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评估以人为本的国家培训计划以加强痴呆症护理人员队伍

2026年4月9日更新者：University of North Carolina, Chapel Hill

该项目将比较针对辅助生活直接护理人员的循证在线痴呆症护理培训计划的两种培训模式与候补名单控制：1) essentiALZ 培训和 2) essentiALZ 培训 + ECHO 项目。它将检查每种模式的实施程度和实现其预期结果的程度，以提高员工知识和态度，改变护理实践，并改善员工、居民和居民家庭成员的福祉。结果将为辅助生活 (AL) 和更广泛的长期护理人员的痴呆症护理培训的后续步骤提供信息。

为了检验这些结果，我们将在 6 个月内从 AL 工作人员和家庭收集数据。工作人员将在基线、培训后、3 个月和 6 个月时填写调查问卷并参加访谈（如适用）。家庭将参加基线、3 个月和 6 个月时的访谈。

研究概览

地位

招聘中

条件

干预/治疗

详细说明

超过 75% 的年满 80 岁的阿尔茨海默病和相关痴呆症患者需要长期住院护理，而这种护理越来越多地通过辅助生活 (AL) 提供。在全国范围内，近2.9万个拥有超过99.6万张床位的AL社区已成为痴呆症患者的主要住宿护理提供者：90%的AL居民患有认知障碍，42%的居民患有中度或重度痴呆，实际比率更高。 AL 提供支持服务，但不提供护理服务；因此，几乎所有护理均由直接护理人员（护理助理和个人护理助理）提供。

不幸的是，直接护理人员的价值被低估且培训不足，导致护理质量差、工伤、不满和高流动率。 AL 是由州监管的，只有 17 个州规定了最低培训时间（有些州低至一小时），这意味着三分之二的州对培训保持沉默。不到 40% 的员工受过高中以上教育，因此少数人报告有足够的知识来照顾痴呆症患者也就不足为奇了。为了努力填补这一空白，必须对直接护理人员进行培训，并且必须能够有效地使工作人员、组织和痴呆症患者受益。

在线培训是一种特别有前途的选择，因为它成本低、可用性广泛，并且具有自定进度、自动化技能测试和认证的潜力。阿尔茨海默病协会是痴呆症护理培训领域的全国领导者，并于 2021 年开发了 essentiALZ（发音为“essentials”），这是一个在线课程，教授循证、以人为本的护理，可以通过计算机、平板电脑或移动设备进行访问。已有超过 1,500 名员工拥有 essentiALZ 认证，但与大多数培训计划一样，缺乏证明其改善护理和结果能力的证据。 essentiALZ 可能有效改变护理和结果，但也可能需要额外的支持才能做到这一点。 ECHO 项目是一种及时的支持模式，该项目作为一种通过远程在线方法提供专家指导和同伴支持的行之有效的方法，已经席卷了长期护理领域。将 ECHO 添加到在线痴呆症培训中可能会为实现护理变革和改善结果提供必要的推动。

该项目响应了国家老龄化研究所的特别关注通知，该通知呼吁通过加强和支持技能培训来加强劳动力队伍。它将在 126 个 AL 社区进行混合实施/有效性随机试验，比较单独的 essentiALZ、essentiALZ + ECHO 增强和候补名单对照。将在六个月内对以覆盖范围、有效性、采用、实施和维护 (RE-AIM) 模型和柯克帕特里克培训有效性模型为基础的结果进行检查，在 (1) 实施和 (2) 有效性方面比较各组，以及(3) 根据 AL 社区、工作人员、居民和家庭成员的特点，检查实施和有效性的差异程度。结果将为 AL 和更广泛的长期护理人员的痴呆症护理培训的后续步骤提供信息。

研究类型

介入性

注册 (估计的)

1764

阶段

不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

姓名：Johanna Hickey, MSW
电话号码：9198433085
邮箱：jvtsilbersack@unc.edu

学习地点

美国
- North Carolina
  - Chapel Hill、North Carolina、美国、27599
    - 招聘中
    - University of North Carolina at Chapel Hill
    - 接触：
      
      Johanna Hickey, MSW
      
      电话号码：919-843-3085
      
      邮箱：jvtsilbersack@unc.edu
    - 首席研究员：
      
      Sheryl Zimmerman, PhD

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

成人
年长者

接受健康志愿者

是的

描述

纳入标准：

AL 工作人员：

为参与辅助生活社区的居民提供直接护理的工作人员（兼职、全职，包括合同工）（例如，认证护理助理、个人护理助理、注册护士、执业护士、活动总监、社会工作者等）由管理员/医疗保健主管确定
年满 18 岁或以上
能够流利地阅读和说英语

