Telephone Assessment and Skill-Building Intervention for Stroke Caregivers

中风护理人员的电话评估和技能培养干预

• 批准号: 7985531
• 负责人: TAMILYN BAKAS
• 金额: $ 38.5万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-21 至 2015-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7985531
• 关键词: Address; Age; American; Behavior; Caregivers; Caring; Climacteric; Data; Data Collection; Emotions; Equation; Family; Family Caregiver; Family member; Fostering; Future; Goals; Growth; Health; Health Personnel; Health Professional; Home environment; Home visitation; Hospitalization; Hour; House Call; Institutionalization; Intervention; Lead; Managed Care; Measures; Mediating; Mediator of activation protein; Mental Health; Modeling; Nurses; Outcome; Patients; Population; Prevalence; Problem Solving; Procedures; Randomized; Relative (related person); Reporting; Risk; Rural; Sampling; Schedule; Screening procedure; Stroke; Survivors; Telephone; Testing; Training; Training Support; Translations; base; caregiver education; caregiving; comparative; cost; cost effectiveness; depressive symptoms; disability; economic evaluation; efficacy testing; empowered; evidence base; expectation; experience; follow-up; improved; innovation; intervention effect; intervention program; optimism; post intervention; premature; primary outcome; programs; public health relevance; resource guides; satisfaction; skills; social; stress management; time use

DESCRIPTION (provided by applicant): Stroke is the leading cause of long-term disability; families are often thrust into providing care for stroke survivors without any training. Stroke family caregivers are of increasing importance because the prevalence of stroke is likely to increase as the population ages. However, there are very few evidence-based, easy-to- deliver follow-up programs after hospitalization to train caregivers in providing care and none that comprehensively address both caregiver and survivor needs through skill-building strategies. Studies have shown that caregiving without training can be detrimental to caregiver's physical and mental health, which can lead to institutionalization of the survivor and higher societal costs. The purpose of this study is to evaluate the efficacy of the revised Telephone Assessment and Skill-building Kit (TASK II), a nurse-led comprehensive intervention that enables caregivers to build skills based on assessment of their own needs. Family caregivers of stroke survivors (N=220) will be randomized to the TASK II intervention or to an Information, Support, and Referral (ISR) group to determine the relative efficacy of the TASK II intervention for reducing task difficulty, increasing optimism, and reducing threat appraisal for providing care. Primary outcomes are caregiver depressive symptoms, caregiving-related negative life changes, and unhealthy days. In an exploratory aim preliminary data will be collected for an economic evaluation of the TASK II intervention. Both the TASK II intervention and ISR procedures involve 8 telephone sessions delivered over 8 weeks, with a booster session at 12 weeks. Data collections will occur at baseline (within 8 weeks of home discharge); at 8 weeks (short-term intervention effect), 12 weeks (after booster), and at 24 weeks and 1 year after baseline (long-term sustainability of intervention effect). Linear mixed models will be applied to the repeated-measures data to test efficacy for Primary Aims 1 & 2. Latent Growth Models using a Structural Equation Model approach will be applied to examine mechanism of intervention effect (Exploratory Aim 1.). An incremental cost-effectiveness ratio (ICER) will be employed to address the comparative costs and outcomes for the TASK II intervention and ISR group (Exploratory Aim 2). PUBLIC HEALTH RELEVANCE: Caring for a family member during the first year after a stroke can be very difficult. The TASK II intervention is a unique, comprehensive caregiver intervention program that enables caregivers to develop the necessary skills to manage care for the survivor, while also taking care of themselves as a caregiver. The long-term goal of this study is to offer training and support for family caregivers through an efficacious, cost-effective program.

描述（由申请人提供）：中风是导致长期残疾的主要原因;家庭经常在没有任何培训的情况下为中风幸存者提供护理。中风的家庭照顾者越来越重要，因为中风的患病率可能会随着人口老龄化而增加。然而，很少有基于证据的，易于提供的后续计划，住院后，培训护理人员提供护理，没有一个全面解决照顾者和幸存者的需要，通过技能建设战略。研究表明，未经培训的照料可能有害于照料者的身心健康，这可能导致幸存者被送入收容机构，并增加社会成本。本研究的目的是评估修订后的电话评估和技能建设工具包（任务II），护士领导的综合干预，使照顾者建立自己的需求评估的基础上的技能的有效性。卒中幸存者的家庭护理者（N=220）将被随机分配至任务II干预组或信息、支持和转诊（ISR）组，以确定任务II干预在降低任务难度、增加乐观情绪和减少提供护理的威胁评估方面的相对疗效。主要结果是照顾者的抑郁症状，与生活相关的负面生活变化和不健康的日子。在探索性目的中，将收集初步数据，用于对任务II干预进行经济评价。任务II干预和ISR程序均涉及在8周内进行的8次电话会议，并在12周时进行加强会议。将在基线（出院后8周内）、第8周（短期干预效果）、第12周（加强后）以及基线后24周和1年（干预效果的长期可持续性）时收集数据。线性混合模型将应用于重复测量数据，以检验主要目的1和2的有效性。采用结构方程模型方法的潜在增长模型将用于检查干预效果的机制（探索性目标1）。将采用增量成本-效果比（ICER）来说明任务II干预和ISR组的比较成本和结局（探索性目标2）。 公共卫生相关性：在中风后的第一年照顾家庭成员可能非常困难。任务II干预是一个独特的，全面的护理人员干预计划，使护理人员能够发展必要的技能来管理幸存者的护理，同时也照顾自己作为一个照顾者。本研究的长期目标是通过一个有效的，具有成本效益的计划，为家庭照顾者提供培训和支持。