A Technology-Enhanced Nursing Intervention for Hospice Caregivers

描述(由申请人提供)：作为临终关怀患者的非正式照顾者的家人和朋友对于提供姑息治疗服务是必不可少的；然而，这一角色对照顾者本身并不是没有不利影响。最近的研究表明，照顾者的焦虑和负担会对临终关怀患者的非正式照顾者的发病率和死亡率产生负面影响。在家中照顾临终病人的个人的情感需求没有得到很好的照顾，缺乏旨在向非正式照顾者提供支助的干预措施对公共卫生产生了影响。我们建议为非正式员工提供经过验证的应对技能干预。 家庭临终关怀患者照顾者(COP)基于准备好的家庭照顾者模式的问题解决框架，使用商业上可用的视频电话技术。我们建议进行为期两年的等效性临床试验。我们的跨学科研究团队将从参与机构招募160名非正式护理人员和他们的患者，并将他们随机分配到接受标准临终关怀加亲自提供COPE干预的组(组1)，或接受标准临终关怀加加COPE干预的组(组1)。 可视电话(第2组)。我们的目的是评估基于视频电话的干预对临终关怀患者的非正式照顾者的有效性(重点是非正式照顾者的生活质量，照顾者 与患者症状和照顾者焦虑相关的负担)，并评估照顾者对使用可视电话作为一种沟通方式的看法和满意度。最后，我们还旨在比较两组临终关怀患者照顾者(面对面与视频电话)实施COPE干预的成本。如果证明成功，这种干预可以成为一种可行和可持续的工具，在不增加临终关怀工作人员的旅行压力和成本的情况下，增加非正式临终关怀人员在其通常短暂的临终关怀经历期间获得的支持量。公共卫生相关性：作为非正式照顾者的家庭成员和朋友对提供临终关怀服务至关重要。护理经历并不是没有负面影响 对照料者本身来说，照料压力和负担会对他们的发病率和死亡率产生负面影响。拟议的研究研究探索了一种干预措施，将改善临终关怀人员的临床结果；因此，这项研究与公共卫生高度相关，因为它影响到我国人口中不断增长的部分人的健康，并旨在证明可行和可持续的临终关怀干预的价值。

DESCRIPTION (provided by applicant): Family members and friends who act as informal caregivers of hospice patients are essential to the provision of palliative care services; however, this role is not without adverse effects on the caregivers themselves. Recent research has revealed that caregiver anxiety and burden can negatively impact morbidity and mortality among informal caregivers of hospice patients. Emotional needs of individuals caring for dying persons in their home are not well attended and the lack of interventions aiming to provide support to informal caregivers has public health implications. We are proposing the delivery of a proven coping skills intervention for informal caregivers of home hospice patients (COPE) based on the problem-solving framework of the prepared family caregiver model, using commercially available videophone technology. We propose a two year equivalence clinical trial. Our interdisciplinary research team will recruit 160 informal caregivers and their patients from a participating agency and will randomly assign them to either a group receiving standard hospice care with the addition of the COPE intervention delivered in person (Group 1), or a group receiving standard hospice care with the addition of the COPE intervention delivered via videophones (Group 2). We aim to evaluate the effectiveness of the videophone-based intervention for informal caregivers of hospice patients (focusing on informal caregivers' quality of life, caregiver burden related to patient symptoms and caregiver anxiety) and to assess caregivers' perceptions of and satisfaction with the videophone use as a communication mode. Finally, we also aim to compare the cost of delivering the COPE intervention for caregivers of hospice patients for the two groups (in person vs. videophone). If proven successful, this intervention can become a feasible and sustainable tool that increases the amount of support received by informal hospice caregivers during their often brief hospice experience, without increasing travel stress and costs for hospice staff. PUBLIC HEALTH RELEVANCE: Family members and friends who act as informal caregivers are essential to the provision of hospice services. The caregiving experience is not without adverse effects on the caregivers themselves as caregiving stress and burden can negatively impact their morbidity and mortality. The proposed research study explores an intervention that will improve clinical outcomes for hospice caregivers; thus, the study is highly relevant to public health as it affects the health of a continuously growing segment of our population and aims to demonstrate the value of a feasible and sustainable hospice intervention.