家庭：

根据基线，预计居民在未来六个月内不会死亡或转移
随访时，居民在访谈日期前的三个月内在 AL 社区居住了至少一个月
是参与 AL 社区的阿尔茨海默病及相关痴呆症 (ADRD) 居民的家庭成员/合法授权代表 (LAR) 或指定联系人
年满 18 岁或以上
是说英语的吗
至少每月拜访一次住户

排除标准：

AL 员工及家人：

- 未满 18 岁

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

主要用途：卫生服务研究
分配：随机化
介入模型：并行分配
屏蔽：单身的

手臂数量

武器和干预

参与者组/臂	干预/治疗
实验性的：基本ALZ 随机分配到该部门的社区将接受 essentiALZ 培训：由 AL 工作人员进行的基于网络的培训，其中包含三个小时的自定进度内容，分为五个模块，外加最终审查。模块包括：1）阿尔茨海默病和痴呆； 2）以人为本的护理； 3）评估和护理计划； 4）日常生活活动； 5）行为和沟通。我们将鼓励员工参加为期四个星期的培训。	行为的：基本ALZ essentiALZ 是一项基于网络的培训，包含三个小时的自定进度内容，分为五个模块，以及最终回顾。模块包括：1）阿尔茨海默病和痴呆； 2）以人为本的护理； 3）评估和护理计划； 4）日常生活活动； 5）行为和沟通。我们将鼓励员工参加为期四个星期的培训。
实验性的：基本 ALZ + 回声随机分配到该部门的社区将接受 essentiALZ 培训：由 AL 工作人员进行的基于网络的培训，其中包含三个小时的自定进度内容，分为五个模块，外加最终审查。模块包括：1）阿尔茨海默病和痴呆； 2）以人为本的护理； 3）评估和护理计划； 4）日常生活活动； 5）行为和沟通。我们将鼓励员工参加为期四个星期的培训。此外，他们还将获得 ECHO 项目的访问权限。 ECHO 是一种基于案例学习的虚拟远程指导模型。它包括每周六次一小时的教学和讨论学习课程。前五个会议将反映五个 essentiALZ 模块的内容，最后一个会议将讨论维护问题。 ECHO 会议是将通过 Zoom 进行的小组会议。	行为的：基本ALZ essentiALZ 是一项基于网络的培训，包含三个小时的自定进度内容，分为五个模块，以及最终回顾。模块包括：1）阿尔茨海默病和痴呆； 2）以人为本的护理； 3）评估和护理计划； 4）日常生活活动； 5）行为和沟通。我们将鼓励员工参加为期四个星期的培训。行为的：回声计划 ECHO 是一种基于案例学习的虚拟远程指导模型。它包括每周六次一小时的教学和讨论学习课程。前五个会议将反映五个 essentiALZ 模块的内容，最后一个会议将讨论维护问题。 ECHO 会议是将通过 Zoom 进行的小组会议。
无干预：不干预将提供标准护理。

研究衡量的是什么？

主要结果指标

结果测量	措施说明	大体时间
痴呆症护理能力感 (SCIDS) 得分随时间的变化大体时间：将在干预期间以及干预结束后额外跟踪参与者 6 个月，预计平均为 8 个月	痴呆症护理能力意识 (SCIDS) 是一个包含 17 项的工具。使用 4 点李克特量表表示响应。最低分数（最差值）= 1。最高分（最佳值）= 4。值越高表示结果越好（范围 17-68）。衡量标准通过基线调查问卷、3 个月随访调查问卷和 6 个月随访调查问卷进行评估。	将在干预期间以及干预结束后额外跟踪参与者 6 个月，预计平均为 8 个月
工作人员与痴呆症居民一起工作的经验问卷的分数随时间的变化 - 护理组织、与患者的满意接触以及对他人期望的满意度子量表 (SEWDRQ) 大体时间：将在干预期间以及干预结束后额外跟踪参与者 6 个月，预计平均为 8 个月	工作人员与痴呆症居民合作的经验调查问卷 - 护理组织、与患者的满意接触以及对他人期望的满意度分量表 (SEWDRQ) 是一个包含 9 项的工具。反应采用 5 点李克特量表表示。最低分数（最差值）= 0。最高分数（最佳值）= 4。值越高表示结果越好（范围 0-36）。衡量标准通过基线调查问卷、3 个月随访调查问卷和 6 个月随访调查问卷进行评估。	将在干预期间以及干预结束后额外跟踪参与者 6 个月，预计平均为 8 个月
痴呆症态度量表分数随时间的变化 - 简式 (DAS-6) 大体时间：将在干预期间以及干预结束后额外跟踪参与者 6 个月，预计平均为 8 个月	痴呆态度量表（简式）是一个包含 6 项的工具。使用 7 点李克特量表表示响应。最低分数（最差值）= 1。最高分（最佳值）= 7。值越高表示结果越好（范围 6-42）。衡量标准通过基线调查问卷、3 个月随访调查问卷和 6 个月随访调查问卷进行评估。	将在干预期间以及干预结束后额外跟踪参与者 6 个月，预计平均为 8 个月

