个体化积极社会心理互动（IPPI）项目的嵌入式务实临床试验。
An Embedded Pragmatic Clinical Trial of the Individualized Positive Psychosocial Interaction (IPPI) Program.
作者信息
Abbott Katherine M, Heid Allison R, Noble Molly, Kotterman Amy, Unroe Kathleen, Van Haitsma Kimberly
机构信息
Scripps Gerontology Center, Miami University, Oxford, OH, USA; Department of Sociology and Gerontology, Miami University, Oxford, OH, USA.
Independent Research Consultant, Ardmore, PA, USA.
出版信息
J Am Med Dir Assoc. 2025 Aug;26(8):105700. doi: 10.1016/j.jamda.2025.105700. Epub 2025 Jun 12.
OBJECTIVES
We implemented a pilot embedded pragmatic clinical trial of the evidence-based Individualized Positive Psychosocial Interaction (IPPI) program for people living with dementia (PLWD) in nursing homes. We sought to answer the following questions: Can staff consistently deliver IPPIs to enrolled residents over 6 months? How does IPPI completion impact the immediate outcome of resident mood? Can we track the impact of IPPI completion on a distal (3-month and 6-month) pragmatic clinical outcome (ie, symptoms of distress) recorded in the Minimum Dataset (MDS) 3.0?
DESIGN
Nursing home staff completed an online training on emotion-focused communication and were trained to deliver IPPIs, which are short (ie, 10-minute) protocol-guided, one-on-one preference-aligned, interactions with PLWD. Staff were instructed to complete 2 IPPIs per week per resident for 6 months.
SETTING AND PARTICIPANTS
130 residents from 7 nursing homes.
METHODS
Pre- and post-IPPI observed emotion evaluations were completed and MDS 3.0 data were collected for all eligible residents in the nursing home community during the study period. Descriptive statistics and frequencies were computed for rates of IPPI completions, sample descriptives, endorsement of mood change, and symptoms of distress at baseline, 3 months, and 6 months.
RESULTS
IPPI participants who did not die or discharge from the nursing home completed on average 45 IPPIs over 6 months. In 59% (n = 2813) of IPPIs, mood immediately improved from negative to neutral/positive or from neutral to positive, whereas in 42% (n = 1994) of cases, mood stayed stable. MDS 3.0 data were able to show change over time in symptoms of distress from baseline to 3 months and 6 months, with most improving during the intervention period.
CONCLUSIONS AND IMPLICATIONS
The IPPI program is an effective person-centered intervention for PLWD in nursing homes. It can be integrated into care and improve resident mood, and symptoms of distress can be tracked in existing clinical data.
目标
我们开展了一项试点嵌入式务实临床试验，针对养老院中的痴呆症患者（PLWD）实施基于证据的个性化积极心理社会互动（IPPI）项目。我们试图回答以下问题：工作人员能否在6个月内持续为登记入住的居民提供IPPI？IPPI的完成情况如何影响居民情绪的即时结果？我们能否追踪IPPI完成情况对最小数据集（MDS）3.0中记录的远期（3个月和6个月）务实临床结果（即痛苦症状）的影响？
设计
养老院工作人员完成了一项关于以情绪为中心的沟通的在线培训，并接受了提供IPPI的培训，IPPI是简短的（即10分钟）、遵循协议指导的、一对一的、与PLWD偏好一致的互动。工作人员被指示为每位居民每周完成2次IPPI，为期6个月。
地点和参与者
来自7家养老院的130名居民。
方法
在研究期间，对所有符合条件的养老院社区居民完成IPPI前后的观察情绪评估，并收集MDS 3.0数据。计算IPPI完成率、样本描述、情绪变化认可情况以及基线、3个月和6个月时痛苦症状的描述性统计数据和频率。
结果
未从养老院死亡或出院的IPPI参与者在6个月内平均完成了45次IPPI。在59%（n = 2813）的IPPI中，情绪立即从消极转变为中性/积极或从中性转变为积极，而在42%（n = 1994）的情况下，情绪保持稳定。MDS 3.0数据能够显示从基线到3个月和6个月痛苦症状随时间的变化，大多数在干预期间有所改善。
结论与启示
IPPI项目是一种针对养老院中PLWD的有效的以人为本的干预措施。它可以融入护理中，改善居民情绪，并且可以在现有临床数据中追踪痛苦症状。
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