Taking Care of Us: A Dyadic Intervention for Heart Failure

心力衰竭是影响650万美国人的主要公共健康问题，也是最常见的 老年人住院和再住院的原因。尽管有证据表明临床和 以患者为导向的心衰结局通过有效的自我护理得到改善，自我护理的参与度通常很低 在患有心力衰竭的成年人中。家庭护理伙伴(例如，配偶、成年子女)对 心力衰竭的管理，但往往以牺牲自己的身心健康和重大护理为代价- 相关菌株。大多数非药物性心衰管理干预措施涉及患者教育和 行为咨询，但取得成功的证据有限。基于家庭的干预已被证明是 在广泛的疾病背景下更成功，但在心力衰竭范围内，结果喜忧参半，很少有基于家庭的结果 干预措施包括护理伙伴的结果。因此，从理论上讲，迫切需要 经验驱动的二元干预措施，以改善心力衰竭患者及其护理伙伴的预后。这个 拟议中的研究将评估一项新的、二元的HF计划，即照顾我们，与教育咨询相比 对72例心衰患者进行随机对照试验控制条件。具体来说，我们将1)确定 护理干预对二元人群健康的影响2)护理效果的测定 美国对二元评估和二元管理的干预；3)确定可行性和可接受性 关爱美国的干预措施。拟议的二元干预将是首批针对 通过以团队为中心的方法，同时实现心力衰竭患者及其护理伙伴的结果 关于合作、沟通和信心。这项研究的结果将提供重要的信息来感动我们 更接近于将成功的项目转化为临床实践，并为以下问题提供了重要的启示： 以及关爱我们计划如何使心衰护理二人组的两名成员受益。

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.