Feasibility of a Theory-Based Online Hip Fracture Resource Center for Caregivers

为护理人员建立基于理论的在线髋部骨折资源中心的可行性

• 批准号: 7314147
• 负责人: EUN-SHIM NAHM
• 金额: $ 18.45万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-15 至 2009-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7314147
• 关键词: Activities of Daily Living; Acute; Admission activity; Adult; Age; Aging; Alzheimer' s Disease; Applications Grants; Area; Attention; Baltimore; Caregiver Burden; Caregivers; Caring; Condition; Data Collection; Dependency; Development; Elderly; Event; Exercise; Exploratory/Developmental Grant; Family; Family member; Feasibility Studies; Feedback; Fracture; Frequencies; Future; Goals; Government; Health; Health Personnel; Health Professional; Health behavior; Hip Fractures; Hip region structure; Hospitals; Household; Injury; Internet; Intervention; Intervention Studies; Investigation; Learning; Libraries; Measures; Methods; Modeling; Motivation; Numbers; Online Systems; Operative Surgical Procedures; Outcome; Outcome Measure; Participant; Patients; Personal Satisfaction; Persons; Phase; Pilot Projects; Population; Prevention; Procedures; Process; Protocols documentation; Psychosocial Assessment and Care; Public Health; Published Comment; Quality of life; Randomized Controlled Trials; Range; Rate; Recovery; Recruitment Activity; Rehabilitation therapy; Research; Research Infrastructure; Research Personnel; Resources; Risk; Role; Safety; Sample Size; Sampling; Secure; Self Care; Self Efficacy; Site; Social support; Source; Statistically Significant; Stress; Structure; Support Groups; Testing; Time; Treatment Protocols; United States; Virtual Library; Week; Work; aging population; base; caregiving; coping; disability; expectation; experience; functional status; health care service organization; improved; innovation; interest; mortality; prevent; programs; statistics; theories; usability; virtual

DESCRIPTION (provided by applicant): Maintaining and improving functional abilities are vital for the quality of life of older adults. In the United States, approximately 340,000 older adults experience hip fractures yearly, leading to increased mortality, prolonged disabilities, and subsequent hip fractures. Unlike other debilitating illnesses, however, hip fracture is an acute episode; with proper interventions, older adults can recover to their baseline. Moreover, a hip fracture can serve as a unique opportunity to prevent further disabilities through improving health behaviors and implementing environmental safety measures. Immediately after hip fracture, many older adults become more dependent on informal caregivers (e.g., family). The role of caregivers is particularly important during recovery because they are a significant source of motivation for older adults to follow their rehabilitation regimens and to improve their health behaviors. While extensive resources are available to the caregivers of persons with several debilitating illnesses (e.g., Alzheimer's disease), few resources are available to the caregivers of hip fracture patients. With the increasing number of online users, an online resource program could be an effective method for providing necessary support to these caregivers. In this R21 exploratory/ developmental application, the investigators propose a study that will (1) develop a theory-based Online Hip Fracture Resource Center (OHRC) for caregivers, and (2) test the feasibility of the OHRC intervention for a future randomized controlled trial (RCT) that will examine the effects of the program on both caregivers and patients. The OHRC is an 8-week program that includes self-learning modules, moderated discussion boards, Ask the Experts, and a virtual library. This study is innovative in that (1) the OHRC will be developed in conformance with two strong theories (i.e., the stress, appraisal, and coping theory/self-efficacy theory); and (2) it will focus on maximizing the care relationship in the caregiver-care recipient dyad, with the goals of providing support to caregivers and preventing further disabilities in hip fracture patients. Once the OHRC is developed, we will conduct a feasibility study on 33 caregiver-care recipient dyads with two data collection points (baseline, end- of-treatment [EOT, 8 wks]). The feasibility of the OHRC program will be assessed by the amount of usage, participant comments about the OHRC content and its usability. The feasibility of the OHRC protocol for the future trial will be assessed by implementing the protocol. The main analysis will be descriptive and content analysis. Additionally, we will compute inferential statistics for outcome measures piloted in this study to ascertain whether changes from baseline to the EOT assessment are statistically significant and to estimate an optimal sample size for the future trial. The findings will serve as preliminary work for the future RTC. If the OHRC proves effective, it can be used as a supplementary intervention for caregivers and patients. Moreover, the method used in the OHRC may serve as a model for other programs. This proposed study focuses on the use of an interactive online resource program for caregivers of older adults who have had a hip fracture, a debilitating injury. Through provision of specific information and psychosocial support, this program will help caregivers cope with caregiving situations and become a source of motivation and information for their care recipients to improve their recovery. Considering the increasing numbers of online users and the aging population, this innovative program has significant potential as a practical and accessible method to promote health in older adults and their caregivers and is a model for other online caregiver programs for older adults.

描述（由申请人提供）：维持和改善功能能力对老年人的生活质量至关重要。在美国，每年约有340，000名老年人经历髋部骨折，导致死亡率增加，长期残疾和随后的髋部骨折。然而，与其他使人衰弱的疾病不同，髋部骨折是一种急性发作;通过适当的干预，老年人可以恢复到基线。此外，髋骨骨折可以作为一个独特的机会，通过改善健康行为和实施环境安全措施，防止进一步的残疾。髋部骨折后，许多老年人立即变得更加依赖非正式的照顾者（例如，家庭）。在康复过程中，照顾者的作用尤为重要，因为他们是老年人遵循康复方案和改善健康行为的重要动力来源。虽然患有几种使人衰弱的疾病（例如，阿尔茨海默氏病），很少有资源可供照顾髋部骨折患者。随着越来越多的在线用户，在线资源计划可能是一种有效的方法，为这些照顾者提供必要的支持。在R21探索性/发展性应用中，研究人员提出了一项研究，该研究将（1）为护理人员开发一个基于理论的在线髋部骨折资源中心（OHRC），（2）测试OHRC干预的可行性，用于未来的随机对照试验（RCT），该试验将检查该计划对护理人员和患者的影响。OHRC是一个为期8周的计划，包括自学模块，主持讨论板，询问专家和虚拟图书馆。这项研究的创新之处在于：（1）OHRC将根据两个强有力的理论（即，压力、评估和应对理论/自我效能理论）;以及（2）它将侧重于最大限度地加强照顾者与接受照顾者的二元关系，目的是为照顾者提供支持，并防止髋部骨折患者进一步残疾。一旦OHRC开发完成，我们将在两个数据收集点（基线、治疗结束[EOT，8周]）对33例患者-治疗接受者配对进行可行性研究。OHRC计划的可行性将通过使用量，参与者对OHRC内容及其可用性的评论进行评估。将通过实施方案来评估OHRC方案在未来试验中的可行性。主要分析将是描述性和内容分析。此外，我们将计算本研究中试行的结局指标的推断统计量，以确定从基线到EOT评估的变化是否具有统计学显著性，并估计未来试验的最佳样本量。调查结果将作为未来RTC的初步工作。如果OHRC被证明是有效的，它可以作为护理人员和患者的补充干预措施。此外，OHRC中使用的方法可以作为其他计划的模型。这项拟议的研究重点是使用一个互动的在线资源计划的照顾者的老年人谁有髋部骨折，一个衰弱的伤害。通过提供具体的信息和心理社会支持，该方案将帮助照顾者科普困境，并成为其照顾对象改善康复的动力和信息来源。考虑到越来越多的在线用户和人口老龄化，这一创新计划具有显着的潜力，作为一个实用和方便的方法，以促进健康的老年人和他们的照顾者，是一个模式，为其他在线照顾者计划的老年人。