Telephone Assessment and Skill-Building Intervention for Stroke Caregivers

中风护理人员的电话评估和技能培养干预

• 批准号: 7985531
• 负责人: TAMILYN BAKAS
• 金额: $ 38.5万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-21 至 2015-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7985531
• 关键词: Address; Age; American; Behavior; Caregivers; Caring; Climacteric; Data; Data Collection; Emotions; Equation; Family; Family Caregiver; Family member; Fostering; Future; Goals; Growth; Health; Health Personnel; Health Professional; Home environment; Home visitation; Hospitalization; Hour; House Call; Institutionalization; Intervention; Lead; Managed Care; Measures; Mediating; Mediator of activation protein; Mental Health; Modeling; Nurses; Outcome; Patients; Population; Prevalence; Problem Solving; Procedures; Randomized; Relative (related person); Reporting; Risk; Rural; Sampling; Schedule; Screening procedure; Stroke; Survivors; Telephone; Testing; Training; Training Support; Translations; base; caregiver education; caregiving; comparative; cost; cost effectiveness; depressive symptoms; disability; economic evaluation; efficacy testing; empowered; evidence base; expectation; experience; follow-up; improved; innovation; intervention effect; intervention program; optimism; post intervention; premature; primary outcome; programs; public health relevance; resource guides; satisfaction; skills; social; stress management; time use

DESCRIPTION (provided by applicant): Stroke is the leading cause of long-term disability; families are often thrust into providing care for stroke survivors without any training. Stroke family caregivers are of increasing importance because the prevalence of stroke is likely to increase as the population ages. However, there are very few evidence-based, easy-to- deliver follow-up programs after hospitalization to train caregivers in providing care and none that comprehensively address both caregiver and survivor needs through skill-building strategies. Studies have shown that caregiving without training can be detrimental to caregiver's physical and mental health, which can lead to institutionalization of the survivor and higher societal costs. The purpose of this study is to evaluate the efficacy of the revised Telephone Assessment and Skill-building Kit (TASK II), a nurse-led comprehensive intervention that enables caregivers to build skills based on assessment of their own needs. Family caregivers of stroke survivors (N=220) will be randomized to the TASK II intervention or to an Information, Support, and Referral (ISR) group to determine the relative efficacy of the TASK II intervention for reducing task difficulty, increasing optimism, and reducing threat appraisal for providing care. Primary outcomes are caregiver depressive symptoms, caregiving-related negative life changes, and unhealthy days. In an exploratory aim preliminary data will be collected for an economic evaluation of the TASK II intervention. Both the TASK II intervention and ISR procedures involve 8 telephone sessions delivered over 8 weeks, with a booster session at 12 weeks. Data collections will occur at baseline (within 8 weeks of home discharge); at 8 weeks (short-term intervention effect), 12 weeks (after booster), and at 24 weeks and 1 year after baseline (long-term sustainability of intervention effect). Linear mixed models will be applied to the repeated-measures data to test efficacy for Primary Aims 1 & 2. Latent Growth Models using a Structural Equation Model approach will be applied to examine mechanism of intervention effect (Exploratory Aim 1.). An incremental cost-effectiveness ratio (ICER) will be employed to address the comparative costs and outcomes for the TASK II intervention and ISR group (Exploratory Aim 2). PUBLIC HEALTH RELEVANCE: Caring for a family member during the first year after a stroke can be very difficult. The TASK II intervention is a unique, comprehensive caregiver intervention program that enables caregivers to develop the necessary skills to manage care for the survivor, while also taking care of themselves as a caregiver. The long-term goal of this study is to offer training and support for family caregivers through an efficacious, cost-effective program.

描述（由申请人提供）：中风是长期残疾的主要原因；家庭通常会在没有任何培训的情况下为中风幸存者提供护理。中风家庭护理人员的重要性越来越重要，因为随着人口年龄的增长，中风的流行可能会增加。但是，住院后，很少有基于证据的，易于提供的后续计划来培训护理人员提供护理，而没有一个通过技能建设策略全面满足照料者和幸存者需求的人。研究表明，没有培训的护理可能会损害照顾者的身心健康，这可能导致幸存者的制度化和更高的社会成本。这项研究的目的是评估经过修订的电话评估和技能建设套件的功效（任务II），这是护士主导的全面干预措施，使护理人员能够根据评估自己的需求来建立技能。中风幸存者的家庭护理人员（n = 220）将被随机分配到任务II干预措施或信息，支持和转诊（ISR）组，以确定任务II干预措施对减少任务难度，增加乐观和减少威胁评估提供护理的相对功效。主要结果是护理人员的抑郁症状，与护理相关的负面生活变化以及不健康的日子。在探索性目标中，将收集初步数据，以对任务II干预进行经济评估。任务II干预和ISR程序均涉及8周的8个电话课程，并在12周时进行助推器会议。数据收集将在基线（在房屋出院后的8周内）发生；在第8周（短期干预效果），12周（加强后）以及基线后24周和1年（长期可持续性的干预效果）。线性混合模型将应用于重复测量数据以测试主要目标1和2的功效。使用结构方程模型方法的潜在增长模型将应用于研究干预效果的机制（探索性目的1.）。将采用增量成本效益比（ICER）来解决任务II干预和ISR组的比较成本和结果（探索目标2）。 公共卫生相关性：中风后的第一年，照顾家庭成员可能非常困难。任务II干预是一项独特，全面的护理人员干预计划，它使护理人员能够发展必要的技能来管理幸存者的护理，同时也将自己照顾为照料者。这项研究的长期目标是通过有效，具有成本效益的计划为家庭护理人员提供培训和支持。