriate methods for collecting data. Thorough training for researchers on data collection with people with dementia was identified as important for ensuring successful data collection.

摘要

三分之一的痴呆症患者生活在养老院环境中,为了提供更好的基于证据的护理,需要进行包括临床试验在内的强有力的研究。研究人员对痴呆症养老院居民参与临床试验的能力表示担忧。这包括自我报告措施,研究人员认为这些措施可能不可靠或不可能完成,并且可能会给居民带来困扰。因此,许多试验仅使用代理完成的结果测量。尽管有证据表明,从轻度到重度痴呆症的个体如果使用适当的措施和数据收集方法,可以可靠地报告结果,但这一点却很少被提及。然而,对于这一群体的数据收集最佳实践,几乎没有什么文献。本研究旨在探讨在养老院进行痴呆症试验的研究人员的经验,并确定最佳实践,以协助未来试验的设计。33 名研究人员完成了一份在线定性问卷,概述了他们在痴呆症研究中的经验,以及收集痴呆症患者数据的益处和挑战。我们确定了五个主要益处:(1)改善以患者为中心的护理服务;(2)听取痴呆症患者的声音;(3)患者与研究人员共度时光;(4)提高研究人员的理解能力;(5)从多个来源获得证据基础。我们还确定了五个主要挑战:(1)有效沟通;(2)认知能力波动;(3)给患者带来困扰;(4)时间压力;(5)员工可用性。研究人员还就如何克服这些挑战提出了建议。我们建议,可以使用适当的方法来克服确定的挑战。为研究人员提供有关痴呆症患者数据收集的全面培训,被认为是确保成功数据收集的重要因素。

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