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“适时卒中家庭支持计划”的随机临床试验:研究方案

Randomized clinical trial of the Timing it Right Stroke Family Support Program: research protocol.

作者信息

Cameron Jill I, Naglie Gary, Gignac Monique A M, Bayley Mark, Warner Grace, Green Theresa, Czerwonka Anna, Huijbregts Maria, Silver Frank L, Phillips Steve J, Cheung Angela M

机构信息

Department of Occupational Science and Occupational Therapy, University of Toronto, 160-500 University Ave, Toronto, Ontario M5G 1V7, Canada.

出版信息

BMC Health Serv Res. 2014 Jan 17;14:18. doi: 10.1186/1472-6963-14-18.

Abstract

BACKGROUND

Family caregivers provide invaluable support to stroke survivors during their recovery, rehabilitation, and community re-integration. Unfortunately, it is not standard clinical practice to prepare and support caregivers in this role and, as a result, many experience stress and poor health that can compromise stroke survivor recovery and threaten the sustainability of keeping the stroke survivor at home. We developed the Timing it Right Stroke Family Support Program (TIRSFSP) to guide the timing of delivering specific types of education and support to meet caregivers' evolving needs. The objective of this multi-site randomized controlled trial is to determine if delivering the TIRSFSP across the stroke care continuum improves caregivers' sense of being supported and emotional well-being.

METHODS/DESIGN: Our multi-site single-blinded randomized controlled trial will recruit 300 family caregivers of stroke survivors from urban and rural acute care hospitals. After completing a baseline assessment, participants will be randomly allocated to one of three groups: 1) TIRSFSP guided by a stroke support person (health care professional with stroke care experience), delivered in-person during acute care and by telephone for approximately the first six to 12 months post-stroke, 2) caregiver self-directed TIRSFSP with an initial introduction to the program by a stroke support person, or 3) standard care receiving the educational resource "Let's Talk about Stroke" prepared by the Heart and Stroke Foundation. Participants will complete three follow-up quantitative assessments 3, 6, and 12-months post-stroke. These include assessments of depression, social support, psychological well-being, stroke knowledge, mastery (sense of control over life), caregiving assistance provided, caregiving impact on everyday life, and indicators of stroke severity and disability. Qualitative methods will also be used to obtain information about caregivers' experiences with the education and support received and the impact on caregivers' perception of being supported and emotional well-being.

DISCUSSION

This research will determine if the TIRSFSP benefits family caregivers by improving their perception of being supported and emotional well-being. If proven effective, it could be recommended as a model of stroke family education and support that meets the Canadian Stroke Best Practice Guideline recommendation for providing timely education and support to families through transitions.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT00958607.

摘要

背景

家庭照顾者在中风幸存者的康复、恢复以及重新融入社区过程中提供了极其宝贵的支持。不幸的是,为照顾者做好准备并支持他们扮演这一角色并非标准临床实践,因此,许多照顾者会经历压力和健康问题,这可能会影响中风幸存者的康复,并威胁到让中风幸存者居家护理的可持续性。我们制定了“适时中风家庭支持计划”(TIRSFSP),以指导提供特定类型教育和支持的时机,以满足照顾者不断变化的需求。这项多中心随机对照试验的目的是确定在中风护理连续过程中实施TIRSFSP是否能提高照顾者的被支持感和情绪健康。

方法/设计:我们的多中心单盲随机对照试验将从城市和农村的急性护理医院招募300名中风幸存者的家庭照顾者。在完成基线评估后,参与者将被随机分配到三组中的一组:1)由中风支持人员(有中风护理经验的医疗保健专业人员)指导的TIRSFSP,在急性护理期间亲自提供,并在中风后的大约前六到十二个月通过电话提供;2)照顾者自我指导的TIRSFSP,由中风支持人员对该计划进行初步介绍;或3)接受心脏与中风基金会编写的教育资源《谈谈中风》的标准护理。参与者将在中风后3个月、6个月和12个月完成三次随访定量评估。这些评估包括对抑郁、社会支持、心理健康、中风知识、掌控感(对生活的控制感)、提供的护理帮助、护理对日常生活的影响以及中风严重程度和残疾指标的评估。定性方法也将用于获取有关照顾者接受教育和支持的经历以及对照顾者被支持感和情绪健康认知的影响的信息。

讨论

这项研究将确定TIRSFSP是否通过改善照顾者的被支持感和情绪健康而使家庭照顾者受益。如果被证明有效,它可以被推荐为一种中风家庭教育和支持模式,符合加拿大中风最佳实践指南中关于通过过渡为家庭提供及时教育和支持的建议。

试验注册

ClinicalTrials.gov:NCT00958607。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f2d/3898562/e5c4120579c2/1472-6963-14-18-1.jpg

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