Evaluation of a Carepartner-Integrated Telehealth Rehabilitation Program for Persons with Stroke - NICHD K-23

中风患者护理人员综合远程医疗康复计划的评估 - NICHD K-23

• 批准号: 9265104
• 负责人: Sarah R. Blanton
• 金额: $ 14.47万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-06-22 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9265104
• 关键词: Adult; American Heart Association; Anxiety; Caring; Clinical Research; Conflict (Psychology); Control Groups; Data; Education; Evaluation; Experimental Designs; Family; Family member; Fostering; Foundations; Funding; Future; Grant; Home environment; Intervention; Limb structure; Measures; Mental Depression; Mental Health; Modeling; National Institute of Child Health and Human Development; Outcome; Persons; Physical Function; Physical therapy; Pilot Projects; Problem Solving; Process; Quality of life; Recovery; Rehabilitation therapy; Research; Role; Seeds; Severities; Social isolation; Stroke; Structure; System; Tablets; Task Performances; Testing; Upper Extremity; Work; base; collaborative environment; constraint induced movement therapy; depressive symptoms; design; digital; disability; effective intervention; exercise intensity; exercise program; experience; improved; innovation; intervention effect; motor impairment; novel; portability; post intervention; programs; public health relevance; skills; stroke recovery; stroke survivor; telehealth; theories; therapy development; usability; user-friendly

DESCRIPTION: Sarah Blanton, PT, DPT, NCS, is clinical specialist in neurorehabilitation committed to a research career investigating effective methods to facilitate the integration of the carepartner in rehabilitation of the stroke survivor. A K23 award will build upon a strong foundation of prior training and research and provide the candidate an opportunity to gain advanced education and experience through a multidisciplinary team of experts. The immediate goals of this Mentored Patient Oriented Research Career Award (K23) are to allow the candidate to gain the skills needed in: (1) advanced clinical research design and statistical methods and (2) psychological theories of self-management and adult learning to perform and evaluate carepartner-centered interventions for stroke survivors and their families. The candidate’s long-term goals are to become an independently funded clinical researcher with expertise in innovative strategies for advancing and expanding the role of carepartner education and the integration of physical therapists in family-centered care. ENVIRONMENT: Dr. Blanton’s training will use resources and mentors from Emory University, Georgia State University and Georgia Institute of Technology. Dr. Dunbar and Dr. Clark are internationally recognized researchers in caregiving research and will provide guidance in potential behavioral mechanisms underlying carepartner responses to treatment, study methodology and design, and interpretation of outcome data. Through coursework and mentorship with Dr.Lyles, she will gain expertise in data management and statistical analysis. Dr.Wolf will provide guidance in grant writing and stroke rehabilitation interventions and Mr. Jones will offer mentorship in telerehabilitation approaches. She will continue learning about study methodology and data management through additional coursework and will attend seminars, professional conferences and meetings to complete her training. RESEARCH: Stroke is the leading cause of adult disability and creates significant societal and familial strain. Family members are a key component in stroke recovery, but they frequently experience high levels of burden, including increased anxiety, depression and social isolation when they assume the role of carepartner. Thus, effective interventions aimed at reducing the impact of stroke on the family are needed. The objective of this proposal is to evaluate a novel, carepartner focused intervention (CARECITE) designed to foster problem solving and skill building while facilitating carepartner involvement in the application of constraint-induced movement therapy (CIMT) for the upper extremity. This psychoeducational intervention is structured to provide general stroke recovery content (e.g. post-stroke depression) and enhance the home-based application of CIMT by teaching the carepartner ways to foster a more therapeutic, autonomy-supportive environment (characterized by empathy, problemsolving, choice and reduction of controlling language). The central hypothesis underpinning this research is that a theory-based, carepartner-centered intervention focused on skill building and problemsolving will improve stroke survivor physical function while reducing carepartner negative outcomes and increasing accessibility of participation. [To test this hypothesis and the feasibility of CARE-CITE in the home setting, we will use a two-group experimental design with 32 intervention dyads (CIMT with structured carepartner involvement) and 16 control dyads (CIMT without structured carepartner involvement) to quantify the effects on carepartner mental health, family conflict surrounding stroke recovery, and stroke survivor upper extremity function. Evaluators will be blind to group assignment. Results of this study will provide preliminary estimates of the intervention efficacy for use in larger, future clinical studies.] The innovation of this research involves the tailoring of a stroke survivor therapy intervention to also address carepartner needs and the use of contemporary telehealth technology to facilitate engagement of the family within the home environment. The findings of this project will provide critical data that can aid in the development of future larger-scale studies exploring family centered care in stroke. RELEVANCE TO PUBLIC HEALTH: The overall significance of this research plan is to increase understanding and further development of interventions that may serve as models in rehabilitation to foster family involvement in the rehabilitation process and to promote more integrative therapy strategies throughout physical therapy practice.

