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COMPREHENSIVE PALLIATIVE CARE: SPOUSAL CAREGIVERS OF HEART FAILURE PATIENTS

综合姑息治疗：心力衰竭患者的配偶照顾者

基本信息

批准号：
7127965
负责人：
Judith E Hupcey
金额：
$ 20.65万
依托单位：
PENNSYLVANIA STATE UNIVERSITY, THE
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-09-19 至 2009-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7127965
关键词：
caregivers clinical research family female heart failure model

项目摘要

DESCRIPTION (provided by applicant): Nearly 5 million Americans live with heart failure with 550,000 newly diagnosed each year (AHA, 2005). Within the first year of diagnosis 30%-50% will die, and among men aged 65 or younger, 80% will be dead within 8 years of diagnosis. Yet, less than 10% are offered supportive services beyond basic medical care. Our long-term goal is to test the utility of a model of palliative care, focusing on female spousal caregivers, to support these pivotal partners in providing high quality care to those living with and dying from heart failure by developing an individualized, need-driven, phase-specific intervention protocol that will be tested in future studies. The specific aims are: 1) to delineate palliative care needs of female spousal caregivers during the phases of chronic, progressive decline preceding the end of life in heart failure; 2) to identify the critical transition point at which female spousal caregivers recognize the severity of the diagnosis of heart failure and thus acknowledge the need for and acceptance of palliative care services beyond symptom management, and 3) to refine/extend the model of palliative care for female spousal caregivers to include known and newly identified interventions in a phase-specific, needs-directed intervention protocol. In order to meet these aims, we will use methods of grounded theory first, to verify the fit of our theoretical models with the experiences of these female spousal caregivers; then, to extend the model by delineating unmet care needs that could be addressed through palliative care services. Approximately 35 female caregivers will be interviewed. Initially, 10 retrospective interviews will be done with women following the death of their spouses; then 25 active caregivers will be recruited and interviewed monthly for one year to capture the dynamic nature of both caregiving and heart failure. The refined model will be extended to a more comprehensive level by integrating additional data from extant literature and small group interviews with experts in medical management of heart failure, palliative care, and end of life. From this comprehensive model, an intervention protocol that prescribes a compendium of need-driven, phase-specific interventions, based on behavioral and verbal cues will be developed. This project will contribute to the public health of the nation by identifying strategies for providing comprehensive palliative care services to informal spousal caregivers who provide significant support to the millions of Americans living and dying with heart failure.

描述（由申请人提供）：近500万美国人患有心力衰竭，每年新诊断出55万例（AHA, 2005）。在确诊的第一年，30%-50%将死亡，在65岁或65岁以下的男性中，80%将在确诊后的8年内死亡。然而，只有不到10%的人获得了基本医疗保健以外的支持性服务。我们的长期目标是测试姑息治疗模式的效用，以女性配偶照顾者为重点，通过制定个性化的、需求驱动的、特定阶段的干预方案，支持这些关键的合作伙伴为心力衰竭患者提供高质量的护理，并将在未来的研究中进行测试。具体目的是：1)描述女性配偶照顾者在心力衰竭患者生命末期前慢性进行性衰退阶段的姑息治疗需求；2)确定女性配偶照顾者认识到心力衰竭诊断的严重性，从而认识到症状管理之外的姑息治疗服务的需要和接受的关键转折点；3)完善/扩展女性配偶照顾者的姑息治疗模式，在特定阶段、需求导向的干预方案中纳入已知和新发现的干预措施。为了达到这些目的，我们将首先使用扎根理论的方法，验证我们的理论模型与这些女性配偶照顾者的经验的拟合性；然后，通过描述可通过姑息治疗服务解决的未满足的护理需求来扩展模型。大约35名女性护理人员将接受采访。最初，将在配偶死亡后对妇女进行10次回顾性访谈；然后，将招募25名积极的护理人员，并在一年内每月接受采访，以捕捉护理和心力衰竭的动态本质。通过整合来自现有文献的额外数据和与心衰、姑息治疗和临终医学管理专家的小组访谈，将改进的模型扩展到更全面的水平。根据这一综合模型，将制定一项干预方案，该方案规定了基于行为和语言线索的需求驱动的特定阶段干预措施纲要。该项目将通过确定为非正式配偶照顾者提供全面姑息治疗服务的战略，为国家的公共卫生做出贡献，这些照顾者为数百万因心力衰竭而生存和死亡的美国人提供了重大支持。

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Achieving medical stability: Wives' experiences with heart failure.

DOI：
10.1177/1054773810371119
发表时间：
2010-08
期刊：
Clinical nursing research
影响因子：
1.7
作者：
Hupcey JE;Fenstermacher K;Kitko L;Penrod J
通讯作者：
Penrod J

Palliative Needs of Spousal Caregivers of Patients with Heart Failure Followed at Specialized Heart Failure Centers.

在专门的心力衰竭中心跟踪心力衰竭患者的配偶照顾者的姑息治疗需求。

DOI：
10.1097/njh.0b013e31820ce15e
发表时间：
2011
期刊：
Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association
影响因子：
0
作者：
Hupcey,JudithE;Fenstermacher,Kimberly;Kitko,Lisa;Fogg,Janet
通讯作者：
Fogg,Janet

Review article: a model of palliative care for heart failure.