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Resourcefulness Intervention for Mothers of Technology-Dependent Children

对技术依赖儿童的母亲进行智谋干预

基本信息

批准号：
9377085
负责人：
Valerie Annette Toly
金额：
$ 47.99万
依托单位：
CASE WESTERN RESERVE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-19 至 2020-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9377085
关键词：
Accident and Emergency department Affect Alzheimer&apos s Disease Attention Behavioral Blood Pressure Caregivers Caring Child Child Care Chronic Chronic stress Cognitive Cognitive Therapy Complex Control Groups Data Deterioration Development Distress Educational Intervention Educational process of instructing Emergency department visit Emotional Enrollment Enteral Feeding Equipment Ethnic Origin Family Female Goals Hair Health Healthcare Home environment Hospitalization Hospitals Hydrocortisone Income Internet Intervention Journals Life Locales Mechanical ventilation Mediating Medical Mental Health Monitor Mothers Outcome Parents Patients Phonation Population Primary Health Care Psychological reinforcement Race Randomized Clinical Trials Reporting Risk Sampling Self Management Sleep Societies Stress Students Technology Telephone Testing Time Training Translations United States Visit Work Writing adverse outcome arm attentional control base care recipients caregiver interventions caregiving complex chronic conditions depressive cognitions depressive symptoms efficacy evaluation efficacy testing experience functional status group intervention help-seeking behavior improved male member mortality nursing intervention patient home care pediatric patients physical conditioning post intervention psychologic randomized trial self help sex skills social stress management stress symptom therapy design treatment as usual vigilance

项目摘要

Project Summary/Abstract: Technology-dependent children, those who rely on medical equipment such as mechanical ventilation or feeding tubes for daily care at home, are among the sickest and most vulnerable subset of children with complex chronic conditions. They comprise 20% of all children discharged from the hospital to home, yet account for 61% of healthcare spending for children, up to $110 billion annually. An estimated 600,000 children in the United States are technology dependent and live at home, and are cared for primarily by their parents. These parents report greater levels of depressive symptoms and stress than other caregiver groups. In addition, these caregivers report poor psychological and physical health that compromise their caregiving capacity and increase their use of emergency rooms (ER) for their children's care needs. Despite these adverse consequences, there are no interventions to meet the needs of these caregivers and their children. Resourcefulness Training, (cognitive-behavioral self-management intervention) has been shown to improve psychological and physical outcomes, mediate the effects of stress, and enhance the care provided to care- recipients. It will be tested in a randomized trial against an attention-only control arm. The intervention arm will receive an intervention that includes: a face-to-face session for teaching social (help-seeking) and personal (self-help) resourcefulness skills; ongoing access to video vignettes of caregivers of technology-dependent children describing resourcefulness skill application in daily life; 4 weeks of skills' reinforcement using daily journal writing; weekly phone calls for the first 4 weeks; and booster sessions at 2 and 4 months post enrollment. The Attention Control arm will receive weekly phone calls for the first 4 weeks and at 2 and 4 months post enrollment plus any usual care. The aims of the study are to: 1) Determine whether Resourcefulness Training versus Attention Control improves psychological (general mental health, depressive cognitions, depressive symptoms, appraised stress, burden) and physical outcomes (general physical health, chronic stress [hair cortisol]) and family functioning over 6 months in parents of technology-dependent children, after controlling for the parents' race/ethnicity, sex, family income, and children's functional status; and 2) Determine whether changes in psychological and physical outcomes and family functioning are mediated by changes in parents' levels of resourcefulness (personal and social). Our study will be the first to test a resourcefulness intervention for this caregiver population and to include male as well as female caregivers. This intervention is distinctive in that it uses web, telephone, and journal components for reinforcement—not multiple face-to-face visits that can be labor intensive. If shown to be efficacious, it can be easily replicated with other populations with strong potential for translation into practice.

项目总结/文摘: