The ResidentialCare Transition Module: a single-blinded randomized controlled evaluation of a telehealth support intervention for family caregivers of persons with dementia living in residential long-term care
The ResidentialCare Transition Module: a single-blinded randomized controlled evaluation of a telehealth support intervention for family caregivers of persons with dementia living in residential long-term care
复制标题
DOI：
10.1186/s12877-020-01542-7
复制
发表时间：
2020-04-15
期刊：
影响因子：
4.1
通讯作者：
Roth, David L.
中科院分区：
文献类型：
--
作者：
Gaugler, Joseph E.;Statz, Tamara L.;Roth, David L.
在亲属进入养老院等长期住宿（RLTC）护理机构后，家庭并没有完全脱离照顾责任。照顾者压力、抑郁或其他关键结果在亲属进入RLTC后保持稳定或有时增加。一些干预措施试图在机构化后增加家庭参与，但很少有严谨的研究证明这些干预措施是否有效地帮助家庭应对亲属过渡到RLTC环境所带来的潜在情绪和心理动荡。住宿护理过渡模块（RCTM）在4个月的时间里，为接收亲属到RLTC环境的家庭护理人员提供6次正式咨询（一对一和家庭会议）。方法采用嵌入式混合方法进行随机对照评估，将承认在RLTC环境下存在认知障碍的家庭成员随机分配到RCTM （n=120）或常规护理对照条件（n=120）。主要结局包括家庭成员主要主观压力和消极心理健康结局的减少；次要角色菌株；以及住院护理压力。混合方法设计将允许在12个月评估结束时通过“嵌入”定性成分（多达30个半结构化访谈）来分析干预行动机制。本评估将通过评估RCTM是否以及如何帮助家庭更好地应对寄宿护理过渡期间的情感和心理挑战，从而填补一个重要的临床和研究空白。临床试验注册：clinicaltrials .gov （NCT02915939，前瞻性注册）。
BackgroundFamilies do not fully disengage from care responsibilities following relatives' admissions to residential long-term (RLTC) care settings such as nursing homes. Caregiver stress, depression, or other key outcomes remain stable or sometimes increase following a relative's RLTC entry. Some interventions have attempted to increase family involvement after institutionalization, but few rigorous studies have demonstrated whether these interventions are effective in helping families navigate the potential emotional and psychological upheaval presented by relatives' transitions to RLTC environments. The Residential Care Transition Module (RCTM) provides six formal sessions of consultation (one-to-one and family sessions) over a 4-month period to family caregivers who have admitted a relative to a RLTC setting.MethodsIn this embedded mixed methods randomized controlled evaluation, family members who have admitted a cognitively impaired relative to a RLTC setting are randomly assigned to the RCTM (n=120) or a usual care control condition (n=120). Primary outcomes include reductions in family members' primary subjective stress and negative mental health outcomes; secondary role strains; and residential care stress. The mixed methods design will allow for an analysis of intervention action mechanisms by "embedding" qualitative components (up to 30 semi-structured interviews) at the conclusion of the 12-month evaluation.DiscussionThis evaluation will fill an important clinical and research gap by evaluating a psychosocial intervention designed for families following RLTC admission that determines whether and how the RCTM can help families better navigate the emotional and psychological challenges of residential care transitions.Trial registrationClinicalTrials.gov (NCT02915939, prospectively registered).