CLOSER_A Videoconference Intervention for Distance Caregivers

CLOSER_远程护理人员的视频会议干预

• 批准号: 9234065
• 负责人: Sara L. Douglas
• 金额: $ 60.1万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-03-01 至 2020-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9234065
• 关键词: Advanced Malignant Neoplasm; Affect; Anxiety; Appointment; Caregiver Burden; Caregiver support; Caregivers; Caring; Control Groups; Data; Decision Making; Development; Distress; Effectiveness; Emotional; Enrollment; Family Caregiver; Family member; Financial cost; Goals; Health; Health Status; Hour; Internet; Intervention; Link; Malignant Neoplasms; Medical; Medical Care Team; Mental Depression; Methods; Modeling; Mothers; Office Visits; Oncologist; Outcome; Patients; Phase; Population; Public Health; Randomized Clinical Trials; Registered nurse; Reporting; Research; Resources; Self Efficacy; Stress; Technology; Testing; Time; Training; Transportation; Travel; Videoconferences; Work; arm; base; care recipients; caregiving; effective intervention; end of life; experience; fly; improved; improved outcome; lost work time; loved ones; meetings; member; oncology; psychologic; psychological outcomes; public health relevance; randomized trial; research study; standard care; web site

 DESCRIPTION (provided by applicant): There are an estimated 7 million family caregivers who live at least one hour from the care recipient and are described as "distance caregivers" (DCGs)1,2,3. DCGs are a growing demographic; a majority are significantly involved in making care decisions as well as managing daily aspects of their family member's care (transportation, finances)3-7. Their anxiety, distress, depression, and poor health status are comparable to, and at times worse than, their local counterparts and they incur financial costs due to travel or lost work time that far exceed those of local caregivers3. A particularly vulnerable sub-population of DCGs are those of patients with advanced cancer-many of whom are near the end of life. To date, no one has tested an intervention aimed at the unique needs of this vulnerable and growing group of caregivers. The need to improve outcomes for DCGs is well recognized and there have been national calls to examine interventions for DCGs1,19-21. We will be the first to test interventions tailored to the unique needs of DCGs and delivered using a videoconference format. The goal of this randomized trial is to test the effectiveness of two arms of an intervention that use videoconference technology for DCGs of patients with advanced cancer. Key components of the full intervention have been tested46,52 and shown effective in reducing untoward caregiver psychological outcomes; they have not been fully tested with DCGs using videoconference technology. The first arm (Closer), will provide a minimum of four videoconference meetings (over a 4-month period) where DCGs participate in patient-oncologist office visits. Also, each DCG will receive a minimum of four personalized coaching sessions (via videoconference) from a registered nurse trained to deliver the key components of the intervention. The second arm (Video-C Only) will consist solely of videoconferences that include the DCG during patient-oncologist office visits-a minimum of four meetings over a 4 month period. The control group will have access to a website (Web-Only) with links to publically available information on cancer, caregiving, and distance caregiving. We project enrolling 613 DCG subjects and patients over a 3 year enrollment period. The study aims are to: 1) Compare the direct effects of Closer, Video-C Only, and Web- Only on DCG outcomes (anxiety, distress, depression, health status) over time, controlling for DCG demographic variables, 2) Examine the indirect effects of Closer, Video-C Only, and Web-Only on DCG outcomes (anxiety, distress, depression, health status) over time, controlling for DCG demographic variables, and 3) Examine the relationships between DCG distress, anxiety, depression and health status and patient distress, anxiety and depression over time. Impact: This will be the first study to test interventions tailored to the unique needs of DCGs using a videoconference format. If our aims are met, use of the Closer intervention has the potential to reach all caregivers who experience barriers to active participation in their family member's care-regardless of distance.

 描述(由申请人提供)：据估计，有700万家庭照顾者居住在距离照顾者至少一个小时的地方，他们被描述为“远程照顾者”(DCGS)1、2、3。DCGS是一个不断增长的人口群体；大多数家庭照顾者在很大程度上参与制定护理决策以及管理其家庭成员护理的日常方面(交通、财务)3-7。他们的焦虑、痛苦、抑郁和糟糕的健康状况与当地同龄人相当，有时甚至更差，他们因旅行或失去工作时间而产生的经济成本远远超过当地照顾者3。DCGS的一个特别脆弱的亚群是晚期癌症患者--他们中的许多人已接近生命末期。到目前为止，还没有人测试过针对这一脆弱且不断增长的照顾者群体的独特需求的干预措施。已充分认识到有必要改善DCGS的成果，并已有国家呼吁审查DCG 1、19-21的干预措施。我们将率先测试针对DCGS的独特需求而定制的干预措施，并使用视频会议的形式进行交付。这项随机试验的目标是测试使用视频会议技术的干预的两个分支对晚期癌症患者DCGS的有效性。已对全面干预的关键组成部分进行了测试46、52，并证明它们在减少不愉快的照顾者心理后果方面是有效的；它们尚未通过使用视频会议技术的DCGS进行充分测试。第一个ARM(CLOSER)将提供至少四次视频会议(为期4个月)，DCGS将参加患者-肿瘤医生办公室的访问。此外，每个DCG将从一名注册护士那里获得至少四次个性化的辅导课程(通过视频会议)，这些注册护士接受过培训，以提供干预的关键部分。第二个ARM(仅限Video-C)将仅包括视频会议，其中包括在患者-肿瘤医生办公室访问期间的DCG-在4个月内至少举行四次会议。控制组将可以访问一个网站(仅限Web)，其中包含有关癌症、护理和远程护理的公开信息的链接。我们计划在3年的注册期内招募613名DCG受试者和患者。本研究的目的是：1)比较Closer、仅使用Video-C和仅使用Web对DCG结果(焦虑、苦恼、抑郁、健康状况)随时间的直接影响，控制DCG的人口统计学变量；2)检查Closer、仅使用Video-C和仅使用Web对DCG结果(焦虑、苦恼、抑郁、健康状况)随时间的间接影响，控制DCG人口统计变量；以及3)检查DCG苦恼、焦虑、抑郁和健康状态与患者随时间的苦恼、焦虑和抑郁之间的关系。影响：这将是第一项使用视频会议形式测试针对DCGS独特需求的干预措施的研究。如果我们的目标实现了，使用更密切的干预措施有可能接触到所有在积极参与家人护理方面遇到障碍的照顾者--无论距离有多远。