A Noninferiority Trial of a Problem-Solving Intervention for Hospice Caregivers: In Person versus Videophone
A Noninferiority Trial of a Problem-Solving Intervention for Hospice Caregivers: In Person versus Videophone
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DOI：
10.1089/jpm.2011.0488
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发表时间：
2012-06-01
影响因子：
2.8
通讯作者：
Berry, Donna
中科院分区：
文献类型：
--
作者：
Demiris, George;Oliver, Debra Parker;Berry, Donna
研究目的：问题解决疗法(PST)在提供给各种疾病患者的非正式照顾者时被发现是有效的。然而，在临终关怀中，由于交付所需资源的增加，其转化为实践的工作受到了阻碍。该研究的目的是比较面对面和通过可视电话对临终关怀主要照顾者进行PST干预的有效性。设计和方法：研究设计为随机非劣势试验，包括两组，第一组照顾者面对面接受PST，第二组照顾者通过可视电话接受PST。家庭临终关怀人员从两家城市临终关怀机构招募，并在临终关怀入院后大约20天内接受PST干预(第一组为三次探视，第二组为三次视频通话)。收集了标准的照顾者人口统计数据。在基线和研究结束时对照顾者进行心理测量，包括照顾者生活质量指数修订版、状态-特质焦虑量表和问题解决问卷。结果：研究招募了126名照顾者，其中77人被随机分配到第一组，49人被分配到第二组。通过视频交付的PST并不低于面对面交付。观察到的分数变化在每组都是相似的。两种情况下照顾者的生活质量均有所提高，状态焦虑均有所降低。结论：通过视频电话进行PST的分娩并不逊色于面对面。通过技术获取的视听反馈可能就足够了，为通常阻碍向临终关怀中的老年人提供这些类型的干预措施的地理障碍提供了解决方案。
Purpose of the study: Problem-solving therapy (PST) has been found effective when delivered to informal caregivers of patients with various conditions. In hospice, however, its translation to practice is impeded by the increased resources needed for its delivery. The study purpose was to compare the effectiveness of a PST intervention delivered face-to-face with one delivered via videophone to hospice primary caregivers.Design and methods: The study design was a randomized noninferiority trial with two groups, Group 1 in which caregivers received PST face-to-face, and Group 2 in which caregivers received PST via videophone. Family hospice caregivers were recruited from two urban hospice agencies and received the PST intervention (in three visits for Group 1 or three video-calls in Group 2) in an approximate period of 20 days after hospice admission. Standard caregiver demographic data were collected. Psychometric instruments administered to caregivers at baseline and at study completion included the CQLI-R (Caregiver Quality of Life Index-Revised), the STAI (State-Trait Anxiety Inventory), and the PSI (Problem-Solving Inventory).Results: One hundred twenty-six caregivers were recruited in the study; 77 were randomly assigned to Group 1 and 49 to Group 2. PST delivered via video was not inferior to face-to-face delivery. The observed changes in scores were similar for each group. Caregiver quality of life improved and state anxiety decreased under both conditions.Conclusions: The delivery of PST via videophone was not inferior to face-to-face. Audiovisual feedback captured by technology may be sufficient, providing a solution to the geographic barriers that often inhibit the delivery of these types of interventions to older adults in hospice.