Telehealth Assessment and Skill-Building Intervention for Stroke Caregivers (TASK III)

中风护理人员的远程医疗评估和技能培养干预（任务 III）

基本信息

批准号：
10608939
负责人：
TAMILYN BAKAS
金额：
$ 60.75万
依托单位：
UNIVERSITY OF CINCINNATI
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-12 至 2027-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10608939
关键词：
Address American American Heart Association Caregivers Caring Chronic Climacteric Clinical Trials Communication Comprehensive Health Care Data Education Emotional Enrollment Family Family Caregiver Family member Fatigue Feasibility Studies Funding Future Goals Guidelines Health Health Personnel Health Technology Healthcare Institutionalization Intervention Learning Managed Care Mediator Mental Health Nurses Outcome Pain Patient Self-Report Patients Perception Physical Function Policies Problem Solving Program Evaluation Public Health Publishing Randomized Randomized Controlled Clinical Trials Recommendation Rehabilitation therapy Reporting Risk Self Efficacy Self Management Shortness of Breath Sleep Stress Stressful Event Stroke Survivors Symptoms Technology Telephone Testing Time Time Management Training Translating Videoconferencing Well in self care systems caregiver interventions caregiving cost depressive symptoms diet and exercise directed attention disability efficacy testing electronic book empowerment expectation experience health assessment health care service utilization health training improved innovation intervention program novel personalized care physical conditioning post intervention preference premature primary outcome programs psychoeducation psychoeducational recruit resource guides satisfaction secondary outcome skills societal costs stress management stroke intervention stroke survivor symptom self management telehealth trend web site

项目摘要

Project Summary/Abstract: Stroke is a leading cause of serious, long-term disability, and has a very sudden onset. Families are often thrust into providing care without sufficient training from health care providers, having to learn on their own to provide care. Studies show that caregiving without proper training can be detrimental to caregiver’s physical and mental health, which can impede survivor rehabilitation and lead to institutionalization and higher societal costs. Unlike existing stroke caregiver interventions, which require costly face-to-face interactions, and that focus primarily on the survivor’s care, the nurse-led Telephone Assessment and Skill-Building Kit (TASK II) is delivered completely by telephone, and empowers caregivers to address both their own and the survivor’s needs using innovative skill-building strategies. Aligned with current patient and caregiver guidelines, TASK II demonstrated evidence of content validity, treatment fidelity, caregiver satisfaction, and efficacy for reducing caregiver depressive symptoms; however, TASK II revealed a need for a stronger focus on self-management (SM) strategies to improve caregiver symptoms and health, along with enhanced use of other telehealth modes of delivery. In an NINR-funded R21, the Telehealth Assessment and Skill-building Kit (TASK III) was optimized through the innovative leveraging of technologies and SM strategies to improve stroke family caregiver symptoms and health. A new goal setting tip sheet promotes caregivers’ self-management of their own symptoms and health through the use of novel skill-building strategies. Caregivers now choose how they want to access the TASK III Resource Guide (mailed hard copy, eBook, USB drive, or interactive website (https://www.task3web.com/) and how they would like to interact with the nurse (telephone, FaceTime, or online videoconferencing). Preliminary TASK III data provided evidence for feasibility of recruitment, retention, treatment fidelity, high satisfaction, and positive data trends in 74 stroke family caregivers randomized to TASK III (n=36) or to an Information, Support, and Referral (ISR) group (n=38). The purpose of the proposed study is to test short-term (immediately post-intervention at 8 weeks) and long-term (12, 24, and 52 weeks) efficacy of the TASK III intervention, compared with the ISR group, in 296 stroke caregivers. The primary outcome is caregiver life changes (i.e., physical health, physical functioning, emotional well-being, general health) as a result of providing care. Secondary outcomes include depressive symptoms (in caregivers with mild to severe depressive symptoms), other symptoms (stress, fatigue, sleep, pain, shortness of breath), unhealthy days, SM of diet/exercise, and self-reported healthcare utilization. Theoretically-based mediators include task difficulty, threat appraisal, and self-efficacy. Program evaluation outcomes (satisfaction, technology ratings) will also be analyzed. If TASK III is shown to be efficacious in the proposed randomized controlled clinical trial, our next goal will be to translate TASK III into ongoing stroke systems of care; and to adapt it for use among caregivers with other debilitating/chronic conditions providing a tremendous public health impact.

项目摘要/摘要：中风是严重，长期残疾的主要原因，并突然发作。家庭经常是在没有医疗保健提供者的足够培训的情况下提供护理，必须自己学习提供护理。研究表明，可以确定有适当培训的护理可以确定照顾者的身体和心理健康，这可能阻碍生存康复并导致制度化和更高的社会化费用。与现有的中风照顾者干预措施不同，这需要昂贵的面对面互动，并且主要关注幸存者的护理，以护士为主导的电话评估和技能建设套件（任务II）是完全通过电话交付，并使护理人员同时解决自己和幸存者的问题需要使用创新的技能建设策略。与当前的患者和护理人员指南保持一致，任务II 证明了内容有效性，治疗保真度，护理人员满意度以及降低效率的证据护理人员抑郁症状；但是，任务II揭示了需要更加专注于自我管理（SM）改善护理人员症状和健康的策略，以及其他远程医疗模式的使用增强交货。在由NINR资助的R21中，对远程医疗评估和技能建设套件（任务III）进行了优化通过对技术和SM策略的创新利用来改善中风家庭护理人员症状和健康。一个新的目标设定小费表可以促进护理人员的自我管理症状和健康，通过使用新颖的技能建设策略。护理人员现在选择他们想要的要访问任务III资源指南（邮寄纸质，电子书，USB驱动器或交互式网站（https://www.task3web.com/）以及他们想如何与护士互动（电话，faceTime或在线视频会议）。初步任务III数据提供了证据证明可行性，保留，保留， 74个中风家庭护理人员随机分配任务的治疗保真度，高满意度和积极的数据趋势 iii（n = 36）或信息，支持和推荐（ISR）组（n = 38）。拟议的研究的目的是要测试短期（8周后干预后立即）和长期（12、24和52周）的效率与ISR组相比，任务III干预在296名中风护理人员中。主要结果是照顾者的生活变化（即身体健康，身体机能，情感健康，一般健康）提供护理的结果。次要结果包括抑郁症状（在轻度至重度的护理人员中抑郁症状），其他症状（压力，疲劳，睡眠，疼痛，呼吸急促），不健康的日子，SM 饮食/运动和自我报告的医疗保健利用。理论上的调解员包括任务困难，威胁评估和自我效能感。计划评估结果（满意度，技术评级）也将是分析。如果在拟议的随机对照临床试验中证明任务III有效，那么我们的下一个目标是将任务III转化为正在进行的中风护理系统；并调整它以在护理人员中使用在其他令人衰弱/慢性病的情况下，带来了巨大的公共卫生影响。