Caregiver Wellness after Traumatic Brain Injury (CG-WELL): An Intervention Designed to Promote Well-being in Caregivers of Acute Moderate to Severe Traumatic Brain Injuries

项目说明/摘要： 我的长期职业目标是通过发展家庭来改善照顾者和患者的结果- 以心理社会干预为中心，加强对儿童照顾者的教育、支持和技能建设 中至重度创伤性脑损伤(MsTBI)幸存者。我的K23建议书中的培训活动包括： (1)有指导的体验式学习；(2)研讨会、工作坊和会议；(3)教学课程；以及(4) 通过完成研究目标而培养的技能。培训将由我的主要导师(Opeolu)监督 辛辛那提大学(UC)的Adeoye)和共同导师(加州大学的Tamilyn Bakas；加州大学的Shari Wade；Brad Kurowski， UC)。将通过与合作者合作获得额外的培训(海蒂·苏查鲁和宝拉·谢尔，加州大学； 和鲍文家庭系统理论研究组的Carrie Collier)。我的研究将测试Caregiver Wellness 在TBI(CG-Well)之后，我开发了一种技能建设、教育和支持干预措施。我会准备好的 在K23奖项完成时，提交R01用于大型第三阶段临床试验。 受伤后，msTBI的幸存者依赖非正式的家庭照顾者。77%以上的家庭 照顾者的结局不佳，例如不良的生活变化，与健康相关的生活质量差，以及 抑郁症状加重。照顾者经常报告说，为他们做好准备的支持或培训很少 他们的新角色。护理过渡期，如ICU出院，是最困难的。大多数(93%) 先前制定的msTBI后照顾者和照顾者/幸存者二元干预措施侧重于提供 向幸存者或长期照顾者(受伤后6个月)提供信息或实用技能，而不是 新照顾者可以主动使用的教育、支持和技能建设，这将使双胞胎受益 在受伤后非常剧烈。本提案的目标是：(1)确定以下各项的可行性、满意度和数据趋势 以及(2)了解基线心理社会风险因素如何影响对CG的反应。 信息、支持和推荐控制组。要做到这一点，我将首先招募6-10名照顾者，并 量身定做CG-直到每个人都认为干预可以接受、适当和可行。那我就录取100分 (50个/组)，并确定CG-Well的满意度、招聘、保留和治疗忠诚度。 此外，我将确定照顾者是否报告抑郁症状的减少和生活的改善 与ISR相比，CG-Well在任务难度和威胁评估方面的改进带来的变化 月份。在AIMS 1和2中获得的信息将用于规划CG-Well的更大规模的第三阶段试验。 完成这些目标和培训计划将改善照顾者的结果和下游结果 并为我提供了成为一名独立研究人员所需的技能 可以开发和测试高影响力、高保真、可持续的干预措施。

Project Description / Abstract: My long-term career goal is to improve caregiver and patient dyad outcomes by developing family- centered psychosocial interventions that enhance education, support, and skill-building in caregivers of moderate to severe traumatic brain injury (msTBI) survivors. The training activities in my K23 proposal include: (1) mentored experiential learning; (2) seminars, workshops, and conferences; (3) didactic coursework; and (4) skills developed by completing the study aims. Training will be overseen by my Primary Mentor (Opeolu Adeoye, University of Cincinnati (UC)), and Co-Mentors (Tamilyn Bakas, UC; Shari Wade, UC; Brad Kurowski, UC). Additional training will be obtained by working with Collaborators (Heidi Sucharew and Paula Shear, UC; and Carrie Collier, Bowen Family Systems Theory Research Group). My research will test Caregiver Wellness after TBI (CG-Well), a skill-building, education, and support intervention I have developed. I will be prepared to submit an R01 for a large Phase III clinical trial at the completion of the K23 award. After injury, survivors of msTBI depend on informal family caregivers. Upwards of 77% of family caregivers experience poor outcomes, such as adverse life changes, poor health related quality of life, and increased depressive symptoms. Caregivers frequently report minimal support or training to prepare them for their new role. Periods of care transitions, such as ICU discharge, are most difficult. The majority (93%) of previously developed caregiver and caregiver/survivor dyad interventions after msTBI focus on providing information or practical skills to either survivors, or to long-term caregivers (>6 months post injury), rather than education, support, and skill-building that the new caregiver may use proactively that will benefit the dyad acutely after injury. The Aims of this proposal are to: (1) Determine feasibility, satisfaction, and data trends of CG-Well; and (2) Understand how baseline psychosocial risk factors affect response to CG-Well compared to an Information, Support, and Referral control group. To accomplish this, I will first enroll 6-10 caregivers and tailor CG-well until each finds the intervention acceptable, appropriate, and feasible. I will then enroll 100 (50/group) dyads and determine satisfaction ratings, recruitment, retention, and treatment fidelity of CG-Well. Additionally, I will determine if caregivers report reductions in depressive symptoms and improvements in life changes as a result of improvements in task difficulty and threat appraisal in CG-Well compared to ISR at six months. Information obtained in Aims 1 and 2 will be used to plan a larger Phase III trial of CG-Well. Completing these Aims and the training plan will improve outcomes of caregivers and downstream outcomes of survivors of msTBI, and provide me with the skillset necessary to become an independent researcher who can develop and test high-impact, high-fidelity, sustainable interventions.