Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
32 participants
OBSERVATIONAL
2024-05-02
2024-09-13
Brief Summary
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1. What features of the healthcare system facilitate or hinder family involvement in care from the perspective of patients, families, and healthcare workers?
2. How do hospital leaders understand the facilitators and barriers to family involvement?
Data collection will occur via semi-structure interviews, direct observation, and artifact analysis.
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Detailed Description
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AIM 1: To identify facilitators and barriers to family member involvement in the care of hospitalized older adults with cognitive impairment using in-context, semi-structured interviews and unobtrusive direct observation of patients, families, and healthcare workers. The investigators will employ participant observation and semi-structured interviews for each enrolled patient-family member dyad. For each dyad, the investigators will conduct two interviews, each lasting approximately 30-60 minutes. One interview will occur within 24 hours of admission ("entry interview") and one within 72 hours of discharge ("exit interview"). Both interviews will address how the participant (patient if able to contribute, and family member) perceive the family member in relation to the healthcare team and their experiences of involvement in care. Each dyadic patient/family interview will be conducted by the Principal Investigator or her delegate and digitally recorded, with the consent of participants, for subsequent transcription and analysis. In addition, three periods of direct observation will occur. Direct observations will focus on interactions between hospital staff, patients, and families, and what family members do during a patient's hospital stay. Observations will be recorded as field notes. Finally, the investigators will interview one to three healthcare workers (physicians, advanced practice providers, nurses) involved in the patient's care for each enrolled patient-family dyad. Healthcare worker interviews will take place either during the patient's hospitalization or within a week of the patient's discharge and may take place in person or remotely (phone or videoconference). Demographic and baseline data from the patient, family member, and healthcare workers that may affect family involvement will also be collected.
AIM 2: To understand hospital leadership perspectives on barriers to integration of family members into care for hospitalized older adult patients with cognitive impairment. For this aim, the investigators will conduct one-on-one interviews hospital leadership. After consent is obtained, study staff will conduct each interview using a semi-structured interview guide which queries topics on system-level facilitators and barriers to family involvement in the care of hospitalized older adults with cognitive impairment (e.g., visiting hour policies, rounding schedules). Aim 2 will also include an artifact analysis of policy documents related to visitation, care of cognitively impaired older adults, and family-centered care in the hospital.
Conditions
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Study Design
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OTHER
CROSS_SECTIONAL
Study Groups
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Patient
Hospitalized older adults with cognitive impairment/dementia
No interventions assigned to this group
Family
Family member, friend, or neighbor involved in a hospitalization of an older adult motivated by a personal relationship rather than financial remuneration
No interventions assigned to this group
Healthcare Worker
Physicians, APPs, or nurses involved in the care of the patient with cognitive impairment/dementia
No interventions assigned to this group
Health system leader
Hospital executives, department chairs, division chiefs, nurse managers, medical directors, and other leaders within the health system.
No interventions assigned to this group
Eligibility Criteria
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Inclusion Criteria
* Slated for admission to the hospital or admitted to the hospital
* Able to speak about the topics in the interview in English
* Capable of providing consent OR legally authorized representative (LAR) consents to patient's participation in study
* Age 18 or older
* Able to speak about the topics in the interview in English
* Is accompanying the patient slated for admission to the hospital or admitted to the hospital when the patient is approached, is the person the patient identifies as being the family member most involved in their hospital care, or is the emergency contact person for the patient listed in the medical record
* Willing to participate
* Age \>18
* Employed by Duke University Health System
* Physician, advanced practice provider (APP), or nurse on the care team of the patient with cognitive impairment
* Able to provide informed consent
* Willing to participate
Exclusion Criteria
* Accompanying patient as a paid caregiver or aide
AIM 2:
18 Years
ALL
No
Sponsors
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Duke University
OTHER
Responsible Party
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Principal Investigators
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Judith Vick, MD, MPH
Role: PRINCIPAL_INVESTIGATOR
Duke University
Locations
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Duke Regional Hospital
Durham, North Carolina, United States
Countries
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Other Identifiers
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Pro00114569
Identifier Type: -
Identifier Source: org_study_id
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