Hendrix Cristina C, Matters Doreen, Griffin Tamara, Batchelder Heather, Kramer Patricia, Prewitt Judy R, Matters Loretta, Lytle Kay, Yang Yesol, Park Hyeyoung, Riedel Richard F, Choi Jessica Y, McConnell Eleanor
associate professor and division chair of health systems and analytics, Duke University School of Nursing, Durham, North Carolina; core investigator, Durham Veterans Affairs Health Care System Geriatric Research, Education, and Clinical Center, Durham, North Carolina
DEFT program director, Duke University School of Nursing, Durham, North Carolina.
N C Med J. 2020 Jul-Aug;81(4):221-227. doi: 10.18043/ncm.81.4.221.
After a hospital stay, many older adults rely on their caregivers for assistance at home. Empirical evidence demonstrates that caregiver support programs in hospital-to-home transitions are associated with favorable caregiver and patient outcomes. We tested the feasibility of implementing the Duke Elder Family/Caregiver Training (DEFT) program in an academic medical center. We recruited adult caregivers of homebound patients who were aged 55 years or older from Duke University Hospital in Durham, North Carolina. Caregivers attended a face-to-face caregiver training and received two telephone checks after hospital discharge with DEFT services ending at 14 days of hospital discharge. We used a one-item survey to measure overall DEFT satisfaction. We also monitored 30-day readmissions of patients whose caregivers completed the DEFT program. The DEFT Center received 104 consult orders in six months. Of these, 61 agreed to participate but nine caregivers were unable to schedule the DEFT training and three decided to eventually withdraw from participation. Forty-nine caregivers received the DEFT training, 12 of whom were ineligible to continue because of change in patients' disposition plan. Of the remaining 37 caregivers, 15 completed the full program and reported high satisfaction; one patient was readmitted within 30 days of discharge. The DEFT implementation was based on academic-medical partnership and relied on electronic medical records for consult and documentation. Replicability and generalizability of findings are limited to settings with similar capabilities and resources. The implementation of a caregiver training and support program in an academic medical center was feasible and was associated with favorable preliminary outcomes.
在住院治疗后，许多老年人在家中需要依靠照料者的帮助。实证证据表明，医院到家庭过渡阶段的照料者支持项目与照料者和患者的良好结局相关。我们在一家学术医疗中心测试了实施杜克老年家庭/照料者培训（DEFT）项目的可行性。我们从北卡罗来纳州达勒姆的杜克大学医院招募了年龄在55岁及以上的居家患者的成年照料者。照料者参加了面对面的照料者培训，并在出院后接受了两次电话回访，DEFT服务在出院14天后结束。我们使用一项单项调查来衡量对DEFT的总体满意度。我们还监测了照料者完成DEFT项目的患者的30天再入院情况。DEFT中心在六个月内收到了104份咨询订单。其中，61人同意参与，但9名照料者无法安排DEFT培训，3人最终决定退出参与。49名照料者接受了DEFT培训，其中12人因患者处置计划的改变而无资格继续参与。在其余3 的7名照料者中，15人完成了整个项目并报告了高度满意度；1名患者在出院后30天内再次入院。DEFT的实施基于学术医疗伙伴关系，并依靠电子病历进行咨询和记录。研究结果的可重复性和普遍性仅限于具有类似能力和资源的环境。在学术医疗中心实施照料者培训和支持项目是可行的，并与良好的初步结果相关。