次要结果测量

结果测量	措施说明	大体时间
EssentiALZ 考试项目的分数随时间的变化大体时间：将在干预期间以及干预结束后额外跟踪参与者 6 个月，预计平均为 8 个月	essentiALZ 考试项目是一个包含 5 项的工具。工具是对干预培训主题的知识的测量。答案是多项选择，每个问题只有一个答案被视为“正确”。正确答案的值越高，代表更好的结果/知识保留（范围 0-5）。衡量标准通过基线调查问卷、培训后调查问卷、3 个月随访调查问卷和 6 个月随访调查问卷进行评估。	将在干预期间以及干预结束后额外跟踪参与者 6 个月，预计平均为 8 个月
EssentiALZ 组织实践的得分随时间的变化大体时间：将在干预期间以及干预结束后额外跟踪参与者 6 个月，预计平均为 8 个月	essentiALZ 考试项目是一个包含 5 项的工具。工具是对干预培训主题的知识的测量。答案是多项选择，每个问题只有一个答案被视为“正确”。正确答案的值越高，代表更好的结果/知识保留（范围 0-5）。衡量标准通过基线调查问卷、3 个月随访调查问卷和 6 个月随访调查问卷进行评估。	将在干预期间以及干预结束后额外跟踪参与者 6 个月，预计平均为 8 个月
情绪倦怠得分随时间的变化大体时间：将在干预期间以及干预结束后额外跟踪参与者 6 个月，预计平均为 8 个月	研究人员将通过询问“总体而言，根据您对倦怠的定义，您如何评价您的倦怠程度来评估离职意图？选择一个。” 回答选项为：“1 = 我喜欢我的工作。我没有倦怠的症状。", "2 = 有时我会感到压力，而且我并不总是像以前那样精力充沛，但我并不感到精疲力尽。", “3 - 我肯定精疲力尽，并且有一种或多种倦怠症状，例如身体和情绪疲惫。”, “4 = 我所经历的倦怠症状不会消失。我经常思考工作中的挫败感。", "5 = 我感到彻底精疲力竭，常常怀疑自己是否还能继续下去。我现在可能需要一些改变，或者可能需要寻求某种帮助。” 最小值 = 1（最佳值），最大值 = 5（最差值）。衡量标准通过基线调查问卷、3 个月随访调查问卷和 6 个月随访调查问卷进行评估。	将在干预期间以及干预结束后额外跟踪参与者 6 个月，预计平均为 8 个月
打算离开的分数随时间的变化大体时间：将在干预期间以及干预结束后额外跟踪参与者 6 个月，预计平均为 8 个月	研究人员将通过询问“您明年离开这份工作的可能性有多大？”来评估离职意图。 “你会说...1 完全不可能，2 有点可能，3 非常可能。” 最小值 = 1（最佳值），最大值 = 3（最差值）。衡量标准通过基线调查问卷、3 个月随访调查问卷和 6 个月随访调查问卷进行评估。	将在干预期间以及干预结束后额外跟踪参与者 6 个月，预计平均为 8 个月
感觉被重视的分数随时间的变化大体时间：将在干预期间以及干预结束后额外跟踪参与者 6 个月，预计平均为 8 个月	essentiALZ 考试项目是一个包含 5 项的工具。工具是对干预培训主题的知识的测量。答案是多项选择，每个问题只有一个答案被视为“正确”。正确答案的值越高，代表更好的结果/知识保留（范围 0-5）。衡量标准通过基线调查问卷、3 个月随访调查问卷和 6 个月随访调查问卷进行评估。	将在干预期间以及干预结束后额外跟踪参与者 6 个月，预计平均为 8 个月

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

University of North Carolina, Chapel Hill

合作者

National Institute on Aging (NIA)

