《住宅护理过渡模块：针对居住在长期护理住宅中的痴呆症患者的家庭护理人员的远程医疗支持干预的单盲随机对照评估》
The ResidentialCare Transition Module: a single-blinded randomized controlled evaluation of a telehealth support intervention for family caregivers of persons with dementia living in residential long-term care.
机构信息
Division of Health Policy and Management, School 8of Public Health, University of Minnesota, D351 Mayo (MMC 729), 420 Delaware Street S.E, Minneapolis, MN, 55455, USA.
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
出版信息
BMC Geriatr. 2020 Apr 15;20(1):133. doi: 10.1186/s12877-020-01542-7.
BACKGROUND
Families do not fully disengage from care responsibilities following relatives' admissions to residential long-term (RLTC) care settings such as nursing homes. Caregiver stress, depression, or other key outcomes remain stable or sometimes increase following a relative's RLTC entry. Some interventions have attempted to increase family involvement after institutionalization, but few rigorous studies have demonstrated whether these interventions are effective in helping families navigate the potential emotional and psychological upheaval presented by relatives' transitions to RLTC environments. The Residential Care Transition Module (RCTM) provides six formal sessions of consultation (one-to-one and family sessions) over a 4-month period to family caregivers who have admitted a relative to a RLTC setting.
METHODS
In this embedded mixed methods randomized controlled evaluation, family members who have admitted a cognitively impaired relative to a RLTC setting are randomly assigned to the RCTM (n = 120) or a usual care control condition (n = 120). Primary outcomes include reductions in family members' primary subjective stress and negative mental health outcomes; secondary role strains; and residential care stress. The mixed methods design will allow for an analysis of intervention action mechanisms by "embedding" qualitative components (up to 30 semi-structured interviews) at the conclusion of the 12-month evaluation.
DISCUSSION
This evaluation will fill an important clinical and research gap by evaluating a psychosocial intervention designed for families following RLTC admission that determines whether and how the RCTM can help families better navigate the emotional and psychological challenges of residential care transitions.
TRIAL REGISTRATION
ClinicalTrials.gov (NCT02915939, prospectively registered).
背景
亲属入住长期居住（RLTC）护理机构（如养老院）后，家庭并未完全卸下护理责任。照料者的压力、抑郁或其他关键结果在亲属进入 RLTC 后仍保持稳定，有时甚至会增加。一些干预措施试图增加机构化后家庭的参与度，但很少有严格的研究表明这些干预措施是否有助于家庭应对亲属过渡到 RLTC 环境带来的潜在情绪和心理困扰。居住护理过渡模块（RCTM）为已将亲属送往 RLTC 环境的家庭照料者提供为期 4 个月的六次正式咨询（一对一和家庭咨询）。
方法
在这项嵌入式混合方法随机对照评估中，将已将认知障碍亲属送往 RLTC 环境的家庭成员随机分配到 RCTM（n=120）或常规护理对照组（n=120）。主要结果包括减少家庭成员的主要主观压力和负面心理健康结果；次要角色紧张；以及居住护理压力。混合方法设计将允许通过“嵌入”定性成分（最多 30 次半结构化访谈）在 12 个月评估结束时分析干预作用机制。
讨论
这项评估将通过评估专为 RLTC 入院后家庭设计的心理社会干预措施来填补重要的临床和研究空白，以确定 RCTM 是否以及如何帮助家庭更好地应对居住护理过渡的情绪和心理挑战。
试验注册
ClinicalTrials.gov（NCT02915939，前瞻性注册）。
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