Telephone Assessment and Skill-Building Kit for Stroke Caregivers: A Randomized Controlled Clinical Trial.
Telephone Assessment and Skill-Building Kit for Stroke Caregivers: A Randomized Controlled Clinical Trial.
复制标题
DOI：
10.1161/strokeaha.115.011099
复制
发表时间：
2015-12
期刊：
影响因子：
8.3
通讯作者：
Weaver MT
中科院分区：
文献类型：
--
作者：
Bakas T;Austin JK;Habermann B;Jessup NM;McLennon SM;Mitchell PH;Morrison G;Yang Z;Stump TE;Weaver MT
有几个基于证据的中风家庭照顾者出院后的程序。本研究的目的是评估电话评估和技能建设工具包（TASKII），护士主导的干预措施，使照顾者建立自己的需求评估的基础上的技能的有效性。共有254名卒中护理人员（主要为女性，TASKII/ISR 78.0%/78.6%;白色70.7%/72.1%;约一半的配偶48.4%/46.6%）被随机分配至TASKII干预组（n=123）或信息、支持和转诊（ISR）组（n=131）。两组都接受了8次每周一次的电话治疗，并在12周时进行了加强治疗。采用重复测量的一般线性模型测试疗效，控制患者住院天数和呼叫分钟数。预先指定的8周主要结局是抑郁症状（患者健康问卷抑郁症状量表PHQ-9≥5）、生活变化和不健康的日子。在基线PHQ-9≥5的照顾者中，与ISR组相比，随机分配到任务II干预组的患者从基线到第8、24和52周的抑郁症状减轻程度更大，从基线到第12周的生活变化改善程度更大（p<.05）;但在总样本中没有发现。虽然在12、24或52周时没有持续，但随机分配到任务II干预组的照顾者从基线到8周的不健康天数减少相对较大（p<0.05）。任务II干预减少了抑郁症状，改善了轻度至重度抑郁症状的照顾者的生活变化。TaskII干预减少了总样本的不健康天数，尽管不能长期维持。
There are few evidence-based programs for stroke family caregivers post-discharge. The purpose of this study was to evaluate efficacy of the Telephone Assessment and Skill-Building Kit (TASKII), a nurse-led intervention enabling caregivers to build skills based on assessment of their own needs. A total of 254 stroke caregivers (primarily female TASK II/ISR 78.0%/78.6%; white 70.7%/72.1%; about half spouses 48.4%/46.6%) were randomized to the TASKII intervention (n=123) or to an Information, Support, and Referral (ISR) group (n=131). Both groups received 8 weekly telephone sessions, with a booster at 12 weeks. General linear models with repeated measures tested efficacy, controlling for patient hospital days and call minutes. Pre-specified 8 week primary outcomes were depressive symptoms (with Patient Health Questionnaire Depressive Symptom Scale PHQ-9≥5), life changes, and unhealthy days. Among caregivers with baseline PHQ-9≥5, those randomized to the TASK II intervention had a greater reduction in depressive symptoms from baseline to 8, 24, and 52 weeks and greater improvement in life changes from baseline to 12 weeks compared to the ISR group (p<.05); but not found for the total sample. Although not sustained at 12, 24, or 52 weeks, caregivers randomized to the TASK II intervention had a relatively greater reduction in unhealthy days from baseline to 8 weeks (p<.05) The TASK II intervention reduced depressive symptoms and improved life changes for caregivers with mild to severe depressive symptoms. The TASK II intervention reduced unhealthy days for the total sample, although not sustained over the long term.