An Upstream Palliative Care Intervention for Rural Family Caregivers

针对农村家庭护理人员的上游姑息治疗干预措施

基本信息

批准号：
9752668
负责人：
James N. Dionne-Odom
金额：
$ 24.25万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-05-01 至 2021-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9752668
关键词：
Address Advance Care Planning Advanced Malignant Neoplasm Alabama Anxiety Cancer Patient Caregiver support Caregivers Caring Clinical Clinical Investigator Clinical Trials Communities Competence Critical Illness Data Decision Making Development Doctor of Philosophy Educational workshop Enrollment Faculty Family Family Caregiver Family health status Formulation Future Goals Health Health Services Accessibility Healthcare Hour Individual Intensive Care Units Intervention Interview Knowledge Lead Life Malignant Neoplasms Mediator of activation protein Mental Depression Mental Health Mentorship Methods Modeling Moods Morbidity - disease rate New England Newly Diagnosed Nurses Outcome Palliative Care Participant Patients Persons Phase Play Population Process Psychology Public Health Quality of life Randomized Controlled Trials Reporting Research Research Ethics Research Training Role Rural Rural Population Science Self Efficacy Services Signal Transduction Social support Standardization Stress Taxes Testing Training Treatment Efficacy Vulnerable Populations Work advanced disease base cancer care care delivery care recipients caregiver interventions caregiving comparative efficacy coping design disparity reduction efficacy testing empowered end of life end of life care experience family caregiving formative assessment hospice environment improved intervention participants meetings motivational enhancement therapy patient home care physical conditioning prevent programs psychologic public health relevance rural counties rural families rural residence skills symposium telehealth tenure track therapy development treatment as usual

项目摘要

DESCRIPTION (provided by applicant): This K99/R00 application describes the background and experience of the applicant, J. Nicholas Dionne- Odom, PhD, RN, and his plan to acquire the knowledge and training necessary to become a leading independent clinical investigator in developing and testing telehealth palliative care interventions that optimize the outcomes of rural family caregivers (FCGs) of persons with advanced cancer. The overall goal during the K99 phase is to gain advanced research training in developing interventions, conducting randomized controlled trials (RCTs), and health coaching/motivational interviewing in order to develop and test a telehealth program for rural FCGs of persons with advanced cancer living in the Southern US. Based on Pearlin's Model of Family Caregiving, the goal of this new intervention will be to promote FCGs' self-efficacy, competence, and decision- making skills by coaching them about how to manage not only the care demands and needs of their care recipients but also their own needs. The specific training objectives during the K99 phase are to: (1) develop and tailor interventions, to: 1a) gain advanced understanding of community engagement in research using mixed methods; 1b) develop advanced understanding and skills in developing, manualizing, and assessing fidelity of an intervention; 1c) gain greater understanding of cutting edge telehealth and other m-health developments; and 1d) develop greater understanding of spiritually- and faith-based-oriented interventions; (2) develop skills to design and lead RCTs relevant to family caregiving; 3) augment knowledge and skills in health coaching; and (4) continue training in research ethics. The research specific aim during the K99 phase is: through interviews with a) rural dwelling persons with advanced cancer, b) their primary FCGs, and c) lay healthcare navigators, develop and tailor the content, format and delivery of a telehealth intervention for FCGs of persons with advanced cancer in the rural South. To meet the K99 training objectives, a comprehensive training plan has been developed in concert with an interdisciplinary mentorship and consultant team of senior research experts. The plan includes intensive one-on-one mentorship, formal coursework/workshops, clinical trial research observerships, and conference attendance. The overall goal during the R00 phase is to conduct a pilot RCT with 60 rural Southern advanced cancer FCGs to assess acceptability, feasibility, and potential efficacy of the newly tailored FCG intervention resulting from the K99 phase. The research specific aims during the R00 phase are to: 1) evaluate the acceptability of a newly tailored FCG intervention and the feasibility of enrolling and retaining 60 participants into a RCT of the FCG intervention for 24 weeks and 2) evaluate the efficacy of the intervention in improving caregiver outcomes (quality of life, burden, and mood [depression/anxiety]) compared to usual care. The results will directly support an R-01 application to conduct an efficacy RCT of an early, telehealth PC intervention for rural Southern FCGs of advanced cancer patients.

描述（由申请人提供）：此 K99/R00 申请描述了申请人 J. Nicholas Dionne-Odom，博士，注册护士的背景和经验，以及他获得成为领先的独立临床研究者所需的知识和培训的计划。开发和测试远程医疗姑息治疗干预措施，以优化晚期癌症患者的农村家庭护理人员（FCG）的结果。 K99 阶段的总体目标是获得开发干预措施、进行随机对照试验 (RCT) 和健康指导/动机访谈方面的高级研究培训，以便为生活在农村地区的晚期癌症患者制定和测试远程医疗计划。美国南部。基于 Pearlin 的家庭护理模型，这项新干预措施的目标是通过指导 FCG 如何管理护理对象的护理需求和需要，以及如何管理护理对象的自我效能、能力和决策技能，提高他们的自我效能、能力和决策能力。也是自己的需要。 K99 阶段的具体培训目标是： (1) 制定和定制干预措施，以： 1a) 深入了解社区参与使用混合方法的研究； 1b) 培养对干预措施的开发、手动化和保真度评估的高级理解和技能； 1c) 更好地了解前沿远程医疗和其他移动医疗的发展； 1d) 加深对以精神和信仰为导向的干预措施的理解； (2) 培养技能设计和领导与家庭护理相关的随机对照试验； 3）增强健康指导方面的知识和技能； (4) 继续进行研究伦理培训。 K99 阶段研究的具体目标是：通过采访 a) 患有晚期癌症的农村居民、b) 他们的主要 FCG 和 c) 非专业医疗保健导航员，开发和定制 FCG 远程医疗干预的内容、格式和实施方式南方农村地区患有晚期癌症的人。为了实现K99培训目标，我们与资深研究专家组成的跨学科导师和顾问团队共同制定了全面的培训计划。该计划包括密集的一对一指导、正式课程/研讨会、临床试验研究观察和会议出席。 R00 阶段的总体目标是对 60 个南方农村晚期癌症 FCG 进行试点随机对照试验，以评估 K99 阶段新定制的 FCG 干预措施的可接受性、可行性和潜在功效。 R00 阶段研究的具体目标是：1) 评估新定制的 FCG 干预措施的可接受性，以及招募和保留 60 名参与者参加为期 24 周的 FCG 干预随机对照试验的可行性；2) 评估干预措施的有效性与常规护理相比，可以改善护理人员的结果（生活质量、负担和情绪[抑郁/焦虑]）。结果将直接支持 R-01 应用程序，对晚期癌症患者的南方 FCG 进行早期远程医疗 PC 干预的有效性随机对照试验。