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为社区中使用呼吸机的个体的家庭照顾者开发基于网络的同伴支持项目:一项试点随机对照试验的方案

Development of a Web-Based Peer Support Program for Family Caregivers of Ventilator-Assisted Individuals Living in the Community: Protocol for a Pilot Randomized Controlled Trial.

作者信息

Wasilewski Marina B, Nonoyama Mika, Dale Craig, McKim Douglas A, Road Jeremy, Leasa David, Goldstein Roger, Rose Louise

机构信息

Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.

Faculty of Health Sciences, University of the Ontario Institute of Technology, Oshawa, ON, Canada.

出版信息

JMIR Res Protoc. 2019 Feb 6;8(2):e11827. doi: 10.2196/11827.

Abstract

BACKGROUND

Across Europe, Canada, Australia, and the United States, the prevalence of home mechanical ventilation (HMV) prevalence is 6.6-12.9 per 100,000. At-home ventilator-assisted individuals (VAIs) are often vulnerable and highly comorbid, requiring complex care. In Canada, most VAI care is provided by family, leading to poor health-related quality of life and increased caregiver burden. No supportive interventions or peer support programs are tailored to VAI caregivers. Owing to the financial, geographic, and time limitations, Web-based support delivery may especially meet VAI family caregiver needs. We have developed a peer mentor training and Web-based peer support program for VAI caregivers including information-sharing, peer-to-peer communication, and peer mentorship.

OBJECTIVE

Study Stage 1 aims to (1) evaluate the face and content validity of the peer mentor training program and (2) investigate participant satisfaction. Study Stage 2 aims to evaluate (1) the feasibility of participant recruitment and Web-based program delivery; (2) acceptability, usability, and satisfactoriness; (3) experiences of caregivers and peer mentors with the Web-based peer support program; and (4) effect of the Web-based peer support program on caregiver health outcomes.

METHODS

Study Stage 1: We will train 7 caregivers to act as peer mentors for the Web-based peer support program trial; they will complete questionnaires rating the utility of individual training sessions and the training program overall. Study Stage 2: We will recruit 30 caregiver peers for a pilot randomized controlled trial of the 12-week Web-based peer support program using a waitlist control; the program includes private chat, a public discussion forum, and weekly moderated chats. Caregiver peers will be randomized to the intervention or waitlist control group using a 1:1 ratio using Randomize.net. Both groups will complete pre- and postintervention health outcome questionnaires (ie, caregiving impact, mastery, coping, personal gain, positive affect, and depression). Caregiver peers in the intervention arm will only complete a program evaluation and will be invited to participate in an interview to provide insight into their experience. Peer mentors will be invited to participate in a Web-based focus group to provide insight into their experience as mentors. We will judge the feasibility per the number of recruitment and program delivery goals met, use analysis of covariance to compare health outcomes between intervention and control groups, and analyze qualitative data thematically.

RESULTS

Peer mentor training was completed with 5 caregivers in July 2018. To date, 2 caregivers have beta-tested the website, and the Web-based peer support program trial will commence in September 2018. Results are expected by early 2019.

CONCLUSIONS

This study will result in the production and initial evaluation of a rigorously developed, evidence- and stakeholder-informed Web-based peer training and peer support program for caregivers of VAIs residing at home.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/11827.

摘要

背景

在欧洲、加拿大、澳大利亚和美国,家庭机械通气(HMV)的患病率为每10万人6.6 - 12.9例。在家中使用呼吸机辅助的个体(VAIs)往往较为脆弱且合并症较多,需要复杂的护理。在加拿大,大多数VAIs的护理由家人提供,这导致与健康相关的生活质量较差,护理人员负担加重。目前没有专门针对VAIs护理人员的支持性干预措施或同伴支持项目。由于经济、地理和时间限制,基于网络的支持服务可能特别能满足VAIs家庭护理人员的需求。我们为VAIs护理人员开发了一个同伴导师培训和基于网络的同伴支持项目,包括信息共享、 peer-to-peer通信和同伴指导。

目的

研究阶段1旨在(1)评估同伴导师培训项目的表面效度和内容效度,以及(2)调查参与者的满意度。研究阶段2旨在评估(1)参与者招募和基于网络的项目实施的可行性;(2)可接受性、可用性和满意度;(3)护理人员和同伴导师参与基于网络的同伴支持项目的体验;以及(4)基于网络的同伴支持项目对护理人员健康结果的影响。

方法

研究阶段1:我们将培训7名护理人员作为基于网络的同伴支持项目试验的同伴导师;他们将完成问卷,对各个培训课程以及整个培训项目的效用进行评分。研究阶段2:我们将招募30名护理人员同伴,对为期12周的基于网络的同伴支持项目进行试点随机对照试验,采用等待名单对照;该项目包括私人聊天、公共讨论论坛和每周的主持聊天。护理人员同伴将使用Randomize.net以1:1的比例随机分配到干预组或等待名单对照组。两组都将完成干预前后的健康结果问卷(即护理影响、掌握程度、应对方式、个人收获、积极情绪和抑郁)。干预组的护理人员同伴只需完成项目评估,并将被邀请参加访谈,以深入了解他们的体验。同伴导师将被邀请参加基于网络的焦点小组讨论,以深入了解他们作为导师的体验。我们将根据达到的招募人数和项目实施目标来判断可行性,使用协方差分析比较干预组和对照组之间的健康结果,并对定性数据进行主题分析。

结果

2018年7月,5名护理人员完成了同伴导师培训。迄今为止,2名护理人员对网站进行了测试,基于网络的同伴支持项目试验将于2018年9月开始。预计2019年初得出结果。

结论

本研究将产生并初步评估一个经过严格开发、基于证据且考虑了利益相关者意见的、针对在家居住的VAIs护理人员 的基于网络的同伴培训和同伴支持项目。

国际注册报告识别号(IRRID):PRR1-10.2196/11827。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f86/6386648/73451a665cf0/resprot_v8i2e11827_fig1.jpg

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