Intervention to Facilitate Family Caregiver Adaptation

描述（由申请人提供）：家庭看护仍然是国家面临的主要公共卫生问题。随着婴儿潮一代的老龄化，对家庭护理的需求将急剧增加，而与此同时，服务提供者的供应正在减少。为了应对这些挑战，研究人员已经开发并评估了旨在支持和提高家庭照顾者能力的干预策略，但迄今为止，很少有人强调照顾者在其照顾职业中经历重大转变。本研究的目的是评估一项干预措施的效果，该干预措施旨在通过关注最近将其亲属安置在长期护理机构的照顾者来提高照顾者及其安置亲属的健康和生活质量。我们小组和其他人最近的研究结果表明，由于受照顾者的安置和死亡，护理职业的转变为具有重大公共卫生意义的干预提供了独特的机会。我们的干预措施主要针对最近安置其亲属的护理人员，旨在改善安置后常见的抑郁和焦虑，预防诸如复杂悲伤等负面的死后结果，并改善养老院居民的生活质量。研究设计为两组随机临床试验，将积极干预组与仅提供信息的对照组进行比较。弱势家庭照顾者将被随机分配到两种情况之一：1)在积极干预条件下，最近安置的居民的照顾者将接受多组件干预，旨在针对三个需求领域-情感健康，养老院的知识和程序，以及临终关怀计划；2)在仅提供信息的控制条件下，照例接受治疗，并增加书面信息，说明需要积极治疗干预的领域。干预措施将在6个月内实施，护理人员和他们的护理对象将被随访18个月，每隔6个月进行一次评估。我们预计大约一半的护理接受者将在随访期间死亡，使我们能够前瞻性地评估死亡和干预对死后护理者结果的影响。干预预计将影响短期和长期照顾者的情绪困扰和负担以及丧亲相关的痛苦。

DESCRIPTION (provided by applicant): Family caregiving continues to be a major public health issue facing the nation. With the aging of the baby boomers, the demand for family caregiving will increase dramatically at the same time that the supply of providers is diminishing. To address these challenges, researchers have developed and assessed intervention strategies designed to support and enhance the capacity of family caregivers, but to date little emphasis as been placed on caregivers undergoing major transitions in their caregiving careers. The purpose of this study is to assess the effects of an intervention designed to enhance health and quality of life of caregivers and their placed relatives by focusing on caregivers who recently placed their relative in a long-term care facility. Recent findings from our group and others on transitions in the caregiving career due to care recipient placement and death suggest unique opportunities for intervention with great public health significance. Focused on caregivers who recently placed their relative, our intervention is designed to ameliorate depression and anxiety common after placement, prevent negative post-death outcomes such as complicated grief, and improve the quality of life of nursing home residents. The study design is a two-group, randomized clinical trial comparing an active intervention condition to an information-only control group. Vulnerable family caregivers will be randomly assigned to one of two conditions: 1) in the active intervention condition, caregivers of recently-placed residents will receive a multi- component intervention designed to target three areas of need - emotional well-being, knowledge and procedures of nursing homes, and end-of-life care planning; 2) in the information-only control condition, caregivers will receive treatment as usual with the addition of written information about areas of need identified for the active treatment intervention. The intervention will be delivered within a 6-month period and caregivers and their care recipients will be followed for an 18-month period with assessments occurring at 6- month intervals. We expect that approximately half of the care recipients will die during the follow-up period, enabling us to prospectively assess the impact of death and the intervention on post-death caregiver outcomes. The intervention is expected to impact both short-term and long-term caregiver emotional distress and burden as well as bereavement-related distress.