Cameron Jill I, Naglie Gary, Green Theresa L, Gignac Monique A M, Bayley Mark, Huijbregts Maria, Silver Frank L, Czerwonka Anna
Department of Occupational Science and Occupational Therapy, University of Toronto, Canada Department of Medicine, UHN-Toronto Rehabilitation Institute, Canada
Department of Medicine and Rotman Research Institute, Baycrest Health Sciences; Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Canada.
Clin Rehabil. 2015 Nov;29(11):1129-40. doi: 10.1177/0269215514564897. Epub 2014 Dec 31.
Examine feasibility of conducting a randomized controlled trial of the Timing it Right Stroke Family Support Program (TIRSFSP) and collect pilot data.
Multi-site mixed method randomized controlled trial.
Acute and community care in three Canadian cities.
Caregivers were family members or friends providing care to individuals who experienced their first stroke.
The TIRSFSP offered in two formats, self-directed by the caregiver or stroke support person-directed over time, were compared to standard care.
Caregivers completed baseline and follow-up measures 1, 3 and 6 months post-stroke including Centre for Epidemiological Studies Depression, Positive Affect, Social Support, and Mastery Scales. We completed in-depth qualitative interviews with caregivers and maintained intervention records describing support provided to each caregiver.
Thirty-one caregivers received standard care (n=10), self-directed (n=10), or stroke support person-directed (n=11) interventions. We retained 77% of the sample through 6-months. Key areas of support derived from intervention records (n=11) related to caregiver wellbeing, caregiving strategies, patient wellbeing, community re-integration, and service delivery. Compared to standard care, caregivers receiving the stroke support person-directed intervention reported improvements in perceived support (estimate 3.1, P=.04) and mastery (estimate .35, P=.06). Qualitative caregiver interviews (n=19) reflected the complex interaction between caregiver needs, preferences and available options when reporting on level of satisfaction.
Preliminary findings suggest the research design is feasible, caregivers' needs are complex, and the support intervention may enhance caregivers' perceived support and mastery. The intervention will be tested further in a large scale trial.
检验开展“适时卒中家庭支持项目”（TIRSFSP）随机对照试验的可行性并收集试点数据。
多地点混合方法随机对照试验。
加拿大三个城市的急症和社区护理机构。
照顾首次卒中患者的家庭成员或朋友。
将以两种形式提供的TIRSFSP（一种由照顾者自主进行，另一种由卒中支持人员随着时间推移进行指导）与标准护理进行比较。
照顾者在卒中后1、3和6个月完成基线及随访测量，包括流行病学研究中心抑郁量表、积极情感量表、社会支持量表和掌控感量表。我们对照顾者进行了深入的定性访谈，并保存了描述为每位照顾者提供的支持的干预记录。
31名照顾者接受了标准护理（n = 10）、自主指导干预（n = 10）或卒中支持人员指导干预（n = 11）。6个月后我们保留了77%的样本。从干预记录（n = 11）中得出的关键支持领域涉及照顾者的幸福感、照顾策略、患者幸福感、重新融入社区以及服务提供。与标准护理相比，接受卒中支持人员指导干预的照顾者报告在感知支持（估计值3.1，P = 0.04）和掌控感（估计值0.35，P = 0.06）方面有所改善。照顾者的定性访谈（n = 19）在报告满意度水平时反映了照顾者需求、偏好和可用选项之间的复杂相互作用。
初步研究结果表明该研究设计可行，照顾者的需求复杂，且支持性干预可能会增强照顾者的感知支持和掌控感。该干预将在大规模试验中进一步测试。
