Multimedia Support for Caregivers of the Seriously Ill

描述(由申请人提供)：该项目将为需要日常生活活动(如穿衣、洗澡、喂奶)和生命即将结束的老年人的有工作的家庭照顾者提供基于网络的多媒体支持计划。该计划在Lazarus&Folkman压力和应对模型的框架内，将通过文本、视频建模和图形表示为照顾者提供知识和认知/行为应对技能。一个独特的功能将是决策辅助工具(DAT)，它将帮助用户逻辑地考虑复杂的备选方案，以便做出知情的决策(例如，关于医疗选项)。第一阶段的概念验证包括护理技能、重要的医疗/法律决定和寻找资源的模块，以及DAT的初步开发。在随机方案评估中，用户在以下方面有显著提高：a)自我效能感对压力和应对策略的评价产生积极影响，b)行为意向采用这些策略。受试者认为该程序易于使用，并给出了很高的满意度分数。第二阶段的开发将增加以下模块：a)情感/精神问题，b)平衡工作和护理，c)严重疾病对护理接受者的影响，d)死亡时的期望，e)丧亲，f)修订和扩展的DAT，以及f)个人节目指南，将帮助用户找到与他们的兴趣和需求相关的内容。第二阶段计划还将包括基于视频的医疗宣传和照顾者与家庭沟通的技能培养模块。此外，还将为客户/工地经理开发一个单独的部分，以建议主管如何减轻工作照顾者的压力并保持工作效率，并通过键盘输入有关员工本地资源的信息。完全开发的第二阶段计划将有互联网和CD-ROM两种版本，并将在一项大型随机试验中进行评估。随着人们年龄的增长和生命的临近，他们在洗澡、穿衣和吃饭等日常活动中可能需要很多帮助。提供这种帮助对那些既要照顾又要保住工作的家庭成员来说真的很难，而且对他们来说可能是压倒性的。拟议的计划通过互联网为照顾者提供自动化的支持和教育，包括文章、视频和帮助思考艰难的决定。

DESCRIPTION (provided by applicant): This project will provide a web-based multimedia support program for employed family caregivers of older adults who require assistance with activities of daily living (e.g., dressing, bathing, feeding) and who are nearing the end of life. Framed in the context of the Lazarus & Folkman stress and coping model, the program will provide the caregiver with knowledge and cognitive/behavioral coping skills using text, video modeling, and graphic representations. A unique feature will be a Decision Assistance Tool (DAT), which will help the user logically consider complex alternatives in order to make an informed decision (e.g., about medical treatment options). The Phase I proof of concept included modules on caregiving skills, important medical/legal decisions, and finding resources, as well as initial development of the DAT. During the randomized program evaluation, users showed significant improvement in: a) self-efficacy to positively influence appraisals of stress and coping strategies, and b) behavioral intentions to adopt the strategies. Subjects found the program easy to use and gave it high satisfaction scores. Phase II development will add modules on: a) emotional/spiritual issues, b) balancing work with caregiving, c) the impact of serious illness on a care receiver, d) expectations at time of death, e) bereavement, f) a revised and expanded DAT, and f) a Personal Program Guide which will help users find contents relevant to their interests and needs. The Phase II program will also include video based skill building modules on medical advocacy and caregiver-family communication. Additionally, a separate section will be developed for customers/worksite managers to suggest how supervisors can reduce the stress and maintain the productivity of working caregivers, and keyboard-enter information about local resources for employees. The fully developed Phase II program will be produced in both Internet and CD-ROM versions and will be evaluated in a large randomized trial. As people age and near the end of life, they may need lots of help with daily activities like bathing and dressing and eating. Providing this help can be really hard on family members who have to be a caregiver and still keep their job, and it can be overwhelming for them. The proposed program provides automates support and education for the caregivers via the Internet, including articles, videos, and help thinking through tough decisions.