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社会/技术干预的有效性，旨在降低脊髓损伤老年幸存者的家庭护理人员的不良健康后果风险，并改善脊髓损伤幸存者的健康状况。 对于照顾者，风险的特点是，作为一个多变量结构包括五个指标：抑郁症状，负担，自我照顾，社会支持和健康症状。 同样的风险结构适用于SCI护理接受者，但负担措施除外。研究设计是一项多中心、三组、随机临床试验，比较两种积极干预条件相互之间以及仅提供信息的对照组。照顾者和幸存者的二人组将被随机分配到三种情况之一：（单一目标），其中护理人员根据其风险状况接受多组分干预：护理人员加护理接受者干预（双重目标），其中护理人员干预由针对SCI幸存者的治疗补充，旨在解决护理接受者的风险因素;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健康机构获得的关于衰老、SCI和衰老的标准信息。治疗的好处，包括抑郁症状，自我护理，健康症状，社会支持，和负担（仅照顾者）的照顾者和护理接受者的多变量的结果来衡量，应该是更大的双重治疗方法相比，只有单独的条件。 在照顾者结果方面，仅信息控制条件应上级仅信息控制条件，但不一定是照顾者结果。 分析计划将使我们能够评估治疗成分和特定结果之间的因果关系，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.