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退伍军人事务部多创伤系统护理中的疗效和实施计划:针对创伤性脑损伤退伍军人和军人照顾者的 REACH 干预措施的协议。

Efficacy and Implementation Planning Across the Veterans Affairs Polytrauma System of Care: Protocol for the REACH Intervention for Caregivers of Veterans and Service Members With Traumatic Brain Injury.

机构信息

School of Data Science, University of Virginia, Charlottesville, VA, United States.

Central Virginia Veterans Affairs Health Care System, Richmond, VA, United States.

出版信息

JMIR Res Protoc. 2024 Aug 15;13:e57692. doi: 10.2196/57692.

Abstract

BACKGROUND

The responsibility of care for Veterans and Service Members (V/SMs) with traumatic brain injury (TBI) often defaults to informal family caregivers. Caregiving demands considerable knowledge, skill, and support to facilitate the health and well-being of V/SMs and themselves. Persistent and common TBI caregiver issues include strain, depression, and anxiety. While evidence-based, brief interventions have been developed and implemented for family caregivers in Veteran neurodegenerative populations, few interventions have been developed, adapted, or tested to support the unique needs of caregivers of V/SMs with TBI.

OBJECTIVE

This study will adapt and test an evidence-based, personalized, 6-session telehealth caregiver intervention, "Resources for Enhancing All Caregivers' Health" (REACH), to meet the unique needs of caregivers of V/SMs with TBI. If successful, a community-based participatory research team will develop an implementation plan to roll out REACH TBI across the national Veterans Affairs Polytrauma System of Care.

METHODS

This mixed methods, crossover waitlist control clinical trial will use a Type 1 Hybrid Effectiveness-Implementation approach to adapt and then test the effects of REACH TBI on key TBI caregiver outcomes.

RESULTS

This study was funded by the Department of Defense in September 2023. Participant enrollment and data collection will begin in 2024.

CONCLUSIONS

If effective, REACH TBI will be the first evidence-based intervention for caregivers of V/SMs with TBI that can be scaled to implement across the Veterans Affairs Polytrauma System of Care and fill a notable gap in clinical services.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/57692.

摘要

背景

照顾患有创伤性脑损伤(TBI)的退伍军人和服务成员(V/SM)的责任通常由非正规的家庭照顾者承担。照顾工作需要相当多的知识、技能和支持,以促进 V/SM 和他们自己的健康和福祉。持续存在且常见的 TBI 照顾者问题包括紧张、抑郁和焦虑。虽然已经为退伍军人神经退行性疾病患者的家庭照顾者开发和实施了基于证据的简短干预措施,但很少有干预措施是为满足 TBI 退伍军人照顾者的独特需求而开发、改编或测试的。

目的

本研究将改编并测试一种基于证据的、个性化的、6 节的远程医疗照顾者干预措施,“资源增强所有照顾者的健康”(REACH),以满足 TBI 退伍军人照顾者的独特需求。如果成功,一个基于社区的参与式研究团队将制定一项实施计划,在全国退伍军人事务复合创伤系统护理中推出 REACH TBI。

方法

本混合方法、交叉等待名单对照临床试验将采用 1 型混合有效性-实施方法来改编和测试 REACH TBI 对 TBI 照顾者关键结果的影响。

结果

这项研究于 2023 年 9 月获得国防部资助。参与者招募和数据收集将于 2024 年开始。

结论

如果有效,REACH TBI 将是第一个针对 TBI 退伍军人照顾者的基于证据的干预措施,可以在退伍军人事务复合创伤系统护理中推广实施,并填补临床服务中的一个显著空白。

国际注册报告标识符(IRRID):PRR1-10.2196/57692。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a42c/11362706/6237e6ccb15d/resprot_v13i1e57692_fig1.jpg

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