日本长期护理服务使用者中，受过培训的护理经理进行干预对预先护理计划参与度的影响：一项多机构的试点前后对比研究。
Effects of intervention by trained care managers on advance care planning engagement among long-term care service users in Japan: a pre- and post-pilot comparative study across multiple institutions.
作者信息
Okochi Shozo, Oshiro Kyoko, Takeuchi Noriyasu, Miyamichi Mariko, Nakamura Tomoe, Matsushima Terumi, Okada Masako, Kudo Yoshimi, Ishiyama Takehiro, Kinoshita Tomoyasu, Kojima Hideki, Nishikawa Mitsunori
机构信息
Social Welfare Corporation Yotsubakai, Kurashiki, Okayama, Japan.
Wabisabi Home Care Support Office, Chita, Aichi, Japan.
出版信息
Palliat Care Soc Pract. 2024 Sep 23;18:26323524241281065. doi: 10.1177/26323524241281065. eCollection 2024.
BACKGROUND
A majority of Japanese care managers lack medical qualifications, feel uncomfortable discussing future medical choices and believe that it is not their responsibility.
OBJECTIVES
As there is a paucity of care manager intervention studies, this study aimed to measure changes in advance care planning engagement among long-term care service users before and after intervention by care managers with communication training.
DESIGN
A multi-institutional pre- and post-pilot comparative study.
METHODS
A multi-institutional pre- and post-trial study was performed from August 2022 to January 2023 (trial ID: 000048573). Nine trained care managers communicated with 30 long-term care service users regarding advance care planning, and the pre- and post-trial advance care planning engagement scores were compared. Additionally, the post-trial impact of events score was investigated.
RESULTS
All 30 long-term care service users completed the trial. The advance care planning engagement score increased after the trial. The sample size was considered adequate for future trials. Years of experience as a care manager, impact of events score, and having a clinical frailty scale of ⩾5 were significant explanatory variables that affected the objective variable of the difference between pre- and post-trial advance care planning engagement score.
CONCLUSION
This study on the impact of advance care planning communication interventions by trained care managers offers insights into determining appropriate sample sizes and identifying factors influencing future research outcomes. Advance care planning engagement of long-term care service users might change before and after intervention by care managers through advance care planning communication.
TRIAL REGISTRATION
University Hospital Medical Information (UMIN) Network Trial ID: 000048573.
背景
大多数日本护理经理没有医学资质，在讨论未来医疗选择时感到不自在，并且认为这不是他们的职责。
目的
由于护理经理干预研究较少，本研究旨在衡量接受沟通培训的护理经理干预前后长期护理服务使用者在预先护理计划参与度方面的变化。
设计
多机构试点前后比较研究。
方法
于2022年8月至2023年1月进行了一项多机构试验前后研究（试验编号：000048573）。九名经过培训的护理经理就预先护理计划与30名长期护理服务使用者进行沟通，并比较试验前后预先护理计划参与度得分。此外，还调查了试验后事件影响得分。
结果
所有30名长期护理服务使用者均完成试验。试验后预先护理计划参与度得分有所提高。样本量被认为足以支持未来的试验。护理经理的工作年限、事件影响得分以及临床衰弱量表评分⩾5是影响试验前后预先护理计划参与度得分差异这一客观变量的重要解释变量。
结论
这项关于经过培训的护理经理进行预先护理计划沟通干预影响的研究为确定合适的样本量以及识别影响未来研究结果的因素提供了见解。通过预先护理计划沟通，长期护理服务使用者的预先护理计划参与度在护理经理干预前后可能会发生变化。
试验注册
大学医院医学信息（UMIN）网络试验编号：000048573。
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