Coles Theresa, Lucas Nicole, Daniell Erin, Sullivan Caitlin, Wang Ke, Olsen Jennifer M, Shepherd-Banigan Megan
Department of Population Health Sciences, Duke University, Durham, NC, United States.
Rosalynn Carter Institute for Caregivers, Americus, GA, United States.
JMIR Form Res. 2022 Apr 8;6(4):e30877. doi: 10.2196/30877.
The Rosalynn Carter Institute for Caregivers (RCI) offers evidence-based interventions to promote caregivers' health and well-being. Trained coaches regularly meet with caregivers to offer education and instructions to improve caregiver health, build skill sets, and increase resilience. Two of these interventions, RCI Resources for Enhancing Alzheimer's Caregiver Health (REACH) and Operation Family Caregiver (OFC), use a set of caregiver-reported questionnaires to monitor caregivers' health status and needs.
This study aims to describe how web-based assessment questionnaires are used to identify and monitor caregiver status in the RCI REACH and OFC programs and outlines perceived enhancements to the web-based system that could support caregiver-coach encounters by directing priorities.
This was a descriptive, qualitative study. Data were collected via semistructured interviews with caregivers and coaches in the RCI REACH and OFC programs from July 2020 to October 2020. During the interviews, participants were asked to describe how the assessment questionnaires were used to inform caregiver-coach encounters, perceived usefulness of enhancements to web-based display, and preference for the structure of score results. The interviews were recorded, transcribed, and coded using structural and interpretive codes from a structured codebook. Qualitative content analysis was used to identify themes and summarize the results.
A total of 25 caregivers (RCI REACH: 13/25, 52%; OFC: 12/25, 48%) and 11 coaches (RCI REACH: 5/11, 45%; OFC: 6/11, 55%) were interviewed. Most caregivers indicated that the assessment questions were relevant to their caregiving experience. Some caregivers and coaches indicated that they thought the assessment should be administered multiple times throughout the program to evaluate the caregiver progress. Overall, caregivers did not want their scores to be compared with those of other caregivers, and there was heterogeneity in how caregivers preferred to view their results at the question or topic level. Coaches were uncertain as to which and how much of the results from the self-reported questionnaires should be shared with caregivers. Overall, the results were very similar, regardless of program affiliation (RCI REACH vs OFC).
Web-based and procedural enhancements were identified to enrich caregiver-coach encounters. New and enhanced strategies for using web-based assessment questionnaires to direct priorities in the caregiver-coach encounters included integrating figures showing caregiver progress at the individual caregiver level, ability to toggle results through different figures focused on individual versus aggregate results, and support for interpreting scores. The results of this qualitative study will drive the next steps for RCI's web-based platform and expand on current standards for administering self-reported questionnaires in clinical practice settings.
罗莎琳·卡特护理者研究所（RCI）提供基于证据的干预措施，以促进护理者的健康和福祉。经过培训的教练定期与护理者会面，提供教育和指导，以改善护理者的健康状况、培养技能并增强适应能力。其中两项干预措施，即RCI增强老年痴呆症护理者健康资源（REACH）和家庭护理者行动（OFC），使用一组由护理者报告的问卷来监测护理者的健康状况和需求。
本研究旨在描述如何使用基于网络的评估问卷来识别和监测RCI REACH和OFC项目中的护理者状况，并概述对基于网络的系统的感知增强功能，这些功能可通过确定优先事项来支持护理者与教练的互动。
这是一项描述性定性研究。2020年7月至2020年10月期间，通过对RCI REACH和OFC项目中的护理者和教练进行半结构化访谈收集数据。在访谈中，参与者被要求描述评估问卷如何用于为护理者与教练的互动提供信息、对基于网络展示的增强功能的感知有用性以及对分数结果结构的偏好。访谈进行了录音、转录，并使用结构化编码手册中的结构和解释性代码进行编码。采用定性内容分析来确定主题并总结结果。
共访谈了25名护理者（RCI REACH：13/25，52%；OFC：12/25，48%）和11名教练（RCI REACH：5/11，45%；OFC：6/11，55%）。大多数护理者表示评估问题与他们的护理经历相关。一些护理者和教练表示，他们认为在整个项目中应多次进行评估，以评估护理者的进展。总体而言，护理者不希望将他们的分数与其他护理者的分数进行比较，并且在护理者希望在问题或主题层面查看结果的方式上存在异质性。教练不确定应与护理者分享自我报告问卷的哪些结果以及多少结果。总体而言，无论所属项目（RCI REACH与OFC）如何，结果都非常相似。
确定了基于网络和程序的增强功能以丰富护理者与教练的互动。使用基于网络的评估问卷来确定护理者与教练互动中的优先事项的新的和增强的策略包括整合显示个体护理者层面护理者进展的图表、能够通过关注个体结果与总体结果的不同图表切换结果以及支持对分数的解释。这项定性研究的结果将推动RCI基于网络平台的下一步发展，并扩展临床实践环境中管理自我报告问卷的当前标准。
