Evaluation of a Carepartner-Integrated Telehealth Rehabilitation Program for Persons with Stroke - NICHD K-23

中风患者护理人员综合远程医疗康复计划的评估 - NICHD K-23

• 批准号: 9481294
• 负责人: Sarah R. Blanton
• 金额: $ 14.37万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-06-22 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9481294
• 关键词: Adult; American Heart Association; Anxiety; Caring; Clinical Research; Conflict (Psychology); Control Groups; Data; Education; Evaluation; Experimental Designs; Family; Family member; Fostering; Foundations; Funding; Future; Grant; Home environment; Integrative Therapy; Intervention; Limb structure; Measures; Mental Depression; Mental Health; Modeling; National Institute of Child Health and Human Development; Outcome; Persons; Physical Function; Physical therapy; Pilot Projects; Problem Solving; Process; Quality of life; Recovery; Rehabilitation therapy; Research; Role; Seeds; Severities; Social isolation; Stroke; Structure; System; Tablets; Task Performances; Testing; Upper Extremity; Work; base; collaborative environment; constraint induced movement therapy; depressive symptoms; design; digital; disability; effective intervention; exercise intensity; exercise program; experience; experimental group; improved; innovation; intervention effect; motor impairment; novel; portability; post intervention; programs; public health relevance; skills; stroke recovery; stroke survivor; telehealth; theories; therapy development; usability; user-friendly

DESCRIPTION: Sarah Blanton, PT, DPT, NCS, is clinical specialist in neurorehabilitation committed to a research career investigating effective methods to facilitate the integration of the carepartner in rehabilitation of the stroke survivor. A K23 award will build upon a strong foundation of prior training and research and provide the candidate an opportunity to gain advanced education and experience through a multidisciplinary team of experts. The immediate goals of this Mentored Patient Oriented Research Career Award (K23) are to allow the candidate to gain the skills needed in: (1) advanced clinical research design and statistical methods and (2) psychological theories of self-management and adult learning to perform and evaluate carepartner-centered interventions for stroke survivors and their families. The candidate’s long-term goals are to become an independently funded clinical researcher with expertise in innovative strategies for advancing and expanding the role of carepartner education and the integration of physical therapists in family-centered care. ENVIRONMENT: Dr. Blanton’s training will use resources and mentors from Emory University, Georgia State University and Georgia Institute of Technology. Dr. Dunbar and Dr. Clark are internationally recognized researchers in caregiving research and will provide guidance in potential behavioral mechanisms underlying carepartner responses to treatment, study methodology and design, and interpretation of outcome data. Through coursework and mentorship with Dr.Lyles, she will gain expertise in data management and statistical analysis. Dr.Wolf will provide guidance in grant writing and stroke rehabilitation interventions and Mr. Jones will offer mentorship in telerehabilitation approaches. She will continue learning about study methodology and data management through additional coursework and will attend seminars, professional conferences and meetings to complete her training. RESEARCH: Stroke is the leading cause of adult disability and creates significant societal and familial strain. Family members are a key component in stroke recovery, but they frequently experience high levels of burden, including increased anxiety, depression and social isolation when they assume the role of carepartner. Thus, effective interventions aimed at reducing the impact of stroke on the family are needed. The objective of this proposal is to evaluate a novel, carepartner focused intervention (CARECITE) designed to foster problem solving and skill building while facilitating carepartner involvement in the application of constraint-induced movement therapy (CIMT) for the upper extremity. This psychoeducational intervention is structured to provide general stroke recovery content (e.g. post-stroke depression) and enhance the home-based application of CIMT by teaching the carepartner ways to foster a more therapeutic, autonomy-supportive environment (characterized by empathy, problemsolving, choice and reduction of controlling language). The central hypothesis underpinning this research is that a theory-based, carepartner-centered intervention focused on skill building and problemsolving will improve stroke survivor physical function while reducing carepartner negative outcomes and increasing accessibility of participation. [To test this hypothesis and the feasibility of CARE-CITE in the home setting, we will use a two-group experimental design with 32 intervention dyads (CIMT with structured carepartner involvement) and 16 control dyads (CIMT without structured carepartner involvement) to quantify the effects on carepartner mental health, family conflict surrounding stroke recovery, and stroke survivor upper extremity function. Evaluators will be blind to group assignment. Results of this study will provide preliminary estimates of the intervention efficacy for use in larger, future clinical studies.] The innovation of this research involves the tailoring of a stroke survivor therapy intervention to also address carepartner needs and the use of contemporary telehealth technology to facilitate engagement of the family within the home environment. The findings of this project will provide critical data that can aid in the development of future larger-scale studies exploring family centered care in stroke. RELEVANCE TO PUBLIC HEALTH: The overall significance of this research plan is to increase understanding and further development of interventions that may serve as models in rehabilitation to foster family involvement in the rehabilitation process and to promote more integrative therapy strategies throughout physical therapy practice.

