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电话和网络为基础的脑卒中照顾者干预措施的可行性和可接受性:RES-CUE 干预的一项先导随机对照试验。

Feasibility and acceptability of a telephone and web-based stroke caregiver intervention: a pilot randomized controlled trial of the RESCUE intervention.

机构信息

Research Service, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA.

Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA.

出版信息

Clin Rehabil. 2021 Feb;35(2):253-265. doi: 10.1177/0269215520957004. Epub 2020 Sep 9.

Abstract

OBJECTIVE

Assess the feasibility and acceptability of an Internet and telephone support and problem-solving intervention for stroke caregivers.

DESIGN

Randomized controlled pilot trial with four arms: four-week intervention ( = 13), eight-week intervention ( = 13), eight-week attention control ( = 13), and standard care ( = 14).

SETTING

Southeastern U.S. Veterans Health System.

PARTICIPANTS

Informal caregivers of Veterans who suffered a stroke in the preceding 2.5 years were enrolled over an 18-month period.

INTERVENTIONS

Intervention participants received RESCUE, a support and problem-solving intervention delivered via telephone and Internet by registered nurses. Attention control participants received active listening with no advice delivered by nurses via telephone.

MAIN MEASURES

Feasibility of a larger trial was assessed via recruitment and retention. Acceptability was assessed using an adapted enactment tool and qualitative interviews. Changes in caregiver depressive symptoms and burden were measured by the Center for Epidemiologic Studies Depression Scale and Zarit Burden Interview. The study was not powered for significance testing.

RESULTS

Of 340 eligible caregivers, 53 (16%) agreed to participate. Among those enrolled, 51 (96%) completed the study. Caregiver mean age was 60.3 (10.1), 49 (93%) were female and 36 (68%) were white. At baseline, 21 (39%) caregivers had high risk of depression and 18 (33%) had significant burden. Acceptability and enactment tool findings indicated positive participant responses to the intervention. Most rated the amount of sessions the "right amount". Qualitative analysis revealed the intervention was valued by and acceptable to caregivers.

CONCLUSIONS

Findings indicate the RESCUE intervention is feasible and acceptable to caregivers and warrants further testing.

摘要

目的

评估一种针对脑卒中照顾者的互联网和电话支持及问题解决干预措施的可行性和可接受性。

设计

随机对照试点试验,设四组:四周干预组(n=13)、八周干预组(n=13)、八周对照注意力组(n=13)和标准护理组(n=14)。

地点

美国东南部退伍军人健康系统。

参与者

在过去 2.5 年内患有脑卒中的退伍军人的非正式照顾者,在 18 个月期间入组。

干预措施

干预组参与者接受由注册护士通过电话和互联网提供的 RESCUE 支持和问题解决干预。对照组参与者接受由护士通过电话进行的积极倾听,但不提供建议。

主要观察指标

通过招募和保留情况评估更大规模试验的可行性。通过改编的实施工具和定性访谈评估可接受性。照顾者抑郁症状和负担的变化通过流行病学研究中心抑郁量表和 Zarit 负担访谈进行测量。该研究没有进行显著性检验。

结果

在 340 名符合条件的照顾者中,有 53 名(16%)同意参与。在入组的参与者中,有 51 名(96%)完成了研究。照顾者的平均年龄为 60.3(10.1)岁,49 名(93%)为女性,36 名(68%)为白人。基线时,21 名(39%)照顾者有较高的抑郁风险,18 名(33%)有显著负担。接受性和实施工具的研究结果表明,参与者对干预措施有积极的反应。大多数人将干预的会话次数评为“适量”。定性分析显示,该干预措施受到照顾者的重视和认可。

结论

研究结果表明,RESCUE 干预措施对照顾者是可行且可接受的,值得进一步测试。

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