Shepherd-Banigan Megan, Goldstein Karen M, Boucher Nathan A, McConnell Eleanor S, McDermott Cara L, Ma Jessica E, Carlson Scott M, Chen Dazhe, Boggan Joel C, Der Tatyana, Alishahi Tabriz Amir, Sims Catherine A, Gordon Adelaide M, Snyder Julee, Ramos Katherine
Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA.
Veterans Affairs Mid-Atlantic Region Mental Illness Research, Durham, NC, USA.
J Appl Gerontol. 2025 Apr 28:7334648251330673. doi: 10.1177/07334648251330673.
Distress behaviors are common in residential care settings and contribute to staff burnout and poor quality of life for older adults. While nonpharmacologic interventions reduce distress behaviors, implementation in routine care remains challenging. Our study applies a narrative reanalysis of interventions identified in a systematic review to describe the setting, focus, core components, and complexity of interventions identified. Most interventions occurred in post-acute settings, followed by transitions between care settings and inpatient mental health settings. Identified interventions were highly complex and heterogeneous regarding the components assessed and the details reported. Intervention components focused on patients, healthcare workers, environmental, and multiple levels. Common patient-level components included individualized care plans, distress behavior detection, medical management, and symptom monitoring. Common staff-level components included education and healthcare team workflow. Current evidence does not provide sufficient detail to replicate these interventions. We provide a template for standardized intervention testing and reporting implementation.
痛苦行为在机构照护环境中很常见，会导致工作人员倦怠以及老年人生活质量低下。虽然非药物干预可减少痛苦行为，但在常规护理中实施仍具有挑战性。我们的研究对系统评价中确定的干预措施进行叙事性再分析，以描述所确定干预措施的背景、重点、核心组成部分和复杂性。大多数干预措施发生在急性后期环境中，其次是护理环境之间的过渡阶段和住院心理健康环境。在所评估的组成部分和报告的细节方面，所确定的干预措施高度复杂且具有异质性。干预组成部分侧重于患者、医护人员、环境以及多个层面。常见的患者层面组成部分包括个性化护理计划、痛苦行为检测、医疗管理和症状监测。常见的工作人员层面组成部分包括教育和医疗团队工作流程。目前的证据没有提供足够的细节来复制这些干预措施。我们提供了一个标准化干预测试和报告实施的模板。
