EFFECTS OF CASE MANAGEMENT ON AIDS INFORMAL CAREGIVERS

已提出将病例管理作为促进 为艾滋病毒相关患者提供全面、经济高效的家庭护理 疾病。尽管非正式照顾者在提供或 为艾滋病毒感染者补充家庭护理，本身可能是 几乎没有研究表明身体和心理健康结果有改变的风险 关于它们如何受到病例管理战略的影响，可以获得。 该项目建议对1989-92年NIH NCNR资助的研究(R01)进行扩展 NR02281)，检查个案管理家庭护理对个人的影响 感染艾滋病毒，但没有评估病例管理的效果 关于非正式的照顾者。该项目与大型研究平行，并且是 设计为一项随机对照试验，比较 接受非正式家庭护理的爱滋病病毒感染者 接受非病例管理的常规家庭护理的照顾者。非正式的 经同意后，照顾者受试者将被允许参加这项研究 病人进入更大的研究。超过382名受试者被预测为 在一年的数据收集期间有资格参加。 每个客户的参与持续时间中值预计为 大约3个月。评估将基于身体状况的测量 和情绪健康，对正式服务的满意度，以及描述性 说明家庭护理过程中的非正式照顾者角色。这个 身体/情绪健康和满意度结果变量将是 以每月一次的间隔进行测量，并通过重复 不同受试者组别的横截面多元回归 时间长短不一。案例管理干预和其他措施的影响 影响结果的重要变量(例如，患者的疾病严重程度)将 需要进行评估，以及成果措施的相互关联性。数据 有关非正式照顾者角色的信息也将每月收集一次 间隔时间。代码将从答复者对不限成员名额的回答中得出 将对问题和频率进行评估。产生的问题 对于编码来说过于特殊或抽象的答案将是 以更多轶事的方式进行主题分析和报道。结果： 该研究将为卫生保健规划者/政策制定者提供具体数据 论非正式案件管理的利弊 艾滋病毒/艾滋病照顾者的作用和范围的描述性数据 与病例管理和常规家庭护理相关的非正式照顾者资源。

Case management has been proposed as a strategy for promoting comprehensive, cost effective, home care to persons with HIV-related illnesses. Although informal caregivers play a vital role in providing or supplementing home care to persons with HIV infection and may themselves be at risk for altered physical and emotional health outcomes, little research is available regarding how they are effected by case management strategies. This project proposes an extension to a 1989-92 NIH NCNR-funded study (R01 NR02281) that examines the effects of case managed home care for persons with HIV infection, but has no assessment of the effects of case management on the informal caregivers. This project parallels the large study and is designed as a randomized control trial comparing the informal caregivers of HIV infected persons receiving case managed home care with the informal caregivers receiving non case managed, routine home care. Informal caregiver subjects will be admitted to this study upon consent following patient entry into the larger study. Over 382 subjects are projected as eligible for participation during the one year period of data collection. The median duration of participation per client is expected to be approximately 3 months. Evaluation will be based upon measures of physical and emotional health, satisfaction with formal services, and a descriptive account of the informal caregiver role over the course of home care. The physical/emotional health and satisfaction outcome variables will be measured at monthly intervals and associations assessed through repeated cross-sectional multiple regression for the varying subject groups at varying times. Impact of the case management intervention and other significant variables (e.g., patient disease severity) on the outcomes will be assessed, as well as interrelatedness of the outcome measures. Data concerning the informal caregiver role will also be collected at monthly intervals. Codes will be derived from respondent's answers to open-ended questions and frequencies will be assessed. Questions that generate answers that are too idiosyncratic or abstract for coding will be thematically analyzed and reported in a more anecdotal fashion. Results of the study will provide health care planners/policymakers with specific data on the advantages and disadvantages of case management for informal HIV/AIDS caregivers and descriptive data on the role and extent of the informal caregiver resource relative to case managed and routine home care.