HealthPartners Center for Memory & Aging, St. Paul, MN, USA.
HealthPartners Institute, Bloomington, MN, USA.
BMC Geriatr. 2023 Aug 24;23(1):515. doi: 10.1186/s12877-023-04146-z.
The University of California, San Francisco Memory and Aging Center (UCSF-MAC) led the development and tested a collaborative care model delivered by lay care team navigators (CTNs) with support from a multidisciplinary team known as the Care Ecosystem (CE). We evaluated outcomes related to the feasibility of the CE in a non-academic healthcare system, including acceptability, adoption, and fidelity to the original UCSF model.
The CE team at HealthPartners consisted of two CTNs, a social worker, an RN, a program coordinator, and a behavioral neurologist. Intake forms were developed to collect demographic, baseline, and annual data at one year related to dementia severity and caregiver status. Experience surveys were completed at 6 and 12 months by participating caregivers. All data was entered into REDCap.
A total of 570 PWD-caregiver dyads were recruited into the CE: 53% PWDs female, average age 75.2 ± 9.43, 19% living within rural communities. Of the 173 dyads assessed at one year, 30% responded to the annual intake forms and 58% of responded to experience surveys. At one year, PWDs progressed in disease severity and functional impairment, although caregiver burden and mood remained unchanged. We observed a significant reduction in caregiver reported emotional challenges associated with caregiving, sleep problems, and obtaining caregiver help at one year. 86% of caregivers reported feeling supported by their CTN nearly always or quite frequently, and 88% rated the CTN as highly responsive to what was important to them.
The CE was feasible and well-received within a non-academic healthcare system.
加州大学旧金山分校记忆与衰老中心（UCSF-MAC）领导开发并测试了一种协作式护理模式，由外行护理团队导航员（CTN）提供，得到了一个称为护理生态系统（CE）的多学科团队的支持。我们评估了 CE 在非学术医疗系统中与可行性相关的结果，包括可接受性、采用率和对原始 UCSF 模型的保真度。
HealthPartners 的 CE 团队由两名 CTN、一名社工、一名注册护士、一名项目协调员和一名行为神经学家组成。我们制定了入组表格，以收集一年时与痴呆严重程度和照护者状况相关的人口统计学、基线和年度数据。参与照护者在 6 个月和 12 个月时完成经验调查。所有数据均输入 REDCap。
CE 共招募了 570 名 PWD-照护者对：53%的 PWD 为女性，平均年龄 75.2±9.43 岁，19%居住在农村社区。在 173 名接受一年评估的患者中，30%完成了年度入组表格，58%完成了经验调查。一年时，PWD 的疾病严重程度和功能障碍有所进展，尽管照护者负担和情绪保持不变。我们观察到，照护者报告的与照护相关的情绪挑战、睡眠问题和获得照护帮助方面的问题在一年时显著减少。86%的照护者报告称他们的 CTN 几乎总是或经常给予他们支持，88%的照护者认为 CTN 对他们重要的事情反应迅速。
CE 在非学术医疗系统中是可行且受欢迎的。
