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家庭照护者提供的安全照护与药物摄入:现实照护研究方案

Safe Care and Medication Intake Provided by Caregivers at Home: Reality Care Study Protocol.

作者信息

Mira José Joaquín, Ballester Pura, Gil-Hernández Eva, Sambrano Valeriano Luisanna, Álvarez Gómez Esther, Olier Garate Clara, Márquez Ruiz Álvaro, Acedo Torrecilla María, Arroyo Rodríguez Almudena, Hidalgo Galache Ezequiel, Navas Gutiérrez Paloma, Pérez-Jover Virtudes, Lorenzo Martínez Susana, Carrillo Murcia Irene, Fernández Peris César, Sánchez-García Alicia, Vicente Ripoll María Asunción, Cobos Vargas Ángel, Pérez-Pérez Pastora, Guilabert Mora Mercedes

机构信息

Departamento Psicología de la Salud, Universidad Miguel Hernández, 03202 Elche, Spain.

Health District Alicante-Sant Joan, 03013 Alicante, Spain.

出版信息

Healthcare (Basel). 2023 Aug 3;11(15):2190. doi: 10.3390/healthcare11152190.

Abstract

JUSTIFICATION

Providing care to patients with several conditions and simultaneously taking several medications at home is inexorably growing in developed countries. This trend increases the chances of home caregivers experiencing diverse errors related with medication or care.

OBJECTIVE

To determine the effectiveness of four different educational solutions compared to the natural intervention (absence of intervention) to provide a safer care at home by caregivers.

METHOD

Prospective, parallel, and mixed research study with two phases. Candidates: Home-based caregivers caring a person with multiple comorbid conditions or polymedication who falls into one of the three profiles of patients defined for the study (oncology, cardiovascular, or pluripathological patients). First phase: Experts first answered an online survey, and then joined together to discuss the design and plan the content of educational solutions directed to caregivers including the identification of medication and home care errors, their causes, consequences, and risk factors. Second phase: The true experiment was performed using an inter- and intrasubject single-factor experimental design (five groups: four experimental groups against the natural intervention (control), with pre- and post-intervention and follow-up measures) with a simple random assignment, to determine the most effective educational solution (n = 350 participants). The participants will be trained on the educational solutions through 360 V, VR, web-based information, or psychoeducation. A group of professionals called the "Gold Standard" will be used to set a performance threshold for the caring or medication activities. The study will be carried out in primary care centers, hospitals, and caregivers' associations in the Valencian Community, Andalusia, Madrid, and Murcia.

EXPECTED RESULTS

We expect to identify critical elements of risk management at home for caregivers and to find the most effective and optimal educational solution to reduce errors at home, increasing caregivers' motivation and self-efficacy whilst the impact of gender bias in this activity is reduced.

TRIAL REGISTRATION

Clinical Trial NCT05885334.

摘要

理由

在发达国家,为患有多种疾病的患者提供护理并同时在家服用多种药物的情况正在无情地增加。这种趋势增加了家庭护理人员出现与用药或护理相关的各种错误的可能性。

目的

确定与自然干预(无干预)相比,四种不同教育方案在使家庭护理人员提供更安全家庭护理方面的有效性。

方法

一项前瞻性、平行且混合的两阶段研究。研究对象:为患有多种合并症或服用多种药物的患者提供居家护理的人员,这些患者属于为该研究定义的三种患者类型之一(肿瘤患者、心血管疾病患者或患有多种疾病的患者)。第一阶段:专家们首先回答一份在线调查问卷,然后聚在一起讨论针对护理人员的教育方案的设计并规划其内容,包括识别用药和家庭护理错误、错误原因、后果及风险因素。第二阶段:采用受试者间和受试者内单因素实验设计进行真实实验(五组:四个实验组与自然干预组(对照组)对比,有干预前、干预后及随访措施),通过简单随机分配来确定最有效的教育方案(n = 350名参与者)。参与者将通过360V、虚拟现实、基于网络的信息或心理教育接受教育方案培训。一组被称为“黄金标准”的专业人员将被用于设定护理或用药活动的绩效阈值。该研究将在巴伦西亚自治区、安达卢西亚、马德里和穆尔西亚的初级保健中心、医院及护理人员协会开展。

预期结果

我们期望识别家庭护理人员在家中风险管理的关键要素,并找到最有效和最佳的教育方案以减少家庭中的错误,提高护理人员的积极性和自我效能感,同时减少性别偏见在这项活动中的影响。

试验注册

临床试验NCT05885334。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d3d/10419200/acbec35cec95/healthcare-11-02190-g001.jpg

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