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社会心理/技术干预措施的功效，该干预措施旨在降低老年脊髓损伤幸存者的家庭照顾者出现不良健康结果的风险，并改善脊髓损伤幸存者的福祉。对于照顾者来说，风险是一个多变量结构，由五个指标组成：抑郁症状、负担、自我照顾、社会支持和健康症状。除了负担测量外，同样的风险结构也适用于脊髓损伤护理接受者。研究设计是一项多地点、三组、随机临床试验，比较两种积极干预条件和仅提供信息的对照组。照顾者和幸存者将被随机分配到以下三种情况中的一种：只有照顾者干预（单目标），照顾者根据他们的风险状况接受多成分干预；照顾者加照顾者干预（双目标），照顾者干预辅以针对脊髓损伤幸存者的治疗，旨在解决照顾者的风险因素；在仅提供信息的控制条件下，照护者接收有关照护、脊髓损伤和老龄化的标准信息，这些信息通常可从社会服务和卫生机构获得。以抑郁症状、自我照顾、健康症状、社会支持和负担（仅照顾者）组成的多变量结果来衡量，双重治疗方法的治疗益处应大于仅照顾者的治疗方法。就照顾者的结果而言，只有照顾者的条件应该优于只有信息的对照条件，但对于照顾者的结果则不一定。分析计划将使我们能够评估治疗成分与具体结果之间的因果关系，并探索治疗效果的文化和种族差异。

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.