Recovering Together: Building resiliency in dyads of patients admitted to the Neuroscience Intensive Care Unit (NICU) and their caregivers

共同康复：为入住神经科学重症监护病房 (NICU) 的患者及其护理人员建立复原力

• 批准号: 9794134
• 负责人: Ana-Maria Vranceanu
• 金额: $ 25.28万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-26 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9794134
• 关键词: Acute; Admission activity; Adult; Adverse effects; Anxiety; Attention; Benchmarking; Caregivers; Caring; Chronic; Client satisfaction; Clinical; Clinical Data; Cognitive; Communication; Data; Diagnosis; Distress; Dose; Educational process of instructing; Electronic Health Record; Emotional; Event; Expectancy; Family; Family Caregiver; Focus Groups; Funding; Future; Goals; Health Services Accessibility; Hospitalization; Hospitals; Individual; Infrastructure; Intensive Care Units; Interdisciplinary Study; Intervention; Interview; Lead; Measures; Mediator of activation protein; Medical; Mental Depression; Modeling; Neurologic; Neurosciences; Nurses; Participant; Patient Care; Patients; Personal Communication; Personal Satisfaction; Persons; Placebo Control; Placebos; Population; Positioning Attribute; Process; Psychologist; Quality of life; Questionnaires; Randomized; Randomized Controlled Trials; Recovery; Recovery of Function; Reporting; Research; Risk; Secure; Self Efficacy; Severity of illness; Site; Social support; Stress; Stroke; Surveys; Symptoms; Team Nursing; Testing; Visit; Work; coping; demographics; design; efficacy trial; emotional distress; emotional factor; evidence base; experience; feasibility trial; follow-up; improved; medical complication; member; mindfulness; mortality; novel; post-traumatic stress; preservation; prevent; primary caregiver; primary outcome; programs; psychosocial; recruit; resilience; response; satisfaction; secondary outcome; skills; social; therapy development; trial comparing; tumor

PROJECT SUMMARY The proposed study will examine the feasibility, credibility, satisfaction and proof of concept of the “Recovering Together” dyadic resiliency skills program in improving emotional distress in dyads of patients (pts) with acute neurological illness (ANI) and their family caregivers (cgs) who screen in as at risk for chronic heightened emotional distress (e.g., symptoms of PTS, depression or anxiety) at hospitalization in the Neuroscience Intensive Care Unit (NICU). “Recovering Together” teaches resiliency skills and interpersonal communication to dyads early in the recovery process, when they embark on their journey for recovery and renewal. We will also explore program related changes in resiliency (e.g., coping, mindfulness, self-efficacy, social support) and interpersonal communication (eg., interpersonal bond). To achieve our aims we will conduct a pilot RCT of the Recovering Together program (2 in person session at hospitalization and 4 via secure live video after discharge,) versus an attention placebo educational control (2 in person sessions and 4 live video after discharge). Both members of the dyad will participate in all sessions. Recovering Together targets and strategies align with the theoretical response-shift framework to adaptation, the family strength vulnerability model, the dyadic longitudinal model, the actor partner interdependence model, and the resiliency framework. Our team is well positioned to conduct this study with specific experience in intervention development with medical populations; established infrastructure in the NICU including ability to recruit and retain participants; and strong preliminary data. Results from this R21 study will be used to apply for funding to conduct a fully powered multi-sited efficacy RCT, if set benchmarks for this feasibility trial are met, through an R01. The goal is dissemination and implementation of the Recovering Together program aimed at optimizing recovery and improving quality of life/wellbeing for both pts and cgs.

项目概要 拟议的研究将检验“恢复”的可行性、可信度、满意度和概念验证。 “一起”二元复原力技能计划，可改善急性重症患者二人组的情绪困扰 神经系统疾病 (ANI) 及其家庭照顾者 (cgs)，他们被筛查为有慢性情绪高涨风险 神经科学重症监护病房住院期间的痛苦（例如 PTS 症状、抑郁或焦虑） （新生儿重症监护病房）。 “一起恢复”在恢复初期向二人传授弹性技能和人际沟通 当他们踏上恢复和更新的旅程时。我们还将探讨与计划相关的变化 弹性（例如，应对、正念、自我效能、社会支持）和人际沟通（例如，人际交往） 纽带）。为了实现我们的目标，我们将开展“共同康复”计划的试点随机对照试验（2 场面对面会议，地点： 住院治疗和出院后通过安全实时视频进行 4 次）与注意安慰剂教育对照（2 次亲自进行） 会议和出院后 4 个实时视频）。两人的两名成员都将参加所有会议。一起康复 目标和战略与适应、家庭力量脆弱性的理论应对转变框架相一致 模型、二元纵向模型、行动者伙伴相互依赖模型和弹性框架。我们的团队是 具有在医学人群干预开发方面的具体经验，能够很好地开展这项研究； 建立新生儿重症监护室的基础设施，包括招募和留住参与者的能力；和强有力的初步数据。 如果确定的话，这项 R21 研究的结果将用于申请资金以进行全面的多中心功效随机对照试验 通过 R01 达到了该可行性试验的基准。目标是传播和实施 “一起康复”计划旨在优化患者和儿童的康复并提高生活质量/福祉。