Resnick Barbara, Boltz Marie, Galik Elizabeth, McPherson Rachel, Kuzmik Ashley, Drazich Brittany, Kim Nayeon, Zhu Shijun, Wells Chris
Associate Dean of Research Department of Research and Scholarship, University of Maryland School of Nursing, Baltimore, Maryland, USA.
Interim Associate Dean for Research & Innovation, Elouise Ross Eberly and Robert Eberly Endowed Chair, Penn State University, College of Nursing, University Park, Pennsylvania, USA.
J Am Geriatr Soc. 2025 May;73(5):1388-1397. doi: 10.1111/jgs.19334. Epub 2024 Dec 27.
The purpose of this study was to test the impact of Function Focused Care for Acute Care Using the Evidence Integration Triangle (FFC-AC-EIT) on hospitalized patients living with dementia.
This was a clustered randomized clinical trial including 12 hospitals from two states and 455 patients living with dementia. Hospitals were randomized to FFC-AC-EIT versus FFC Education Only. The mean age of the participants was 82.5 (SD = 8.5), the majority were women (62.6%), White (65.3%), married (64.4%), and had 3.0 (SD = 2.4) comorbidities. Outcome measures included the Barthel Index; the Physical Activity Survey, the Confusion Assessment Method Short Form (CAM-S), the Neuropsychiatric Inventory (NPI), and the Pain Assessment in Advanced Dementia.
At discharge, both groups improved in function and physical activity, patients in the intervention group had less increase in pain than those in the control group (β = -0.58, 95% confidence interval [95% CI] (-0.89, -0.26), p < 0.001). There were no group differences in behavioral symptoms or delirium. At 1 month post-discharge there was a significant improvement in function (β = 5.55, 95% CI [0.36, 10.75], p = 0.036) and physical activity (β = 3.07, 95% CI [1.87, 4.28], p < 0.001).
Exposure to information about function focused care may help staff in acute care settings maintain and increase function and physical activity for older patients living with dementia during the hospital stay and help facilitate an increase in function and physical activity after discharge.
本研究旨在测试使用证据整合三角模型的急性护理功能聚焦照护（FFC-AC-EIT）对住院痴呆患者的影响。
这是一项整群随机临床试验，纳入了来自两个州的12家医院的455名痴呆患者。医院被随机分为接受FFC-AC-EIT组和仅接受FFC教育组。参与者的平均年龄为82.5岁（标准差=8.5），大多数为女性（62.6%）、白人（65.3%）、已婚（64.4%），合并症有3.0种（标准差=2.4）。结局指标包括巴氏指数、身体活动调查、简易精神状态检查表（CAM-S）、神经精神科问卷（NPI）以及晚期痴呆疼痛评估。
出院时，两组患者的功能和身体活动均有所改善，干预组患者的疼痛增加幅度低于对照组（β=-0.58，95%置信区间[95%CI]为（-0.89，-0.26），p<0.001）。两组在行为症状或谵妄方面无差异。出院后1个月，功能（β=5.55，95%CI为[0.36，10.75]，p=0.036）和身体活动（β=3.07，95%CI为[1.87，4.28]，p<0.001）有显著改善。
接触功能聚焦照护相关信息可能有助于急性护理环境中的工作人员在住院期间维持和提高老年痴呆患者的功能及身体活动，并有助于促进出院后功能和身体活动的增加。
