评估针对后天性脑损伤患者伴侣的CARE4Carer综合护理干预措施：一项随机对照试验方案

Evaluating the CARE4Carer Blended Care Intervention for Partners of Patients With Acquired Brain Injury: Protocol for a Randomized Controlled Trial.

作者信息

Cox Vincent Cm, Schepers Vera Pm, Ketelaar Marjolijn, van Heugten Caroline M, Visser-Meily Johanna Ma

机构信息

Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, Netherlands.

Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.

出版信息

JMIR Res Protoc. 2018 Feb 16;7(2):e60. doi: 10.2196/resprot.9108.

DOI:10.2196/resprot.9108

PMID:29453189

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5834754/

Abstract

BACKGROUND

Support programs for partners of patients with acquired brain injury are necessary since these partners experience several unfavorable consequences of caregiving, such as a high burden, emotional distress, and poor quality of life. Evidence-based support strategies that can be included in these support programs are psychoeducation, skill building, problem solving, and improving feelings of mastery. A promising approach would seem to be to combine web-based support with face-to-face consultations, creating a blended care intervention.

OBJECTIVE

This paper outlines the protocol of a randomized controlled trial to evaluate the CARE4Carer blended care intervention for partners of patients with acquired brain injury.

METHODS

A multicenter two-arm randomized controlled trial will be conducted. A total of 120 partners of patients with acquired brain injury will be recruited from five rehabilitation centers in the Netherlands. The blended care intervention consists of a nine-session web-based support program and two face-to-face consultations with a social worker. Themes that will be addressed are: giving partners insight into their own situation, including possible pitfalls and strengths, learning how to cope with the situation, getting a grip on thoughts and feelings, finding a better balance in the care for the patient with acquired brain injury, thinking about other possible care options, taking care of oneself, and communication. The intervention lasts 20 weeks and the control group will receive usual care. The outcome measures will be assessed at baseline and at 24- and 40-week follow-up. The primary outcome is caregiver mastery. Secondary outcome measures are strain, burden, family functioning, emotional functioning, coping, quality of life, participation, and social network.

RESULTS

The effect of the intervention on the primary and secondary outcome measures will be determined. Additional a process evaluation will be conducted.

CONCLUSIONS

The findings of this study will be used to improve the care for partners of patients with acquired brain injury. Barriers and facilitators that emerge from the process evaluation will be used in the nationwide implementation of the intervention.

TRIAL REGISTRATION

Dutch Trial Register NTR6197; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6197 (Archived by WebCite at http://www.webcitation.org/6xHBAxx0y).

摘要

背景

为后天性脑损伤患者的伴侣提供支持项目很有必要，因为这些伴侣会经历护理带来的一些不利影响，比如负担过重、情绪困扰和生活质量差。可纳入这些支持项目的循证支持策略包括心理教育、技能培养、问题解决以及增强掌控感。一种有前景的方法似乎是将基于网络的支持与面对面咨询相结合，创建一种混合式护理干预。

目的

本文概述了一项随机对照试验的方案，以评估针对后天性脑损伤患者伴侣的CARE4Carer混合式护理干预。

方法

将开展一项多中心双臂随机对照试验。将从荷兰的五个康复中心招募120名后天性脑损伤患者的伴侣。混合式护理干预包括一个为期九节的基于网络的支持项目以及与一名社会工作者进行的两次面对面咨询。将涉及的主题包括：让伴侣了解自身情况，包括可能存在的陷阱和优势，学习如何应对这种情况，控制思想和情绪，在照顾后天性脑损伤患者方面找到更好的平衡，考虑其他可能的护理选择，照顾好自己以及沟通。干预为期20周，对照组将接受常规护理。结局指标将在基线以及24周和40周随访时进行评估。主要结局是照顾者的掌控感。次要结局指标包括压力、负担、家庭功能、情绪功能、应对方式、生活质量、参与度和社交网络。