Feasibility of a Theory-Based Online Hip Fracture Resource Center for Caregivers

为护理人员建立基于理论的在线髋部骨折资源中心的可行性

• 批准号: 7463778
• 负责人: EUN-SHIM NAHM
• 金额: $ 15.07万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-15 至 2010-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7463778
• 关键词: Activities of Daily Living; Acute; Admission activity; Adult; Age; Aging; Alzheimer' s Disease; Applications Grants; Area; Attention; Baltimore; Caregiver Burden; Caregivers; Caring; Condition; Data Collection; Dependency; Development; Elderly; Event; Exercise; Exploratory/Developmental Grant; Family; Family member; Feasibility Studies; Feedback; Fracture; Frequencies; Future; Goals; Government; Health; Health Personnel; Health Professional; Health behavior; Hip Fractures; Hip region structure; Hospitals; Household; Injury; Internet; Intervention; Intervention Studies; Investigation; Learning; Libraries; Measures; Methods; Modeling; Motivation; Numbers; Online Systems; Operative Surgical Procedures; Outcome; Outcome Measure; Participant; Patients; Personal Satisfaction; Persons; Phase; Pilot Projects; Population; Prevention; Procedures; Process; Protocols documentation; Psychosocial Assessment and Care; Public Health; Published Comment; Quality of life; Randomized Controlled Trials; Range; Rate; Recovery; Recruitment Activity; Rehabilitation therapy; Research; Research Infrastructure; Research Personnel; Resources; Risk; Role; Safety; Sample Size; Sampling; Secure; Self Care; Self Efficacy; Site; Social support; Source; Statistically Significant; Stress; Structure; Support Groups; Testing; Time; Treatment Protocols; United States; Virtual Library; Week; Work; aging population; base; caregiving; coping; disability; expectation; experience; functional status; health care service organization; improved; innovation; interest; mortality; prevent; programs; statistics; theories; usability; virtual

DESCRIPTION (provided by applicant): Maintaining and improving functional abilities are vital for the quality of life of older adults. In the United States, approximately 340,000 older adults experience hip fractures yearly, leading to increased mortality, prolonged disabilities, and subsequent hip fractures. Unlike other debilitating illnesses, however, hip fracture is an acute episode; with proper interventions, older adults can recover to their baseline. Moreover, a hip fracture can serve as a unique opportunity to prevent further disabilities through improving health behaviors and implementing environmental safety measures. Immediately after hip fracture, many older adults become more dependent on informal caregivers (e.g., family). The role of caregivers is particularly important during recovery because they are a significant source of motivation for older adults to follow their rehabilitation regimens and to improve their health behaviors. While extensive resources are available to the caregivers of persons with several debilitating illnesses (e.g., Alzheimer's disease), few resources are available to the caregivers of hip fracture patients. With the increasing number of online users, an online resource program could be an effective method for providing necessary support to these caregivers. In this R21 exploratory/ developmental application, the investigators propose a study that will (1) develop a theory-based Online Hip Fracture Resource Center (OHRC) for caregivers, and (2) test the feasibility of the OHRC intervention for a future randomized controlled trial (RCT) that will examine the effects of the program on both caregivers and patients. The OHRC is an 8-week program that includes self-learning modules, moderated discussion boards, Ask the Experts, and a virtual library. This study is innovative in that (1) the OHRC will be developed in conformance with two strong theories (i.e., the stress, appraisal, and coping theory/self-efficacy theory); and (2) it will focus on maximizing the care relationship in the caregiver-care recipient dyad, with the goals of providing support to caregivers and preventing further disabilities in hip fracture patients. Once the OHRC is developed, we will conduct a feasibility study on 33 caregiver-care recipient dyads with two data collection points (baseline, end- of-treatment [EOT, 8 wks]). The feasibility of the OHRC program will be assessed by the amount of usage, participant comments about the OHRC content and its usability. The feasibility of the OHRC protocol for the future trial will be assessed by implementing the protocol. The main analysis will be descriptive and content analysis. Additionally, we will compute inferential statistics for outcome measures piloted in this study to ascertain whether changes from baseline to the EOT assessment are statistically significant and to estimate an optimal sample size for the future trial. The findings will serve as preliminary work for the future RTC. If the OHRC proves effective, it can be used as a supplementary intervention for caregivers and patients. Moreover, the method used in the OHRC may serve as a model for other programs. This proposed study focuses on the use of an interactive online resource program for caregivers of older adults who have had a hip fracture, a debilitating injury. Through provision of specific information and psychosocial support, this program will help caregivers cope with caregiving situations and become a source of motivation and information for their care recipients to improve their recovery. Considering the increasing numbers of online users and the aging population, this innovative program has significant potential as a practical and accessible method to promote health in older adults and their caregivers and is a model for other online caregiver programs for older adults.

描述（由申请人提供）：维持和提高功能能力对于老年人的生活质量至关重要。在美国，大约340,000名老年人每年出现髋部骨折，导致死亡率增加，长期残疾和随后的髋部骨折。但是，与其他使人衰弱的疾病不同，髋部骨折是一个急性发作。通过适当的干预措施，老年人可以恢复到基线。此外，髋部骨折可以作为通过改善健康行为和实施环境安全措施来防止进一步残疾的独特机会。髋部骨折后，许多老年人立即变得更加依赖非正式护理人员（例如家庭）。护理人员在恢复过程中尤其重要，因为他们是老年人遵循康复方案并改善健康行为的重要动机来源。虽然有多种使人衰弱的疾病的人（例如，阿尔茨海默氏病）可以使用大量资源，但髋部骨折患者的看护人几乎没有资源。随着在线用户数量的越来越多，在线资源程序可能是为这些护理人员提供必要支持的有效方法。在此R21探索/发展应用中，研究人员提出了一项研究，该研究将（1）为护理人员开发基于理论的在线髋部断裂资源中心（OHRC），（2）测试OHRC干预对未来随机对照试验（RCT）的可行性，该试验将检查该计划对吸收者和患者的影响。 OHRC是一个为期8周的计划，包括自学模块，主持讨论板，询问专家和虚拟库。这项研究具有创新性，因为（1）OHRC将符合两种强大的理论（即压力，评估和应对理论/自我效能理论）； （2）它将着重于最大化护理人员护理人员二元组中的护理关系，其目标是为护理人员提供支持并防止髋部骨折患者进一步残疾。一旦开发了OHRC，我们将对具有两个数据收集点的33名护理人员二元组进行可行性研究（基线，处理末端[EOT，8 wks]）。 OHRC计划的可行性将通过使用数量，参与者对OHRC内容及其可用性的评论来评估。 OHRC协议对未来试验的可行性将通过实施该协议来评估。主要分析将是描述性和内容分析。此外，我们将计算本研究试点的结果指标的推论统计数据，以确定从基线到EOT评估的变化是否具有统计学意义，并估算未来试验的最佳样本量。这些发现将作为未来RTC的初步工作。如果OHRC证明有效，则可以用作护理人员和患者的补充干预措施。此外，OHRC中使用的方法可以作为其他程序的模型。这项拟议的研究重点是使用互动的在线资源计划，以供患有髋部骨折的老年人的护理人员，令人沮丧的伤害。通过提供特定的信息和社会心理支持，该计划将帮助护理人员应对护理情况，并成为其护理接收者改善康复的动力和信息的来源。考虑到越来越多的在线用户和老龄化人口，该创新计划具有巨大的潜力，可以作为一种实用且易于获得的方法来促进老年人及其护理人员的健康，并且是针对老年人其他在线护理人员计划的典范。