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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：
10259740
负责人：
Christopher Sean Lee
金额：
$ 23.6万
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 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10259740
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 acceptability and feasibility 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，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中心的心力衰竭结果可通过有效的自我护理得到改善，但自我护理的参与度普遍较差患有心力衰竭的成年人。家庭照顾伙伴（例如配偶、成年子女）为家庭做出了重大贡献心力衰竭的管理，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。大多数非药物性心力衰竭管理干预措施涉及患者教育和行为咨询，成功的证据有限。以家庭为基础的干预措施已被证明在广泛的疾病背景下更成功，但在心力衰竭方面，结果好坏参半，而且很少有基于家庭的干预措施包括护理伙伴的结果。因此，迫切需要从理论上和经验驱动的二元干预措施可改善心力衰竭患者及其护理伙伴的预后。这拟议的研究将评估一种新颖的二元高频计划“照顾我们”与教育咨询使用对 72 名 HF 护理二人组进行的随机对照试验来控制病情。具体来说，我们将 1) 确定 “照顾我们”干预措施对二元健康的功效； 2) 确定护理的功效美国对二元考核和二元管理的干预； 3）确定可行性和可接受性照顾我们的干预。拟议的二元干预措施将是首先针对的干预措施之一通过以团队为中心的方法，同时评估心力衰竭患者及其护理伙伴的结果关于协作、沟通和信心。这项研究的结果将为我们提供重要的信息更接近于将成功的项目转化为临床实践，并阐明是否、为谁，以及照顾我们计划如何使 HF 护理二人组的成员受益。