Recovering Together: Building resiliency in dyads of patients admitted to the Neuroscience Intensive Care Unit (NICU) and their caregivers

项目摘要 拟议的研究将审查“恢复”方案的可行性、可信度、满意度和概念证明 一起”二元弹性技能计划在改善急性心肌梗死患者（pts）的二元情绪困扰 神经系统疾病（ANI）和他们的家庭照顾者（cgs），他们被筛选为有慢性情绪升高风险， 遇险（例如，在神经科学重症监护病房住院时的PTS、抑郁或焦虑症状） （新生儿重症监护病房）。“一起康复”在康复早期向二人组教授弹性技能和人际沟通 当他们踏上恢复和复兴的旅程时，我们还将探讨与计划相关的变化， 弹性（例如，应对，正念，自我效能，社会支持）和人际交往（例如，人际 债券）。为了实现我们的目标，我们将进行一项共同康复计划的试点RCT（2个面对面会议， 住院治疗和4例出院后通过安全现场视频）与注意力安慰剂教育对照组（2例亲自 出院后的4次会议和4次现场视频）。二人组的两名成员将参加所有会议。一起康复 目标和战略与适应的理论反应转移框架、家庭力量脆弱性 模型，二元纵向模型，演员合作伙伴相互依赖模型，和弹性框架。我们的团队是 在医学人群干预开发方面具有特定经验，能够很好地开展本研究; 新生儿重症监护室建立的基础设施，包括招募和留住参与者的能力;以及强大的初步数据。 本R21研究的结果将用于申请资金，以进行充分把握度的多中心疗效RCT（如果设定） 通过R 01，满足本可行性试验的基准。目标是传播和执行 共同康复计划旨在优化患者和cgs的康复并改善其生活质量/健康状况。

PROJECT SUMMARY The proposed study will examine the feasibility, credibility, satisfaction and proof of concept of the “Recovering Together” dyadic resiliency skills program in improving emotional distress in dyads of patients (pts) with acute neurological illness (ANI) and their family caregivers (cgs) who screen in as at risk for chronic heightened emotional distress (e.g., symptoms of PTS, depression or anxiety) at hospitalization in the Neuroscience Intensive Care Unit (NICU). “Recovering Together” teaches resiliency skills and interpersonal communication to dyads early in the recovery process, when they embark on their journey for recovery and renewal. We will also explore program related changes in resiliency (e.g., coping, mindfulness, self-efficacy, social support) and interpersonal communication (eg., interpersonal bond). To achieve our aims we will conduct a pilot RCT of the Recovering Together program (2 in person session at hospitalization and 4 via secure live video after discharge,) versus an attention placebo educational control (2 in person sessions and 4 live video after discharge). Both members of the dyad will participate in all sessions. Recovering Together targets and strategies align with the theoretical response-shift framework to adaptation, the family strength vulnerability model, the dyadic longitudinal model, the actor partner interdependence model, and the resiliency framework. Our team is well positioned to conduct this study with specific experience in intervention development with medical populations; established infrastructure in the NICU including ability to recruit and retain participants; and strong preliminary data. Results from this R21 study will be used to apply for funding to conduct a fully powered multi-sited efficacy RCT, if set benchmarks for this feasibility trial are met, through an R01. The goal is dissemination and implementation of the Recovering Together program aimed at optimizing recovery and improving quality of life/wellbeing for both pts and cgs.