Multimedia Support for Caregivers of the Seriously Ill

描述（由申请人提供）：本项目将提供一个基于网络的多媒体支持计划，为那些需要帮助进行日常生活活动（如穿衣、洗澡、喂食）和接近生命终结的老年人的受雇家庭照顾者提供帮助。在Lazarus & Folkman压力和应对模型的背景下，该项目将通过文本、视频建模和图形表示向护理人员提供知识和认知/行为应对技能。一个独特的功能将是决策辅助工具（DAT），它将帮助用户在逻辑上考虑复杂的备选方案，以便做出明智的决定（例如，关于医疗方案）。第一阶段的概念验证包括护理技能、重要的医疗/法律决定、寻找资源以及数据的初步开发等模块。在随机化程序评估中，用户在自我效能感和行为意向方面表现出显著的改善，从而正向影响压力和应对策略的评估。受试者发现该程序易于使用，并给了它很高的满意度分数。第二阶段的开发将增加以下模块：a)情感/精神问题，b)平衡工作与照顾，c)严重疾病对受照顾者的影响，d)死亡时的期望，e)丧恸，f)修订和扩展的数据，f)个人计划指南，帮助用户找到与他们的兴趣和需求相关的内容。第二阶段的项目还将包括基于视频的医疗宣传和护理人员与家庭沟通的技能培养模块。此外，将为客户/现场经理开发一个单独的部分，以建议主管如何减轻工作护理人员的压力并保持其生产力，并为员工提供有关本地资源的键盘输入信息。完整开发的二期计划将以互联网和CD-ROM两种版本制作，并将在一项大型随机试验中进行评估。随着人们年龄的增长和接近生命的尽头，他们可能需要很多日常活动的帮助，比如洗澡、穿衣和吃饭。提供这种帮助对那些既要照顾别人又要保住工作的家庭成员来说真的很难，这对他们来说可能是压倒性的。该计划通过互联网为护理人员提供自动化支持和教育，包括文章、视频，并帮助他们思考艰难的决定。

DESCRIPTION (provided by applicant): This project will provide a web-based multimedia support program for employed family caregivers of older adults who require assistance with activities of daily living (e.g., dressing, bathing, feeding) and who are nearing the end of life. Framed in the context of the Lazarus & Folkman stress and coping model, the program will provide the caregiver with knowledge and cognitive/behavioral coping skills using text, video modeling, and graphic representations. A unique feature will be a Decision Assistance Tool (DAT), which will help the user logically consider complex alternatives in order to make an informed decision (e.g., about medical treatment options). The Phase I proof of concept included modules on caregiving skills, important medical/legal decisions, and finding resources, as well as initial development of the DAT. During the randomized program evaluation, users showed significant improvement in: a) self-efficacy to positively influence appraisals of stress and coping strategies, and b) behavioral intentions to adopt the strategies. Subjects found the program easy to use and gave it high satisfaction scores. Phase II development will add modules on: a) emotional/spiritual issues, b) balancing work with caregiving, c) the impact of serious illness on a care receiver, d) expectations at time of death, e) bereavement, f) a revised and expanded DAT, and f) a Personal Program Guide which will help users find contents relevant to their interests and needs. The Phase II program will also include video based skill building modules on medical advocacy and caregiver-family communication. Additionally, a separate section will be developed for customers/worksite managers to suggest how supervisors can reduce the stress and maintain the productivity of working caregivers, and keyboard-enter information about local resources for employees. The fully developed Phase II program will be produced in both Internet and CD-ROM versions and will be evaluated in a large randomized trial. As people age and near the end of life, they may need lots of help with daily activities like bathing and dressing and eating. Providing this help can be really hard on family members who have to be a caregiver and still keep their job, and it can be overwhelming for them. The proposed program provides automates support and education for the caregivers via the Internet, including articles, videos, and help thinking through tough decisions.