Evaluating the Unmet Needs of Older Adults to Promote Functional Recovery After a Critical Illness
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 350
- 试验地点
- 2
- 主要终点
- Disability Count
研究概览
简要总结
This is a prospective longitudinal study that will evaluate the unmet needs of older adults (65 and older) who return home (either directly or after short-term rehab) after an ICU hospitalization, evaluate the association of these unmet needs with clinically relevant outcomes, and assess barriers and facilitators to addressing these unmet needs. The proposed research will inform the development and evaluation of a subsequent intervention to improve functional outcomes among older ICU survivors, in alignment with the NIH's mission to reduce disability.
详细描述
To identify unmet needs in multiple domains after return home from an ICU hospitalization, evaluate whether these unmet needs are associated with disability burden in the subsequent 6 months, and ascertain whether these associations are moderated by initial discharge destination (home or STR).
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •PARTICIPANTS
- •Age ≥ 65 years
- •Survived an ICU admission of ≥2 days
- •Age ≥ 18 years
- •Identified as caregiver of LANTERN participant who is an informal (unpaid) caregiver.
排除标准
- •PARTICIPANTS
- •Advance directive of comfort measures only (CMO) or a transition to hospice
- •Planned discharge to a location other than home or Short-Term Rehab
- •Tracheostomy with ventilator dependence
- •Severe acute or prior neurologic injury (such as anoxic brain injury or acute, massive stroke)
- •Advanced dementia
- •ICU admission for monitoring only (e.g., antibiotic desensitization)
- •Primary language other than English.
- •Homelessness
- •Active drug or alcohol use disorder.
- •Primary language other than English
- •Is a paid caregiver
- •Unwilling to complete a qualitative interview
结局指标
主要结局
Disability Count
时间窗: monthly up to 6 months
Number of instances of disability during activities of daily living (ADLs), instrumental activities of daily living (IADLs), and mobility activity. Disability is defined as an inability to complete the task or the need for personal assistance to complete the task. The higher the count, the more disability.
Number of hospital readmissions
时间窗: monthly up to 6 months
Number of hospital readmissions monthly up to 6 months.
Number of deaths
时间窗: monthly up to 6 months
Number of deaths each month up to 6 months.
Barriers and Facilitators to addressing unmet needs
时间窗: month 6
Barriers and facilitators to addressing unmet needs will be assessed using qualitative interviews. A subgroup of participants will receive qualitative interviews conducted with members of the study team. Content analysis will then be used to identify barriers and facilitators to addressing unmet needs that will be informative when planning a future intervention.
次要结局
- Functional non-recovery(monthly up to 6 months)