Intervention to Facilitate Family Caregiver Adaptation

描述（由申请人提供）：家庭暴力仍然是国家面临的一个主要公共卫生问题。随着婴儿潮一代的老龄化，家庭养老的需求将急剧增加，同时提供者的供应正在减少。为了应对这些挑战，研究人员制定和评估了旨在支持和提高家庭照顾者能力的干预战略，但迄今为止，很少强调照顾者在其职业生涯中经历重大转变。本研究的目的是评估干预措施的影响，旨在提高健康和生活质量的照顾者和他们安置的亲属，专注于照顾者谁最近把他们的亲属在长期护理设施。最近的研究结果，从我们的小组和其他人的过渡，在职业生涯中，由于照顾对象的安置和死亡建议独特的机会，具有重大的公共卫生意义的干预。关注最近安置亲属的照顾者，我们的干预措施旨在改善安置后常见的抑郁和焦虑，防止负面的死亡后结果，如复杂的悲伤，并提高养老院居民的生活质量。研究设计是一项两组随机临床试验，比较了主动干预条件和仅提供信息的对照组。弱势家庭照顾者将被随机分配到两个条件之一：1）在积极干预条件下，最近安置的居民的照顾者将接受针对三个需求领域的多组件干预-情感健康，护理之家的知识和程序，以及临终护理计划; 2）在仅信息控制条件下，护理人员将像往常一样接受治疗，并添加有关主动治疗干预所需领域的书面信息。干预将在6个月内进行，护理人员及其护理接受者将接受18个月的随访，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结果的影响。预计干预措施将影响短期和长期照顾者的情绪困扰和负担以及与丧亲相关的困扰。

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.