Telehealth Assessment and Skill-Building Intervention for Stroke Caregivers (TASK III)

中风护理人员的远程医疗评估和技能培养干预（任务 III）

• 批准号: 10342306
• 负责人: TAMILYN BAKAS
• 金额: $ 63.65万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-12 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10342306
• 关键词: Address; American; American Heart Association; Caregivers; Caring; Chronic; Climacteric; Clinical Trials; Communication; Data; Education; Emotional; Enrollment; Family; Family Caregiver; Family member; Fatigue; Feasibility Studies; Funding; Future; Goals; Guidelines; Health; Health Personnel; Healthcare; Institutionalization; Intervention; Lead; Learning; Mediator of activation protein; Mental Health; Nurses; Outcome; Pain; Patient Self-Report; Patients; Perception; Physical Function; Policies; Problem Solving; Program Evaluation; Public Health; Publishing; Randomized; Randomized Controlled Clinical Trials; Recommendation; Rehabilitation therapy; Reporting; Risk; Self Efficacy; Self Management; Shortness of Breath; Sleep; Stress; Stressful Event; Stroke; Survivors; Symptoms; Technology; Telephone; Testing; Time; Time Management; Training; Translating; Videoconferencing; Well in self; base; care systems; caregiver interventions; caregiving; cost; depressive symptoms; diet and exercise; directed attention; disability; efficacy testing; electronic book; expectation; experience; health care service utilization; health training; improved; innovation; intervention program; novel; physical conditioning; post intervention; preference; premature; primary outcome; programs; psychoeducational; recruit; resource guides; satisfaction; secondary outcome; skills; societal costs; stress management; stroke intervention; stroke survivor; symptom self management; telehealth; trend; web site

Project Summary/Abstract: Stroke is a leading cause of serious, long-term disability, and has a very sudden onset. Families are often thrust into providing care without sufficient training from health care providers, having to learn on their own to provide care. Studies show that caregiving without proper training can be detrimental to caregiver’s physical and mental health, which can impede survivor rehabilitation and lead to institutionalization and higher societal costs. Unlike existing stroke caregiver interventions, which require costly face-to-face interactions, and that focus primarily on the survivor’s care, the nurse-led Telephone Assessment and Skill-Building Kit (TASK II) is delivered completely by telephone, and empowers caregivers to address both their own and the survivor’s needs using innovative skill-building strategies. Aligned with current patient and caregiver guidelines, TASK II demonstrated evidence of content validity, treatment fidelity, caregiver satisfaction, and efficacy for reducing caregiver depressive symptoms; however, TASK II revealed a need for a stronger focus on self-management (SM) strategies to improve caregiver symptoms and health, along with enhanced use of other telehealth modes of delivery. In an NINR-funded R21, the Telehealth Assessment and Skill-building Kit (TASK III) was optimized through the innovative leveraging of technologies and SM strategies to improve stroke family caregiver symptoms and health. A new goal setting tip sheet promotes caregivers’ self-management of their own symptoms and health through the use of novel skill-building strategies. Caregivers now choose how they want to access the TASK III Resource Guide (mailed hard copy, eBook, USB drive, or interactive website (https://www.task3web.com/) and how they would like to interact with the nurse (telephone, FaceTime, or online videoconferencing). Preliminary TASK III data provided evidence for feasibility of recruitment, retention, treatment fidelity, high satisfaction, and positive data trends in 74 stroke family caregivers randomized to TASK III (n=36) or to an Information, Support, and Referral (ISR) group (n=38). The purpose of the proposed study is to test short-term (immediately post-intervention at 8 weeks) and long-term (12, 24, and 52 weeks) efficacy of the TASK III intervention, compared with the ISR group, in 296 stroke caregivers. The primary outcome is caregiver life changes (i.e., physical health, physical functioning, emotional well-being, general health) as a result of providing care. Secondary outcomes include depressive symptoms (in caregivers with mild to severe depressive symptoms), other symptoms (stress, fatigue, sleep, pain, shortness of breath), unhealthy days, SM of diet/exercise, and self-reported healthcare utilization. Theoretically-based mediators include task difficulty, threat appraisal, and self-efficacy. Program evaluation outcomes (satisfaction, technology ratings) will also be analyzed. If TASK III is shown to be efficacious in the proposed randomized controlled clinical trial, our next goal will be to translate TASK III into ongoing stroke systems of care; and to adapt it for use among caregivers with other debilitating/chronic conditions providing a tremendous public health impact.

项目概要/摘要： 中风是导致严重、长期残疾的主要原因，并且具有非常突然的发作。家庭往往 在没有得到医疗保健提供者足够培训的情况下被迫提供护理，必须自己学习， 提供照顾。研究表明，没有适当的训练，照顾者的身体可能会受到损害。 和心理健康，这可能会阻碍幸存者的康复，并导致机构化和更高的社会地位。 成本不像现有的中风护理人员干预，需要昂贵的面对面的互动， 主要关注幸存者的护理，护士主导的电话评估和技能建设工具包（任务二）是 完全通过电话提供，并授权照顾者解决自己和幸存者的问题， 需要使用创新的技能建设战略。符合当前患者和护理人员指南，任务II 证明了内容效度、治疗保真度、照顾者满意度和降低 照顾者抑郁症状;然而，任务II揭示了需要更加注重自我管理 (SM)改善护理人员症状和健康的战略，沿着加强使用其他远程保健模式 的交付。在国家核研究所资助的R21中，远程保健评估和技能培养工具包（任务三）得到了优化 通过技术和SM策略的创新杠杆作用来改善卒中家庭护理者 症状与健康一个新的目标设定提示表促进照顾者的自我管理自己 症状和健康通过使用新的技能建设战略。照顾者现在选择他们想要的方式 访问《任务III资源指南》（邮寄的硬拷贝、电子书、USB驱动器或交互式网站 （https：//www.task3web.com/）以及他们希望如何与护士互动（电话、FaceTime或 在线视频会议）。初步任务III数据提供了招募、保留 随机分配到任务组的74名卒中家庭照顾者的治疗保真度、高满意度和积极数据趋势 III（n = 36）或信息、支持和转诊（ISR）组（n = 38）。拟议研究的目的是 测试短期（干预后8周立即）和长期（12、24和52周）疗效， 在296名卒中照顾者中，与ISR组相比，使用了TaskIII干预。主要结局是 护理者生活改变（即，身体健康、身体功能、情绪健康、一般健康）作为 提供护理的结果。次要结果包括抑郁症状（轻度至重度抑郁症的照顾者） 抑郁症状）、其他症状（压力、疲劳、睡眠、疼痛、呼吸急促）、不健康的日子、SM 饮食/运动，以及自我报告的医疗保健利用。理论上的中介因素包括任务难度， 威胁评估和自我效能。项目评估结果（满意度、技术评级）也将 分析了如果在拟议的随机对照临床试验中显示了TaskIII的有效性， 目标是将任务III转化为持续的卒中护理系统，并使其适用于护理人员 与其他衰弱/慢性疾病一起提供巨大的公共卫生影响。