Powell Janet M, Fraser Robert, Brockway Jo Ann, Temkin Nancy, Bell Kathleen R
Division of Occupational Therapy, Department of Rehabilitation Medicine (Dr Powell), Departments of Rehabilitation Medicine, Neurology, and Neurological Surgery (Dr Fraser), Department of Rehabilitation Medicine (Dr Brockway), and Departments of Neurological Surgery and Biostatistics (Dr Temkin), University of Washington, Seattle; and Department of Physical Medicine and Rehabilitation, University of Texas Southwestern, Dallas (Dr Bell).
J Head Trauma Rehabil. 2016 May-Jun;31(3):180-90. doi: 10.1097/HTR.0000000000000167.
To determine whether a telephone-based, individualized education and mentored problem-solving intervention would improve outcomes for caregivers of persons with traumatic brain injury (TBI).
Parallel group, randomized controlled trial with blinded outcome assessment.
General community.
A total of 153 caregivers (mean age = 49.7 years; 82% female; 54% spouses/partners, 35% parents) of persons with moderate to severe TBI who received acute and/or rehabilitation care at a level I trauma center. Eighty-two percent of participants were evaluated at 6-month follow-up.
Individualized education and mentored problem-solving intervention focused on caregivers' primary concerns delivered via up to 10 telephone calls at 2-week intervals.
Composite of Bakas Caregiving Outcomes Scale (BCOS) and Brief Symptom Inventory (BSI-18) at 6 months post-TBI survivor discharge. Secondary measures included the Brief COPE.
Caregivers in the treatment arm scored higher on the BCOS-BSI composite (P = .032), with more active coping (P = .020) and less emotional venting (P = .028) as measured by the Brief COPE.
An individualized education and mentored problem-solving approach delivered via telephone in the first few months following community discharge of the TBI survivor resulted in better caregiver outcomes than usual care. Consideration should be given to using this approach to augment the limited support typically offered to caregivers.
确定基于电话的个性化教育和指导下的问题解决干预措施是否能改善创伤性脑损伤(TBI)患者照顾者的结局。
采用平行组随机对照试验,结局评估设盲。
一般社区。
共153名中重度TBI患者的照顾者(平均年龄 = 49.7岁;82%为女性;54%为配偶/伴侣,35%为父母),这些患者在一级创伤中心接受了急性和/或康复治疗。82%的参与者在6个月随访时接受了评估。
个性化教育和指导下的问题解决干预措施,重点关注照顾者的主要担忧,通过每2周进行一次、最多10次的电话沟通来实施。
TBI幸存者出院后6个月时的巴卡斯照顾者结局量表(BCOS)和简明症状量表(BSI-18)的综合得分。次要指标包括简易应对方式问卷(Brief COPE)。
治疗组的照顾者在BCOS-BSI综合得分上更高(P = 0.032),根据简易应对方式问卷测量,其积极应对更多(P = 0.020),情绪宣泄更少(P = 0.028)。
在TBI幸存者社区出院后的头几个月,通过电话提供个性化教育和指导下的问题解决方法,比常规护理能带来更好的照顾者结局。应考虑采用这种方法来增强通常给予照顾者的有限支持。