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：2019冠状病毒病大流行对家庭产生了连锁反应， 社区.人们对潜在的负面身心健康表示担忧 由于COVID-19的直接风险以及次要社会和经济风险， 方面的影响.家庭照顾者可能特别容易受到短期和长期影响。 重要性/影响：非正规护理人员提供了大部分家庭和社区护理服务。 长期护理。大多数功能受损的退伍军人依靠非正式的日常护理 支持和条件管理。大流行病的负面影响有可能 减少非正式照顾者的能力，以支持退伍军人选择留在家里。 ·创新：目前还没有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，了解一个重要的盟友在照顾 退伍军人，以及退伍军人管理局系统可以加强对退伍军人的支持的方式 经历功能和临床损伤。我们独特地将联合收割机和生态系统 框架和“级联效应”的概念，从灾害研究，以帮助我们框架， 了解不同的复杂的短期和长期影响照顾者可能会遇到的。 ·具体目标： 目标1。描述COVID-19期间积极和消极的护理人员体验 大流行病，并确定长期护理人员弹性的威胁。我们将进行调查， 来自我们5个研究中心（圣安东尼奥、帕洛阿尔托、迈阿密、盐湖湖城 达勒姆），以描述影响的变化，并有目的地抽样照顾者进行深入， 半结构化面试我们将对当地退伍军人管理局护理人员的访谈结果进行三角分析 持份者 目标2.反馈初步数据，并与VISN和国家级VA利益相关者进行汇报 了解这些问题在区域和国家一级是如何看待和应对的， 水平，以及他们的照顾者服务和研究的优先事项。 目标3。让退伍军人护理人员参与参与协商过程， 未来研究和干预的重点。 ·方法：我们将进行一项为期15个月的多地点混合方法研究， 退伍军人照顾者调查，与照顾者和VA利益相关者的半结构化访谈，以及 虚拟焦点小组我们将重点关注护理人员如何受到影响， 回答，VA组织的反应，并确定未来研究的优先领域， 干预 实施/后续步骤：该试点是制定长期 了解退伍军人护理人员及其护理能力已经并将 受疫情影响。它是开发更有针对性和敏感性的 (e.g.,退伍军人护理系统支持。我们的设计包括反馈循环 向VA利益相关者和合作伙伴提供信息，以便我们的调查结果可以采取行动，并为正在进行的调查提供信息。 以研究和实践为中心的业务工作。