Taking Care of Us: A Dyadic Intervention for Heart Failure

照顾我们：心力衰竭的二元干预

• 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
• 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

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， 老年人住院和再住院的原因。虽然有证据表明，临床和 通过有效的自我护理改善了以患者为导向的HF结局，自我护理参与度通常较差 成人HF患者中。家庭护理伙伴（例如，配偶、成年子女）为社会做出了重大贡献。 HF的管理，但往往以牺牲自己的身心健康和重要的照顾- 相关菌株大多数非药物性HF管理干预措施涉及患者教育， 行为咨询，成功的证据有限。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中，结果好坏参半，很少以家庭为基础 干预措施包括护理伙伴的成果。因此，迫切需要从理论上和 以外科手术为驱动的二元干预，以改善HF患者及其护理伙伴的结局。的 拟议的研究将评估一个新的，二元HF计划，照顾我们，与教育咨询 对照条件下使用随机对照试验72 HF护理二人组。具体来说，我们将1）确定 照顾我们的干预对二元健康的功效; 2）确定照顾我们的功效 美国对双元评价和双元管理的干预; 3）确定可行性和可接受性 “照顾我们”的干预措施拟议的二元干预将是第一批针对 通过以团队为基础的方法， 合作、沟通和信心。这项研究的结果将提供重要的信息， 更接近于将成功的项目转化为临床实践，并揭示了是否，为谁， 以及照顾我们计划如何使HF护理二人组的两个成员受益。