Caregiver Intervention for Caregivers of SCI Patients

描述(由申请人提供)：拟议项目的总体目标是测试一种创新的多成分心理/技术干预措施的有效性，旨在降低患有脊髓损伤的老年幸存者的家庭照顾者出现不良健康后果的风险，并改善脊髓损伤幸存者的福祉。对于照顾者来说，风险被描述为一个由五个指标组成的多变量结构：抑郁症状、负担、自我护理、社会支持和健康症状。除负担措施外，同样的风险结构也适用于SCI护理接受者。研究设计是一项多点、三组、随机的临床试验，比较两种主动干预条件，并与仅提供信息的对照组进行比较。护理者和幸存者二人组将被随机分配到三种情况之一：仅护理者干预(单一目标)，其中护理者根据他们的风险状况接受多组分干预：护理者+护理者干预(双重目标)，其中护理者干预辅之以针对SCI幸存者的治疗，旨在解决护理者风险因素；以及仅信息控制条件，其中护理者接收通常可从社会服务和卫生机构获得的关于护理、SCI和老龄化的标准信息。根据包括抑郁症状、自我护理、健康症状、社会支持和照顾者和接受者负担(仅照顾者)的多变量结果来衡量治疗的好处，与仅照顾者情况相比，双重治疗方法的益处应该更大。关于护理者的结果，仅照顾者的情况应该优于仅提供信息的对照情况，但对于护理接受者的结果不一定如此。分析计划将使我们能够评估治疗组成部分和具体结果之间的因果联系，并探索治疗有效性的文化和种族差异。

DESCRIPTION (provided by applicant): The overall objective of the proposed project is to test the efficacy of an innovative multi-component psychosocial/technology intervention aimed at reducing the risk for adverse health outcomes among family caregivers of older survivors with spinal cord injury, and to improve the well being of the spinal cord injured survivor. For the caregiver, risk is characterized, as a multivariate construct comprised of five indicators: depressive symptoms, burden, self-care, social support, and health symptoms. The same risk construct applies to the SCI care recipient with the exception of the burden measure. The study design is a multi-site, three-group, randomized clinical trial comparing two active intervention conditions with each other and to an information-only control group. Caregiver and survivor dyads will be randomly assigned to one of three conditions: a caregiver-only intervention (single target) in which caregivers receive a multi- component intervention based on their risk profile: a caregiver plus care-recipient intervention (dual target) in which the caregiver intervention is complemented by a treatment targeting the SCI survivor, designed to address care recipient risk factors; and an information-only control condition in which the caregiver receives standard information about caregiving, SCI , and aging typically available from social service and health agencies. The benefits of treatment, measured in terms of a multivariate outcome comprised of depressive symptoms, self-care, health symptoms, social support, and burden (caregiver only) for both the caregiver and care recipient should be greater in the dual treatment approach when compared to the caregiver-only condition. The caregiver-only condition should be superior to the information-only control condition with respect to caregiver outcomes, but not necessarily for care recipient outcomes. The analytic plan will enable us to assess causal links between treatment components and specific outcomes as well as explore cultural and racial variations in treatment effectiveness.