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“关爱我们”(TCU)研究方案:针对心力衰竭患者夫妇的二元干预措施的可行性与可接受性

Taking Care of Us© (TCU) study protocol: feasibility and acceptability of a dyadic intervention for couples living with heart failure.

作者信息

Lyons Karen S, Whitlatch Carol J, Vest Amanda R, Upshaw Jenica N, Johnson Stacy Hutton, Morelock Jeremiah, Lee Christopher S

机构信息

Boston College William F. Connell School of Nursing, Maloney Hall, 231, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA.

Center for Research and Education, Benjamin Rose Institute On Aging, Cleveland, OH, USA.

出版信息

Pilot Feasibility Stud. 2023 Jan 25;9(1):16. doi: 10.1186/s40814-023-01249-7.

Abstract

BACKGROUND

There are more than 1 million hospital admissions and 3 million emergency visits for heart failure in the USA annually. Although spouse/partners make substantial contributions to the management of heart failure and experience poor health and high levels of care strain, they are rarely the focus of heart failure interventions. This protocol describes a pilot randomized controlled trial that tests the feasibility, acceptability, and preliminary change in outcomes of a seven-session couple-based intervention called Taking Care of Us© (TCU). The TCU© intervention is grounded in the theory of dyadic illness management and was developed to promote collaborative illness management and better physical and mental health of adults with heart failure and their partners.

METHODS

A two-arm randomized controlled trial will be conducted. Eligible adults with heart failure and their co-residing spouse/partner will be recruited from a clinical site in the USA and community/social media outreach and randomized to either the TCU© intervention or to a control condition (SUPPORT©) that offers education around heart failure management. The target sample is 60 couples (30 per arm). TCU© couples will receive seven sessions over 2 months via Zoom; SUPPORT© couples will receive three sessions over 2 months via Zoom. All participants will complete self-report measures at baseline (T1), post-treatment (T2), and 3 months post-treatment (T3). Acceptability and feasibility of the intervention will be examined using both closed-ended and open-ended questions as well as enrollment, retention, completion, and satisfaction metrics. Preliminary exploration of change in outcomes of TCU© on dyadic health, dyadic appraisal, and collaborative management will also be conducted.

DISCUSSION

Theoretically driven, evidence-based dyadic interventions are needed to optimize the health of both members of the couple living with heart failure. Results from this study will provide important information about recruitment and retention and benefits and drawbacks of the TCU© program to directly inform any needed refinements of the program and decision to move to a main trial.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT04737759) registered on 27 January 2021.

摘要

背景

在美国,每年因心力衰竭而住院的人数超过100万,急诊就诊人数达300万。尽管配偶/伴侣对心力衰竭的管理做出了重大贡献,且自身健康状况不佳、护理压力较大,但他们很少成为心力衰竭干预措施的重点对象。本方案描述了一项试点随机对照试验,该试验旨在测试一种名为“关爱我们自己”(TCU)的为期七节的基于夫妻的干预措施在可行性、可接受性以及结局方面的初步变化。TCU干预措施以二元疾病管理理论为基础,旨在促进患有心力衰竭的成年人及其伴侣进行协作性疾病管理,并改善他们的身心健康。

方法

将进行一项双臂随机对照试验。符合条件的心力衰竭成年患者及其共同居住的配偶/伴侣将从美国的一个临床地点以及社区/社交媒体宣传活动中招募,并随机分为接受TCU干预组或接受围绕心力衰竭管理提供教育的对照组(SUPPORT)。目标样本为60对夫妻(每组30对)。TCU组的夫妻将在2个月内通过Zoom平台接受七节课程;SUPPORT组的夫妻将在2个月内通过Zoom平台接受三节课程。所有参与者将在基线(T1)、治疗后(T2)以及治疗后3个月(T3)完成自我报告测量。将使用封闭式和开放式问题以及入组、留存、完成情况和满意度指标来检验干预措施的可接受性和可行性。还将对TCU在二元健康、二元评估和协作管理方面的结局变化进行初步探索。

讨论

需要理论驱动、基于证据的二元干预措施来优化患有心力衰竭的夫妻双方的健康状况。本研究的结果将提供有关招募和留存以及TCU项目的利弊等重要信息,以直接为该项目所需的改进以及是否进入主要试验的决策提供参考。

试验注册情况

于2021年1月27日在ClinicalTrials.gov注册(NCT04737759)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66ae/9875518/ad2ab13d7561/40814_2023_1249_Fig1_HTML.jpg

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