Miller Lyndsey M, Solomon Diane N, Whitlatch Carol J, Hiatt Shirin O, Wu Chao-Yi, Reynolds Christina, Au-Yeung Wan-Tai Michael, Kaye Jeffrey, Steele Joel S
School of Nursing, Oregon Health and Science University, Portland, Oregon, USA.
Oregon Center for Aging & Technology (ORCATECH), Oregon Health and Science University, Portland, Oregon, USA.
Innov Aging. 2022 Feb 7;6(2):igac006. doi: 10.1093/geroni/igac006. eCollection 2022.
The Remote Assessment and Dynamic Response (READyR) Program was developed in order to address the current lack of early-stage dementia care planning programs that assess the care needs of persons with dementia. The goal was to create a program informed by care values and ongoing ecologically valid data. The objectives of this study are to describe the development and design process of the READyR Program, and to evaluate the utility of the READyR Program for identifying dementia-related care needs.
A prototype of the web-based READyR Program tool was first created using digital activity data that were collected by previous studies using a platform of multimodal sensors installed in the homes of older adult couples with and without dementia. Digital activity data were then mapped onto potential care values (e.g., safety & autonomy) to create a values-based needs assessment that is tailored to the individual care dyad. Next, evaluation of the READyR Program by 11 professional dementia care coordinators and case managers (across 3 semistructured focus groups) was used to explore the utility of READyR for assessing dementia-related needs. Qualitative description using conventional content analysis was used to iteratively code focus group data and to describe prevalent themes.
Prevalent focus groups themes included barriers to (e.g., family relationship strain) and facilitators of (e.g., tailored assessments) the optimal process for assessing dementia-related care needs by care coordinators, as well as advantages to (e.g., providing new objective insights into function, and routines) and disadvantages of (e.g., bringing up new questions about care) incorporating the remote monitoring data into a values-based needs assessment.
READyR has the potential to help family members, as well as care coordinators and providers, gain insight into the values-based care needs of persons with early-stage dementia. NCT04542109.
为解决目前缺乏评估痴呆症患者护理需求的早期痴呆症护理规划项目的问题，开发了远程评估与动态响应（READyR）项目。目标是创建一个以护理价值观和持续有效的生态数据为依据的项目。本研究的目的是描述READyR项目的开发和设计过程，并评估该项目在识别痴呆症相关护理需求方面的效用。
首先使用数字活动数据创建基于网络的READyR项目工具的原型，这些数据是先前研究通过安装在患有和未患有痴呆症的老年夫妇家中的多模式传感器平台收集的。然后将数字活动数据映射到潜在的护理价值观（如安全与自主性）上，以创建针对个体护理二元组的基于价值观的需求评估。接下来，由11名专业痴呆症护理协调员和病例经理（通过3个半结构化焦点小组）对READyR项目进行评估，以探讨其在评估痴呆症相关需求方面的效用。使用传统内容分析法进行定性描述，以迭代编码焦点小组数据并描述普遍主题。
焦点小组的普遍主题包括护理协调员评估痴呆症相关护理需求的最佳过程中的障碍（如家庭关系紧张）和促进因素（如量身定制的评估），以及将远程监测数据纳入基于价值观的需求评估的优点（如提供关于功能和日常活动的新客观见解）和缺点（如引发关于护理的新问题）。
READyR有潜力帮助家庭成员以及护理协调员和提供者深入了解早期痴呆症患者基于价值观的护理需求。 临床试验编号：NCT04542109。
