Section of Palliative Medicine, Division of General Internal Medicine Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.
School of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.
Am J Hosp Palliat Care. 2024 Dec;41(12):1400-1407. doi: 10.1177/10499091241228835. Epub 2024 Feb 6.
Hospice family caregivers (HFCGs) support the needs of their loved ones but are at risk of developing distress and anxiety. NOVELA is a four-chapter telenovela-style educational video to support topics related to hospice caregiving. Telehealth visits are scheduled in 4 weekly sessions consisting of a chapter and subsequent discussion with an interventionist. This feasibility pilot study tested NOVELA's effect to change HFCGs' outcomes, session and outcome measure completion (defined a priori as >70%).
This is a single-group pretest-posttest study of HFCGs of care recipients with PPS score >20% from 3 hospices in the U.S. Mid-Atlantic region. At baseline and at final posttest, participants completed a web-based survey assessing 3 outcomes: anxiety, self-efficacy, and satisfaction with intervention. Descriptive, t-test, and chi-square statistics were computed.
Participants in our study (N = 59) were mainly collage educated, White, female, adult children of home-bound people with a non-cancer diagnosis. Outcomes changed in the expected direction ( > .05) with higher self-efficacy (Cohen's d = -.08 [95% CI -.4 to .2) and lower anxiety (Cohen's d = .2 [95% CI -.1 to .5]) scores from final to baseline, 86% of HFCGs were satisfied or very satisfied with NOVELA, session (33/59) and outcome measure (43/59) completion averaged 68%.
Encouraging trends in NOVELA's estimation of effect suggests that NOVELA may buffer stressful aspects of hospice caregiving. However, further refinement of NOVELA is needed. Supporting HFCGs through supportive educational interventions may reduce distress and anxiety with broad implications for quality improvement.
临终关怀家庭照顾者(HFCG)满足亲人的需求,但有出现痛苦和焦虑的风险。NOVELA 是一部四章的电视剧式教育视频,用于支持与临终关怀相关的主题。远程医疗访问安排在 4 个每周一次的会议中,包括一章内容和随后与干预者的讨论。这项可行性试点研究测试了 NOVELA 改变 HFCG 结果的效果,即会议和结果测量的完成情况(预先定义为>70%)。
这是一项在美国中大西洋地区 3 家临终关怀机构的 PPS 评分>20%的临终关怀照顾者的单组预测试-后测试研究。在基线和最终后测时,参与者完成了一项在线调查,评估了 3 项结果:焦虑、自我效能感和对干预的满意度。计算了描述性、t 检验和卡方检验统计数据。
我们研究中的参与者(N=59)主要受过大学教育,是白人,女性,居家患者的成年子女,患有非癌症诊断。结果朝着预期的方向变化(>0.05),自我效能感(Cohen's d=-.08 [95%CI -.4 至.2)和焦虑(Cohen's d=0.2 [95%CI -.1 至.5)得分从最终到基线都有所提高,86%的 HFCG 对 NOVELA 感到满意或非常满意,会议(33/59)和结果测量(43/59)的完成率平均为 68%。
NOVELA 对效果的估计显示出令人鼓舞的趋势,表明 NOVELA 可能缓解临终关怀的压力方面。然而,需要进一步改进 NOVELA。通过支持性教育干预来支持 HFCG 可能会减轻痛苦和焦虑,对质量改进有广泛的影响。