描述：Sarah Blanton，PT，DPT，NCS，是神经康复临床专家，致力于 研究生涯探讨促进照顾者融入社会的有效方法 中风幸存者的康复。K23奖项将建立在先前培训和 研究并为应聘者提供通过以下途径获得高级教育和经验的机会 多学科专家团队。这项以患者为导向的指导研究的近期目标 职业奖(K23)是为了让应聘者获得以下方面所需的技能：(1)高级临床研究 设计和统计方法以及(2)自我管理和成人学习的心理学理论 为中风幸存者及其家人实施和评估以护理伙伴为中心的干预措施。这个 候选人的长期目标是成为一名独立资助的临床研究人员，拥有 促进和扩大关怀伙伴教育和融合的作用的创新战略 以家庭为中心的护理中的理疗师。 环境：布兰顿博士的培训将使用佐治亚州埃默里大学的资源和导师 州立大学和佐治亚理工学院。邓巴博士和克拉克博士在国际上 在照看研究方面得到认可的研究人员，并将在潜在的行为方面提供指导 照顾者对治疗反应的机制，研究方法和设计，以及 对结果数据的解释。通过课程学习和莱尔斯博士的指导，她将获得 具有数据管理和统计分析方面的专业知识。沃尔夫博士将在拨款撰写和 中风康复干预和Jones先生将在远程康复方法方面提供指导。 她将通过其他途径继续学习研究方法和数据管理 完成课程，并将参加研讨会、专业会议和会议，以完成培训。 研究：中风是成人残疾的主要原因，并造成重大的社会和家庭问题 紧张。家庭成员是中风康复的关键组成部分，但他们经常经历兴奋 负担水平，包括当他们担任这一角色时增加的焦虑、抑郁和社会孤立 关爱伙伴。因此，旨在减少中风对家庭影响的有效干预措施是 需要的。这项建议的目的是评估一种新的、以护理伙伴为重点的干预(CARECITE) 旨在促进问题解决和技能培养，同时促进护理人员参与 强迫诱导运动疗法(CIMT)在上肢的应用这一心理教育 干预的结构是为了提供一般的中风恢复内容(例如中风后 抑郁症)，并通过教授照顾者方法来增强CIMT的居家应用 培养一个更具治疗性的、支持自主的环境(以移情、解决问题、 控制语言的选择和减少)。支撑这一观点的核心假设 研究表明，以理论为基础、以护理伙伴为中心的干预侧重于技能培养和解决问题 将改善中风幸存者的身体功能，同时减少护理伙伴的负面后果 提高参与的可及性。[为了检验这一假设和CARE-CITE在 家庭环境，我们将使用两组实验设计，32个干预双联(CIMT和 结构化护理伙伴参与)和16个控制对偶(没有结构化护理伙伴的CIMT 参与)，以量化对照顾者心理健康、中风周围的家庭冲突的影响 恢复和卒中幸存者上肢功能。评价者将对小组分配视而不见。 这项研究的结果将提供干预效果的初步估计，用于更大规模的、 未来的临床研究。]这项研究的创新涉及中风幸存者治疗的量身定做 采取干预措施，也满足护理人员的需求，并利用当代远程保健技术 促进家庭在家庭环境中的参与。该项目的调查结果将提供 有助于开发未来探索以家庭为中心的护理的更大规模研究的关键数据 在中风中。与公共卫生的相关性：这项研究计划的总体意义是增加 了解和进一步发展可作为康复模式的干预措施 促进家庭参与康复过程，并促进更多的综合治疗策略 在整个物理治疗实践中。