Health Care Team Interventions to Reduce Distress Behaviors in Older Adults: A Systematic Review.

Autor:	Ramos K; Durham Evidence Synthesis Program (ESP) Center, Durham VA Health Care System, Durham, NC, USA.; Department of Population Health Sciences, Duke University School of Medicine, Duke University, Durham, North Carolina, USA.; School of Medicine, Duke University, Durham, North Carolina, USA.; Geriatric Research, Education, and Clinical Center (GRECC), Durham VA Health Care System, Durham, North Carolina, USA.; Duke Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, North Carolina, USA.; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Duke University, Durham, North Carolina, USA., Shepherd-Banigan M; Durham Evidence Synthesis Program (ESP) Center, Durham VA Health Care System, Durham, NC, USA.; Department of Population Health Sciences, Duke University School of Medicine, Duke University, Durham, North Carolina, USA.; Veterans Affairs Mid-Atlantic Region Mental Illness Research, U.S. Department of Veterans Affairs, USA.; Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA., McDermott C; Department of Population Health Sciences, Duke University School of Medicine, Duke University, Durham, North Carolina, USA.; School of Medicine, Duke University, Durham, North Carolina, USA.; Geriatric Research, Education, and Clinical Center (GRECC), Durham VA Health Care System, Durham, North Carolina, USA.; Duke Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, North Carolina, USA., McConnell ES; Geriatric Research, Education, and Clinical Center (GRECC), Durham VA Health Care System, Durham, North Carolina, USA.; Duke Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, North Carolina, USA.; VA Quality Scholars Program, Durham VA Health Care System, Durham, North Carolina, USA.; Internal Medicine, Duke University School of Nursing, Durham, North Carolina, USA., Raman SR; Department of Population Health Sciences, Duke University School of Medicine, Duke University, Durham, North Carolina, USA., Chen D; Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA., Der T; School of Medicine, Duke University, Durham, North Carolina, USA., Tabriz AA; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA., Boggan JC; School of Medicine, Duke University, Durham, North Carolina, USA.; Durham VA Health Care System, Durham, North Carolina, USA., Boucher NA; School of Medicine, Duke University, Durham, North Carolina, USA.; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA.; Sanford School of Public Policy, Duke University, Durham, North Carolina, USA., Carlson SM; Department of Medicine, Duke University School of Medicine, Durham, NC, USA., Joseph L; Durham VA Health Care System, Durham, North Carolina, USA., Sims CA; School of Medicine, Duke University, Durham, North Carolina, USA.; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA., Ma JE; School of Medicine, Duke University, Durham, North Carolina, USA.; Geriatric Research, Education, and Clinical Center (GRECC), Durham VA Health Care System, Durham, North Carolina, USA.; Duke Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, North Carolina, USA., Gordon AM; Durham Evidence Synthesis Program (ESP) Center, Durham VA Health Care System, Durham, NC, USA., Dennis P; Durham Evidence Synthesis Program (ESP) Center, Durham VA Health Care System, Durham, NC, USA., Snyder J; Durham Evidence Synthesis Program (ESP) Center, Durham VA Health Care System, Durham, NC, USA., Jacobs M; Durham Evidence Synthesis Program (ESP) Center, Durham VA Health Care System, Durham, NC, USA., Cantrell S; School of Medicine, Duke University, Durham, North Carolina, USA., Gierisch JM; Durham Evidence Synthesis Program (ESP) Center, Durham VA Health Care System, Durham, NC, USA.; Department of Population Health Sciences, Duke University School of Medicine, Duke University, Durham, North Carolina, USA.; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA., Goldstein KM; Durham Evidence Synthesis Program (ESP) Center, Durham VA Health Care System, Durham, NC, USA.; Department of Population Health Sciences, Duke University School of Medicine, Duke University, Durham, North Carolina, USA.; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA.
Jazyk:	angličtina
Zdroj:	Clinical gerontologist [Clin Gerontol] 2024 Oct-Dec; Vol. 47 (5), pp. 730-745. Date of Electronic Publication: 2024 Jul 02.
DOI:	10.1080/07317115.2024.2372424
Abstrakt:	Objectives: This review examines health care team-focused interventions on managing persistent or recurrent distress behaviors among older adults in long-term residential or inpatient health care settings. Methods: We searched interventions addressing health care worker (HCW) knowledge and skills related to distress behavior management using Ovid MEDLINE, Elsevier Embase, and Ovid PsycINFO from December 2002 through December 2022. Results: We screened 6,582 articles; 29 randomized trials met inclusion criteria. Three studies on patient-facing HCW interactions (e.g. medication management, diagnosing distress) showed mixed results on agitation; one study found no effect on quality of life. Six HCW-focused studies suggested short-term reduction in distress behaviors. Quality-of-life improvement or decreased antipsychotic use was not evidenced. Among 17 interventions combining HCW-focused and patient-facing activities, 0 showed significant distress reduction, 8 showed significant antipsychotic reduction (OR = 0.79, 95%CI [0.69, 0.91]) and 9 showed quality of life improvements (SMD = 0.71, 95%CI [0.39, 1.04]). One study evaluating HCW, patient-, and environmental-focused intervention activities showed short-term improvement in agitation. Conclusions and Clinical Implications: Novel health care models combining HCW training and patient management improve patient quality of life, reduce antipsychotic use, and may reduce distress behaviors. Evaluation of intervention's effects on staff burnout and utilization is needed.
Databáze:	MEDLINE
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