A Technology-Enhanced Nursing Intervention for Hospice Caregivers

针对临终关怀人员的技术增强护理干预

• 批准号: 7435725
• 负责人: George Demiris
• 金额: $ 25.18万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-06 至 2010-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7435725
• 关键词: Address; Adopted; Adverse effects; Affect; American; Anxiety; Area; Automobile Driving; Biological; Caregiver Burden; Caregivers; Caring; Cessation of life; Chronic; Clinical; Clinical Trials; Communication; Communication Tools; Control Groups; Coping Skills; Cost Savings; Creativeness; Direct Costs; Effectiveness; Elderly; Emotional; Family Caregiver; Family member; Frequencies; Friends; Health; Health Professional; Home environment; Hospice Care; Individual; Information Technology; Interdisciplinary Study; Intervention; Love; Maintenance; Modeling; Morbidity - disease rate; Numbers; Nursing Research; Outcome; Palliative Care; Palliative Care Nursing; Patient Education; Patients; Perception; Personal Satisfaction; Persons; Population; Preparation; Problem Solving; Public Health; Quality of life; Randomized; Randomized Clinical Trials; Recruitment Activity; Research; Resources; Risk; Role; Score; Services; Site; Standards of Weights and Measures; Stress; Symptoms; Technology; Terminally Ill; Testing; Time; Travel; Visit; Visiting Nurse; Work; base; caregiving; cost; cost effectiveness; design; emotional distress; experience; hospice environment; improved; innovation; interdisciplinary approach; mortality; novel; nursing intervention; optimism; patient home care; research study; satisfaction; telehealth; tool

DESCRIPTION (provided by applicant): Family members and friends who act as informal caregivers of hospice patients are essential to the provision of palliative care services; however, this role is not without adverse effects on the caregivers themselves. Recent research has revealed that caregiver anxiety and burden can negatively impact morbidity and mortality among informal caregivers of hospice patients. Emotional needs of individuals caring for dying persons in their home are not well attended and the lack of interventions aiming to provide support to informal caregivers has public health implications. We are proposing the delivery of a proven coping skills intervention for informal caregivers of home hospice patients (COPE) based on the problem-solving framework of the prepared family caregiver model, using commercially available videophone technology. We propose a two year equivalence clinical trial. Our interdisciplinary research team will recruit 160 informal caregivers and their patients from a participating agency and will randomly assign them to either a group receiving standard hospice care with the addition of the COPE intervention delivered in person (Group 1), or a group receiving standard hospice care with the addition of the COPE intervention delivered via videophones (Group 2). We aim to evaluate the effectiveness of the videophone-based intervention for informal caregivers of hospice patients (focusing on informal caregivers' quality of life, caregiver burden related to patient symptoms and caregiver anxiety) and to assess caregivers' perceptions of and satisfaction with the videophone use as a communication mode. Finally, we also aim to compare the cost of delivering the COPE intervention for caregivers of hospice patients for the two groups (in person vs. videophone). If proven successful, this intervention can become a feasible and sustainable tool that increases the amount of support received by informal hospice caregivers during their often brief hospice experience, without increasing travel stress and costs for hospice staff. PUBLIC HEALTH RELEVANCE: Family members and friends who act as informal caregivers are essential to the provision of hospice services. The caregiving experience is not without adverse effects on the caregivers themselves as caregiving stress and burden can negatively impact their morbidity and mortality. The proposed research study explores an intervention that will improve clinical outcomes for hospice caregivers; thus, the study is highly relevant to public health as it affects the health of a continuously growing segment of our population and aims to demonstrate the value of a feasible and sustainable hospice intervention.

描述（由申请人提供）：家庭成员和朋友谁作为临终关怀患者的非正式照顾者是必不可少的姑息治疗服务的提供;然而，这一作用是不是没有对照顾者本身的不利影响。最近的研究表明，照顾者的焦虑和负担会对临终关怀患者的非正式照顾者的发病率和死亡率产生负面影响。在家中照顾垂死者的个人的情感需求没有得到很好的照顾，缺乏旨在向非正式照顾者提供支持的干预措施，对公共卫生产生了影响。我们建议提供一个行之有效的应对技能干预， 家庭临终关怀患者的护理人员（科普）的基础上准备的家庭护理人员模型的问题解决框架，使用商用可视电话技术。我们建议进行为期两年的等效临床试验。我们的跨学科研究团队将从一个参与机构招募160名非正式护理人员及其患者，并将他们随机分配到接受标准临终关怀并添加亲自提供科普干预的一组（第1组），或接受标准临终关怀并添加科普干预的一组。 视频电话（第2组）。我们的目标是评估基于视频电话的干预对临终关怀患者非正式护理人员的有效性（重点关注非正式护理人员的生活质量、护理人员 与患者症状和护理者焦虑相关的负担），并评估护理者对使用可视电话作为通信模式的感知和满意度。最后，我们还旨在比较两组（亲自与视频电话）为临终关怀患者的护理人员提供科普干预的成本。如果被证明是成功的，这种干预措施可以成为一种可行的和可持续的工具，增加非正式临终关怀护理人员在他们通常短暂的临终关怀经历中获得的支持量，而不会增加临终关怀工作人员的旅行压力和成本。公共卫生相关性：家庭成员和朋友谁作为非正式的照顾者是必不可少的临终关怀服务的提供。这段经历并非没有负面影响 对照顾者本身的压力和负担可能产生负面影响，他们的发病率和死亡率。拟议的研究探讨了一种干预措施，将改善临终关怀护理人员的临床结果;因此，这项研究与公共卫生高度相关，因为它影响了我们人口中不断增长的部分的健康，旨在证明可行和可持续的临终关怀干预的价值。