Alzheimer's Association

调查人员

首席研究员：Sheryl Zimmerman, PhD、University of North Carolina, Chapel Hill

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

一般刊物

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Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999 Sep;89(9):1322-7. doi: 10.2105/ajph.89.9.1322.
Onken LS, Carroll KM, Shoham V, Cuthbert BN, Riddle M. Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health. Clin Psychol Sci. 2014 Jan 1;2(1):22-34. doi: 10.1177/2167702613497932.
Ballard C, Corbett A, Orrell M, Williams G, Moniz-Cook E, Romeo R, Woods B, Garrod L, Testad I, Woodward-Carlton B, Wenborn J, Knapp M, Fossey J. Impact of person-centred care training and person-centred activities on quality of life, agitation, and antipsychotic use in people with dementia living in nursing homes: A cluster-randomised controlled trial. PLoS Med. 2018 Feb 6;15(2):e1002500. doi: 10.1371/journal.pmed.1002500. eCollection 2018 Feb.
Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004;82(4):581-629. doi: 10.1111/j.0887-378X.2004.00325.x.
Astrom S, Nilsson M, Norberg A, Sandman PO, Winblad B. Staff burnout in dementia care--relations to empathy and attitudes. Int J Nurs Stud. 1991;28(1):65-75. doi: 10.1016/0020-7489(91)90051-4.
Moyle W, Murfield JE, Griffiths SG, Venturato L. Care staff attitudes and experiences of working with older people with dementia. Australas J Ageing. 2011 Dec;30(4):186-90. doi: 10.1111/j.1741-6612.2010.00470.x. Epub 2010 Oct 8.
Zimmerman S, Williams CS, Reed PS, Boustani M, Preisser JS, Heck E, Sloane PD. Attitudes, stress, and satisfaction of staff who care for residents with dementia. Gerontologist. 2005 Oct;45 Spec No 1(1):96-105. doi: 10.1093/geront/45.suppl_1.96.
Sloane PD, Williams CS, Zimmerman S. Immigrant status and intention to leave of nursing assistants in U.S. nursing homes. J Am Geriatr Soc. 2010 Apr;58(4):731-7. doi: 10.1111/j.1532-5415.2010.02781.x.
Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, Griffey R, Hensley M. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011 Mar;38(2):65-76. doi: 10.1007/s10488-010-0319-7.
Glasgow RE, Harden SM, Gaglio B, Rabin B, Smith ML, Porter GC, Ory MG, Estabrooks PA. RE-AIM Planning and Evaluation Framework: Adapting to New Science and Practice With a 20-Year Review. Front Public Health. 2019 Mar 29;7:64. doi: 10.3389/fpubh.2019.00064. eCollection 2019.
Brownie S, Nancarrow S. Effects of person-centered care on residents and staff in aged-care facilities: a systematic review. Clin Interv Aging. 2013;8:1-10. doi: 10.2147/CIA.S38589. Epub 2013 Jan 3.
Reblin M, Uchino BN. Social and emotional support and its implication for health. Curr Opin Psychiatry. 2008 Mar;21(2):201-5. doi: 10.1097/YCO.0b013e3282f3ad89.
Arora S, Thornton K, Murata G, Deming P, Kalishman S, Dion D, Parish B, Burke T, Pak W, Dunkelberg J, Kistin M, Brown J, Jenkusky S, Komaromy M, Qualls C. Outcomes of treatment for hepatitis C virus infection by primary care providers. N Engl J Med. 2011 Jun 9;364(23):2199-207. doi: 10.1056/NEJMoa1009370. Epub 2011 Jun 1.
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研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2024年4月12日

初级完成 (估计的)

2027年4月30日

研究完成 (估计的)

2027年4月30日

研究注册日期

首次提交

2024年1月24日

首先提交符合 QC 标准的

2024年1月24日

首次发布 (实际的)

2024年2月2日

研究记录更新

最后更新发布 (实际的)

2026年4月13日

上次提交的符合 QC 标准的更新

2026年4月9日

最后验证

2026年4月1日

评估以人为本的国家培训计划以加强痴呆症护理人员队伍

研究概览

地位

条件

干预/治疗

详细说明

研究类型

注册 (估计的)

阶段

联系人和位置

学习联系方式

学习地点

参与标准

资格标准

适合学习的年龄

接受健康志愿者

描述

学习计划

研究是如何设计的？

设计细节

手臂数量

武器和干预

参与者组/臂

干预/治疗

研究衡量的是什么？

主要结果指标

结果测量

措施说明

大体时间

次要结果测量

结果测量

措施说明

大体时间

合作者和调查者

赞助

合作者

调查人员

出版物和有用的链接

一般刊物

研究记录日期

研究主要日期

学习开始 (实际的)

初级完成 (估计的)

研究完成 (估计的)

研究注册日期

首次提交

首先提交符合 QC 标准的

首次发布 (实际的)

研究记录更新

最后更新发布 (实际的)

上次提交的符合 QC 标准的更新

最后验证

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

IPD 计划说明

IPD 共享时间框架

IPD 共享访问标准

药物和器械信息、研究文件

研究美国 FDA 监管的药品

研究美国 FDA 监管的设备产品

在美国制造并从美国出口的产品