School of Nursing, University of Auckland, Private Bag 92 019, Auckland, 1142, New Zealand.
Department of Geriatric Medicine, University of Auckland, Level 1, Building 5, Waitemata District Health Board, PO Box 93 503, Auckland, Takapuna, 0740, New Zealand.
BMC Geriatr. 2020 Jul 17;20(1):247. doi: 10.1186/s12877-020-01640-6.
There is increasing interest among older people in moving into retirement villages (RVs), an attractive option for those seeking a supportive community as they age, while still maintaining independence. Currently in New Zealand there is limited knowledge of the medical, service supports, social status and needs of RV residents. The objective of this study is to explore RV facilities and services, the health and functional status of RV residents, prospectively study their healthcare trajectories and to implement a multidisciplinary team intervention to potentially decrease dependency and impact healthcare utilization.
All RVs located in two large district health boards in Auckland, New Zealand were eligible to participate. This three-year project comprised three phases: The survey phase provided a description of RVs, residents' characteristics and health and functional status. RV managers completed a survey of size, facilities and recreational and healthcare services provided in the village. Residents were surveyed to establish reasons for entry to the village and underwent a Gerontology Nurse Specialist (GNS) assessment providing details of demographics, social engagement, health and functional status. The cohort study phase examines residents' healthcare trajectories and adverse outcomes, over three years. The final phase is a randomised controlled trial of a multidisciplinary team intervention aimed to improve health outcomes for more vulnerable residents. Residents who triggered potential unmet health needs during the assessment in the survey phase were randomised to intervention or usual care groups. Multidisciplinary team meetings included the resident and support person, a geriatrician or gerontology nurse practitioner, GNS, pharmacist and General Practitioner. The primary outcome of the randomised controlled trial will be first acute hospitalization. Secondary outcomes include all acute hospitalizations, long-term care admissions, and all-cause mortality.
This paper describes the study protocol of this complex study. The study aims to inform policies and practices around health care services for residents in retirement villages. The results of this trial are expected early 2020 with publication subsequently.
Australia and New Zealand Clinical Trials Registry: ACTRN12616000685415 . Registered 25.5.2016. Universal Trial Number (UTN): U111-1173-6083.
随着年龄的增长，老年人对搬入退休村（RV）的兴趣越来越大，对于那些寻求支持性社区的人来说，这是一个有吸引力的选择，同时他们仍然保持独立。目前，新西兰对 RV 居民的医疗、服务支持、社会地位和需求知之甚少。本研究的目的是探索 RV 设施和服务、RV 居民的健康和功能状况，前瞻性研究他们的医疗保健轨迹，并实施多学科团队干预，以潜在减少依赖和影响医疗保健利用。
所有位于新西兰奥克兰两个大型地区卫生局的 RV 都有资格参加。这个为期三年的项目包括三个阶段：调查阶段提供了 RV、居民特征以及健康和功能状况的描述。RV 经理完成了一项关于村庄规模、设施以及娱乐和医疗保健服务的调查。对居民进行了调查，以确定他们进入村庄的原因，并由老年病护士专家（GNS）进行评估，提供人口统计学、社会参与、健康和功能状况的详细信息。队列研究阶段在三年内检查居民的医疗保健轨迹和不良后果。最后一个阶段是一项针对多学科团队干预的随机对照试验，旨在改善脆弱居民的健康结果。在调查阶段的评估中，对触发潜在未满足健康需求的居民进行随机分组，分为干预组或常规护理组。多学科团队会议包括居民和支持人员、老年病医生或老年病护士从业者、GNS、药剂师和全科医生。随机对照试验的主要结局将是首次急性住院。次要结局包括所有急性住院、长期护理入院和全因死亡率。
本文介绍了这项复杂研究的研究方案。该研究旨在为退休村居民的医疗保健服务政策和实践提供信息。预计该试验的结果将于 2020 年初公布，随后将发表。
澳大利亚和新西兰临床试验注册中心：ACTRN12616000685415。注册于 2016 年 5 月 25 日。通用试验编号（UTN）：U111-1173-6083。
