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Resourcefulness Intervention to Promote Self-Management in Parents of Technology-Dependent Children

智谋干预促进技术依赖儿童父母的自我管理

基本信息

批准号：
10301000
负责人：
Valerie Annette Toly
金额：
$ 52.04万
依托单位：
CASE WESTERN RESERVE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-12-28 至 2023-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10301000
关键词：
Acute Affect Alzheimer&apos s disease caregiver Alzheimer&apos s disease patient Behavior Behavioral Blood Pressure Caregivers Caring Child Child Care Child health care Chronic Chronic stress Cognitive Cognitive Therapy Control Groups Deterioration Educational Intervention Educational process of instructing Emergency department visit Enrollment Enteral Feeding Ethnic Origin Family Fathers Gender Goals Hair Health Health Promotion Healthcare Home Hospitalization Hospitals Hour Household Hydrocortisone Income Internet Intervention Journals Length of Stay Life Locales Mechanical ventilation Mediating Mediator of activation protein Mental Health Mothers Outcome Parents Population Psychological reinforcement Race Randomized Controlled Trials Reporting Sampling Savings Science Self Management Sleep Societies Stress Structure Technology Telephone Testing Time Training Translations United States Work Writing adverse outcome attentional control base care recipients caregiver interventions caregiving complex chronic conditions depressive cognitions depressive symptoms effectiveness testing experience functional status group intervention health related quality of life help-seeking behavior improved mortality risk neglect nursing intervention physical conditioning post intervention psychoeducational intervention psychologic randomized trial self help skill acquisition skills sleep pattern social stress management theories therapy design treatment as usual vigilance

项目摘要

Project Summary/Abstract Parent caregivers of children who require life-saving technology such as mechanical ventilation or feeding tubes must maintain a high level of vigilance 24 hours a day, 7 days a week. They report greater levels of stress, compromised self-management behaviors and poorer psychological and physical health than other caregiver groups which dramatically increases their mortality risk. Technology-dependent children (approximately 600,000) are among the sickest and most vulnerable subset of children with complex chronic conditions in the United States. 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. Despite the adverse consequences for caregivers, there are no interventions to meet their specific needs. 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. A Resourcefulness Training Intervention (RTI) will be tested in a randomized trial against an attention control group. The RTI includes face-to-face session for teaching social (help-seeking) and personal (self-help) resourcefulness skills, ongoing web access to the RTI video and 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 group 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 the RTI versus Attention Control improves psychological (mental HRQoL depressive cognitions, depressive symptoms, appraised stress, burden) and physical outcomes (physical HRQoL, chronic stress [hair cortisol]) over 9 months in parents of technology-dependent children, after controlling for covariates (parent race/ethnicity and gender, family income, and children's functional status, type of technology). 2) Determine whether changes in psychological and physical outcomes are mediated by changes in parents' levels of resourcefulness based on intervention condition. 3) Compare self-management behavior (sleep, positive health practices) over 9 months in parents who received RTI versus Attention Control. 4) Explore whether resourcefulness is a mediator between intervention condition and self-management behaviors controlling for baseline self-management behavior over 9 months. 5) Explore the relationship between self-management behavior and parent psychological and physical outcomes based on intervention condition. Our study will be the first to test a cognitive-behavioral RTI for this caregiver population. 6) Compare target children's ER visits, hospital days over 9 months based on parent intervention condition. If shown to be efficacious, it can be replicated with other caregivers of children with complex chronic conditions with strong potential for translation into practice.

项目总结/摘要需要机械通气或喂养等救生技术的儿童的父母照顾者管必须保持高度警惕，每天24小时，每周7天。他们报告说，压力，自我管理行为受损以及心理和身体健康状况较差这大大增加了他们的死亡风险。技术依赖儿童（约600，000人）是患有复杂慢性病的儿童中病情最严重和最脆弱的一部分。美国的条件。他们占从医院出院回家的所有儿童的20%，占儿童医疗保健支出的61%，每年高达1100亿美元。尽管不利的对照料者造成的后果，没有任何干预措施来满足他们的具体需求。足智多谋培训（认知行为自我管理干预）已被证明可以改善心理和这些措施可改善身体状况，调节压力的影响，并加强向接受护理者提供的护理。一足智多谋训练干预（RTI）将在一项针对注意力控制的随机试验中进行测试组RTI包括面对面的会议，用于教授社会（寻求帮助）和个人（自助）足智多谋的技能，正在进行的网络访问RTI视频和视频短片的照顾者的技术- 依赖儿童描述日常生活中的机智技能应用，4周技能强化使用每日日记写作，前4周每周电话，以及2个月和4个月的助推器会议登记后。注意力控制组将在前4周每周接受一次电话呼叫，入组后4个月加上任何常规护理。本研究的目的是：1）确定RTI是否与注意力控制相比，改善了心理（精神HRQoL抑郁认知，抑郁症状，评估的压力，负担）和身体结果（身体HRQoL，慢性压力[头发皮质醇]）超过9 在控制协变量（父母种族/民族和性别、家庭收入和儿童的功能状况、技术类型）。2)确定是否发生变化心理和身体的结果是由父母的机智水平的变化介导的，干预条件3)比较9个月内的自我管理行为（睡眠，积极的健康实践）在接受RTI和注意力控制的父母中。4)探索足智多谋是否是一个调解人干预条件与自我管理行为之间的关系 9个月以上的行为。5)探讨自我管理行为与父母的关系基于干预条件的心理和生理结果。我们的研究将是第一个测试认知-行为RTI。6)比较目标儿童的急诊就诊次数、住院天数根据父母干预情况，9个月以上。如果被证明是有效的，它可以被复制与其他这是一个具有很大潜力的复杂慢性病儿童照料者的实践。

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Collaborative development of an innovative virtual research recruitment strategy through an academic/clinical partnership.

DOI：
10.1016/j.apnr.2022.151626
发表时间：
2022-12
期刊：
APPLIED NURSING RESEARCH
影响因子：
2.2
作者：
Toly, Valerie Boebel;Eliades, Aris;Miller, Amber;Sidora, Shelley;Kracker, Jessica;Fiala, Marisa;AlShammari, Tahani
通讯作者：
AlShammari, Tahani

Self-collection of hair samples during the COVID-19 pandemic.