Telephone Assessment and Skill-Building Intervention for Stroke Caregivers

中风护理人员的电话评估和技能培养干预

• 批准号: 8232006
• 负责人: TAMILYN BAKAS
• 金额: $ 38.12万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-21 至 2015-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8232006
• 关键词: Address; Age; American; Behavior; Caregivers; Caring; Climacteric; Data; Data Collection; Emotions; Equation; Family; Family Caregiver; Family member; Fostering; Future; Goals; Growth; Health; Health Professional; Healthcare; Home environment; Home visitation; Hospitalization; Hour; House Call; Institutionalization; Intervention; Lead; Managed Care; Measures; Mediating; Mediator of activation protein; Mental Health; Modeling; Nurses; Outcome; Patients; Population; Prevalence; Problem Solving; Procedures; Randomized; Relative (related person); Reporting; Risk; Rural; Sampling; Schedule; Screening procedure; Stroke; Survivors; Telephone; Testing; Training; Training Support; Translations; base; caregiver education; caregiving; comparative; cost; cost effective; cost effectiveness; depressive symptoms; disability; economic evaluation; efficacy testing; empowered; evidence base; expectation; experience; follow-up; group intervention; improved; innovation; intervention effect; intervention program; optimism; physical conditioning; post intervention; premature; primary outcome; programs; public health relevance; resource guides; satisfaction; skills; social; stress management; time use

DESCRIPTION (provided by applicant): Stroke is the leading cause of long-term disability; families are often thrust into providing care for stroke survivors without any training. Stroke family caregivers are of increasing importance because the prevalence of stroke is likely to increase as the population ages. However, there are very few evidence-based, easy-to- deliver follow-up programs after hospitalization to train caregivers in providing care and none that comprehensively address both caregiver and survivor needs through skill-building strategies. Studies have shown that caregiving without training can be detrimental to caregiver's physical and mental health, which can lead to institutionalization of the survivor and higher societal costs. The purpose of this study is to evaluate the efficacy of the revised Telephone Assessment and Skill-building Kit (TASK II), a nurse-led comprehensive intervention that enables caregivers to build skills based on assessment of their own needs. Family caregivers of stroke survivors (N=220) will be randomized to the TASK II intervention or to an Information, Support, and Referral (ISR) group to determine the relative efficacy of the TASK II intervention for reducing task difficulty, increasing optimism, and reducing threat appraisal for providing care. Primary outcomes are caregiver depressive symptoms, caregiving-related negative life changes, and unhealthy days. In an exploratory aim preliminary data will be collected for an economic evaluation of the TASK II intervention. Both the TASK II intervention and ISR procedures involve 8 telephone sessions delivered over 8 weeks, with a booster session at 12 weeks. Data collections will occur at baseline (within 8 weeks of home discharge); at 8 weeks (short-term intervention effect), 12 weeks (after booster), and at 24 weeks and 1 year after baseline (long-term sustainability of intervention effect). Linear mixed models will be applied to the repeated-measures data to test efficacy for Primary Aims 1 & 2. Latent Growth Models using a Structural Equation Model approach will be applied to examine mechanism of intervention effect (Exploratory Aim 1.). An incremental cost-effectiveness ratio (ICER) will be employed to address the comparative costs and outcomes for the TASK II intervention and ISR group (Exploratory Aim 2). PUBLIC HEALTH RELEVANCE: Caring for a family member during the first year after a stroke can be very difficult. The TASK II intervention is a unique, comprehensive caregiver intervention program that enables caregivers to develop the necessary skills to manage care for the survivor, while also taking care of themselves as a caregiver. The long-term goal of this study is to offer training and support for family caregivers through an efficacious, cost-effective program.

描述（由申请人提供）：中风是导致长期残疾的主要原因；家庭往往未经任何培训就被迫为中风幸存者提供护理。中风家庭护理人员变得越来越重要，因为随着人口老龄化，中风的患病率可能会增加。然而，很少有基于证据的、易于实施的住院后培训护理人员提供护理的后续计划，也没有一个能够通过技能建设策略全面满足护理人员和幸存者的需求。研究表明，未经培训的护理可能会损害护理人员的身心健康，从而导致幸存者被送入收容机构并造成更高的社会成本。本研究的目的是评估修订后的电话评估和技能培养套件（TASK II）的功效，这是一种由护士主导的综合干预措施，使护理人员能够根据自身需求的评估来培养技能。中风幸存者的家庭护理人员 (N=220) 将被随机分配到任务 II 干预组或信息、支持和转介 (ISR) 组，以确定任务 II 干预对于降低任务难度、增加乐观情绪和减少提供护理的威胁评估的相对功效。主要结局是看护者抑郁症状、与看护相关的负面生活变化以及不健康的日子。在探索性目标中，将收集初步数据，用于对任务 II 干预措施进行经济评估。 TASK II 干预和 ISR 程序均涉及 8 周内进行的 8 次电话会议，并在 12 周时进行加强会议。数据收集将在基线时进行（出院后 8 周内）； 8周（短期干预效果）、12周（加强后）以及基线后24周和1年（干预效果的长期可持续性）。线性混合模型将应用于重复测量数据，以测试主要目标 1 和 2 的功效。使用结构方程模型方法的潜在增长模型将应用于检查干预效果的机制（探索性目标 1）。将采用增量成本效益比 (ICER) 来解决任务 II 干预和 ISR 组的比较成本和结果（探索性目标 2）。 公共卫生相关性：在中风后的第一年照顾家庭成员可能非常困难。任务 II 干预是一项独特、全面的护理人员干预计划，使护理人员能够培养必要的技能来管理幸存者的护理，同时也作为护理人员照顾好自己。这项研究的长期目标是通过有效、具有成本效益的计划为家庭护理人员提供培训和支持。