The Impact of the COVID-19 Pandemic on Veteran Caregivers: A Mixed Methods Study to inform the VA Caregiver Support System

COVID-19 大流行对退伍军人护理人员的影响：为 VA 护理人员支持系统提供信息的混合方法研究

• 批准号: 10188706
• 负责人: Lauren Penney
• 金额: --
• 依托单位: SOUTH TEXAS VETERANS HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-01 至 2022-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10188706
• 关键词: Address; Ally; Appointment; Area; COVID-19; COVID-19 pandemic; Caregiver Burden; Caregiver research; Caregiver support; Caregiver well-being; Caregivers; Caring; Chronic; Cities; Clinical; Communicable Diseases; Communication; Communities; Complex; Data; Disasters; Disease Management; Ecology; Economics; Ecosystem; Environment; Epidemic; Face; Family; Family Caregiver; Feedback; Feeling; Focus Groups; Friends; Future; Goals; Health; Health Services Research; Healthcare Systems; Home; Home Health Aides; Impairment; Institution; Internist; Interruption; Intervention; Interview; Learning; Long-Term Care; Long-Term Effects; Measures; Mental Health; Methodology; Methods; Nurses; Play; Policies; Politics; Process; Provider; Psychologist; Research; Risk; Role; Sampling; Services; Site; Social Distance; Sodium Chloride; Stress; Structure; Support System; Surveys; Survivors; System; Time; Uncertainty; Veterans; Work; base; burnout; care giving burden; care recipients; caregiver interventions; caregiving; coronavirus disease; design; experience; functional disability; health care availability; informal care; informal caregiver; innovation; insight; meetings; operation; pandemic disease; physical conditioning; programs; resilience; response; service organization; social; social organization; stressor; synergism; virtual

Background: The COVID-19 pandemic has had cascading impacts for families and communities. Concerns have been raised for potential negative physical and mental health consequences due to the immediate risk of COVID-19 and the secondary social and economic effects. Family caregivers may be especially vulnerable to short- and long-term impacts. • Significance/Impact: Informal caregivers provide the majority of home and community-based long-term care. A majority of functionally impaired Veterans rely on informal care for daily support and condition management. Negative impacts from the pandemic have the potential to reduce the capacity of informal caregivers to support Veterans choosing to remain at home. • Innovation: There are no known studies of how the pandemic has impacted Veteran caregivers. This study provides a unique opportunity to learn about an essential ally in the care of Veterans, and the ways in which the VA system can enhance their support for Veterans experiencing functional and clinical impairment. We uniquely combine an ecological systems framework and the concept of “cascading effects” from disaster research to help us frame and understand the different complex short- and long-term effects caregivers may experience. • Specific Aims: Aim 1. To describe both positive and negative caregiver experiences during the COVID-19 pandemic and to identify threats to long-term caregiver resiliency. We will conduct surveys with Veteran caregivers from each of our 5 sites (San Antonio, Palo Alto, Miami, Salt Lake City, Durham), to describe variability of impacts and to purposively sample caregivers for in-depth, semi-structured interviews. We will triangulate findings from interviews with local VA caregiver stakeholders. Aim 2. To feedback preliminary data and debrief with VISN and national level VA stakeholders to understand how these issues are perceived and responded to at a regional and national level, and their priorities for caregiver services and research. Aim 3. To engage Veteran caregivers in a participatory, deliberative process to identify top priorities for future research and intervention. • Methodology: We will conduct a 15-month, multi-sited, mixed methods study, utilizing a brief Veteran caregiver survey, semi-structured interviews with caregivers and VA stakeholders, and virtual focus groups with caregivers. We will focus on how caregivers have been impacted and responded, VA organizational responses, and identifying priority areas for future research and intervention. Implementation/Next Steps: This pilot is a first step toward developing a long term understanding of how Veteran caregivers and their capacity for caregiving have been and will be impacted by the pandemic. It is an entry point for developing more tailored and sensitive (e.g., to inequities) VA Veteran caregiver system supports. Our design includes feedback loops to VA stakeholders and partners so that our findings may be actionable and inform ongoing research and caregiver-centered, operations work.

背景：COVID-19大流行对家庭产生了层叠的影响 社区。人们对潜在的负面身心健康提出了担忧 由于与19号的直接风险以及二级社会和经济的直接风险造成的后果 效果。家庭护理人员可能特别容易受到短期和长期影响的影响。 •意义/影响力：非正式护理人员为家庭和社区提供大多数 长期护理。大多数功能障碍的退伍军人都依靠非正式护理来每天 支持和状况管理。大流行的负面影响有可能 降低非正式护理人员支持选择留在家中的退伍军人的能力。 •创新：尚无关于大流行如何影响退伍军人的已知研究 照顾者。这项研究提供了一个独特的机会来了解护理中的基本盟友 退伍军人以及VA系统可以增强对退伍军人的支持的方式 经历功能和临床障碍。我们独特地结合了生态系统 框架和灾难研究中“级联效应”的概念，以帮助我们构架和 了解护理人员可能会遇到不同复​​杂的短期和长期影响。 •具体目的： 目的1。描述COVID-19期间正面和负面照顾者的经验 大流行并确定对长期护理人员弹性的威胁。我们将与 来自我们5个地点的每个网站（圣安东尼奥，帕洛阿尔托，迈阿密，盐湖城，盐湖城， Durham），描述影响的可变性，并普遍对护理人员进行深入调查， 半结构化访谈。我们将从当地VA护理人员的访谈中进行三角调查结果 利益相关者。 目标2。与VISN和国家级别VA利益相关者的反馈初步数据和汇报 了解如何在区域和民族中对这些问题的感知和回应 水平及其护理人员服务和研究的优先事项。 目标3。让资深护理人员参与参与，审议过程以识别顶级 未来研究和干预的优先事项。 •方法：我们将使用简短 资深护理人员调查，对看护人和VA利益相关者的半结构化访谈，以及 虚拟焦点小组与护理人员。我们将重点介绍护理人员如何受到影响以及 响应，VA组织的回应，并确定未来研究的优先领域 干涉。 实施/下一步：该飞行员是发展长期的第一步 了解资深护理人员及其护理能力的发展 受到大流行的影响。这是开发更量身定制和敏感的切入点 （例如，不平等）VA老兵护理人员系统的支持。我们的设计包括反馈循环 给VA利益相关者和合作伙伴，以便我们的发现可以采取行动并告知正在进行的 以研究和照顾者为中心的操作工作。