Taking Care of Us: A Dyadic Intervention for Heart Failure

照顾我们：心力衰竭的二元干预

基本信息

批准号：
10041459
负责人：
Christopher Sean Lee
金额：
$ 19.75万
依托单位：
BOSTON COLLEGE
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-10 至 2022-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10041459
关键词：
Academic advising Address Adherence Adult Adult Children Affect American Anxiety Behavior Behavioral Caring Chronic Disease Clinical Collaborations Communication Consult Control Groups Coronary Arteriosclerosis Counseling Coupled Data Dyspnea Education Elderly Failure Family Fatigue Future Goals Health Heart failure Hospitalization Individual Intervention Lead Life Light Literature Mental Health Meta-Analysis Methods Mission Modality Outcome Pain Participant Patient Care Patient Education Patient-Focused Outcomes Patients Pilot Projects Program Acceptability Public Health Quality of life Randomized Controlled Trials Research Science Self Care Self Management Spouses Symptoms Translating United States Work base clinical practice compliance behavior depressive symptoms experience health care service utilization hospital readmission improved improved outcome member novel patient oriented physical conditioning primary outcome programs psychosocial success symptom management theories

项目摘要

Heart failure (HF) is a major public health problem affecting 6.5 million Americans and is the most common reason for hospitalization and rehospitalization among older adults. Although there is evidence that clinical and patient-oriented HF outcomes are improved with effective self-care, engagement in self-care is generally poor among adults with HF. Family care partners (e.g., spouses, adult-children) make substantial contributions to the management of HF, but frequently at the expense of their own physical and mental health and significant care- related strain. The majority of non-pharmacologic HF management interventions involve patient education and behavioral counseling, with limited evidence of success. Family-based interventions have been shown to be more successful in the broad illness context, but within HF results have been mixed and few family-based interventions have included care partner outcomes. Thus, there is a critical need for theoretically- and empirically-driven dyadic interventions to improve the outcomes of both HF patients and their care partners. The proposed study will evaluate a novel, dyadic HF program, Taking Care of Us, versus an educational counseling control condition using a randomized controlled trial on 72 HF care dyads. Specifically, we will 1) determine the efficacy of the Taking Care of Us intervention on dyadic health; 2) determine the efficacy of the Taking Care of Us intervention on dyadic appraisal and dyadic management; and 3) determine the feasibility and acceptability of the Taking Care of Us intervention. The proposed dyadic intervention will be one of the first to target the outcomes of both the HF patient and their care partner simultaneously through a team-based approach centered on collaboration, communication and confidence. Results of this study will provide vital information to move us closer to translating successful programs into clinical practice and shed important light on whether, for whom, and how the Taking Care of Us program benefits both members of the HF care dyad.

心力衰竭（HF）是影响650万美国人的主要公共卫生问题，是最常见的老年人住院和重新住院的原因。尽管有证据表明临床和通过有效的自我保健，以患者为导向的HF结果得到改善，参与自我保健通常很差在患有HF的成年人中。家庭护理伙伴（例如配偶，成年儿童）为 HF的管理，但经常以自己的身心健康为代价，并且很重要相关菌株。大多数非药物HF管理干预措施都涉及患者教育和行为咨询，有限的成功证据。基于家庭的干预措施已被证明是在广泛的疾病背景下，更成功，但在HF结果中有混杂，几乎没有家庭的结果干预措施包括护理伙伴成果。因此，理论上和经验驱动的二元干预措施，以改善HF患者及其护理伙伴的结果。这拟议的研究将评估一个新颖的二元HF计划，照顾我们，而不是教育咨询使用72 HF护理二元的随机对照试验进行控制条件。具体来说，我们将1）确定照顾美国干预二元健康的功效； 2）确定照顾的功效美国干预二元评估和二元管理； 3）确定可行性和可接受性照顾美国干预。拟议的二元干预将是最早针对的 HF患者及其护理伙伴的成果通过基于团队的方法为中心关于协作，沟通和信心。这项研究的结果将提供至关重要的信息来移动我们更接近将成功的程序转化为临床实践，并就身份，谁，以及美国计划如何使HF护理二元成员的两个成员受益。