描述：莎拉·布兰顿（Sarah Blanton），PT，DPT，NCS，是致力于A的临床专家 研究职业研究有效的方法，以促进凯他的整合 中风幸存者的康复。 K23奖将建立在先前培训的强大基础上， 研究并为候选人提供了通过一个机会获得高级教育和经验的机会 多学科专家团队。这项以患者为导向的研究的直接目标 职业奖（K23）允许候选人获得所需的技能：（1）高级临床研究 设计和统计方法以及（2）自我管理和成人学习的心理理论 对中风幸存者及其家人进行和评估以手术为中心的干预措施。这 候选人的长期目标是成为具有专业知识的独立资助的临床研究人员 促进和扩展凯他的角色和整合的创新策略 以家庭为中心的护理中的物理治疗师。 环境：布兰顿博士的培训将使用佐治亚州埃默里大学的资源和导师 州立大学和佐治亚理工学院。邓巴博士和克拉克博士在国际上 公认的护理研究研究人员，将为潜在行为提供指导 头部护理人员对治疗，研究方法论和设计的反应的机制以及 结果数据的解释。通过与Lyles博士的课程和心态，她将获得 数据管理和统计分析方面的专业知识。沃尔夫博士将在赠款写作方面提供指导 中风康复干预措施和琼斯先生将在远程化方法中提供心态。 她将继续通过其他 课程工作，将参加半手，专业会议和会议，以完成她的培训。 研究：中风是成人残疾的主要原因，并创造了重要的社会和家庭 拉紧。家庭成员是中风恢复的关键组成部分，但他们经常经历高度 伯恩（Burnen）的水平，包括增加焦虑，抑郁和社会隔离时的水平 卡雷佩纳。那是旨在减少中风对家庭影响的有效干预措施 需要。该提案的目的是评估一种新颖的，摄制者的重点干预措施（CareCite） 旨在促进解决问题和技能的建设，同时支持拍摄者参与 在上肢的约束诱导运动疗法（CIMT）的应用。这个心理教育 干预措施的结构是提供一般中风恢复含量（例如，中风后 抑郁症）并通过教授头部的方法来增强CIMT的家庭应用 促进一个更具治疗性，自主支持的环境（其特征是同理心，有问题， 选择和减少控制语言）。基于此基础的中心假设 研究是，以理论为中心的理论干预措施着重于技能和解决问题 将改善中风生存的身体功能，同时减少头部的负面结果和 增加参与的可及性。 [检验这一假设和护理中的可行性 家庭环境，我们将使用32个干预二元组的两组实验设计（CIMT 结构化的拍摄者参与）和16个对照二元组（CIMT没有结构化摄影师 参与）为了量化对卡雷特纳心理健康的影响，围绕中风的家庭冲突 恢复和中风幸存者上肢功能。评估人员将对小组分配视而不见。 这项研究的结果将提供对较大的干预效率的初步估计。 [未来的临床研究。]这项研究的创新涉及裁缝中风生存疗法 干预措施，以满足看法的需求以及使用当代远程医疗技术的干预措施 促进家庭在家庭环境中的参与。该项目的发现将提供 可以帮助发展未来大规模研究的关键数据探讨家庭为中心的护理 中风。与公共卫生有关：该研究计划的总体意义是增加 理解和进一步发展可能作为康复模型的干预措施 促进家庭参与康复过程，并促进更多综合的治疗策略 通过物理疗法实践。