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Evaluation of a Skills-Building Program for Caregivers of Veterans Post-Stroke
Uphold CR, Jordan MM, Rutter TJ, Ruiz D, Bartolomeo N, Sorial AL, Freytes IM, Fernandez C, Barnett S, Praisoody A, Dang S. Evaluation of a Skills-Building Program for Caregivers of Veterans Post-Stroke. Poster session presented at: Southern Nurses Research Society Annual Conference; 2015 Feb 26; Tampa, FL.
Introduction: Caregiver depression and burden are common following strokes and are major contributors of survivors' hospital readmissions and institutionalizations. Prior caregiver interventions have been underused because they were too time-intensive for staff and already overwhelmed caregivers. Thus, we implemented and evaluated a brief (i.e., four sessions), skills building program that used nurse-led telephone support plus the Internet (our team's previously developed and nationally available RESCUE website). The intervention was based on the COPE model (i.e., Creative thinking, Optimistic attitude, Problem solving skills, Expert information).
Method(s): The evaluation used mixed methods. We conducted telephone assessments to obtain pre-test and post-test data on caregiver depressive symptoms (Center for Epidemiologic Studies Depression), burden (Zarit Burden Interview) problem-solving abilities (Social Problem-Solving Inventory) and quality of life (VR-12 health survey). We obtained pre- and post-test data on Veterans' functional abilities (Barthel Index). We conducted qualitative, telephone interviews with a subsample of 15 caregivers.
Results: To date, 51 caregivers completed the program at two VA medical centers in Gainesville and Miami, Florida. The majority of caregivers were female (96%), Caucasian (66%), high-school or college graduates (100%) and caring for their spouses (72%). Using one-tailed, paired t-tests, we found a significant decrease in caregiver burden (t = -2.02, df = 50, p = 0.02) and an increase in problem-solving skills (t = 3.48, df = 31, p = 0.0008). We found an improvement in Veterans' functional abilities (t = 1.73, df = 49, p = 0.04). Although not statistically significant, caregivers' depressive symptoms decreased and physical quality of life improved. In qualitative interviews, caregivers stated they gained confidence in problem-solving and learned ways to relieve stress. All caregivers would recommend the program to new caregivers
Discussion and Conclusions: The program improved several caregiver outcomes and Veterans' functional abilities. Caregivers viewed the program as beneficial without causing additional burden. A randomized clinical trial is warranted to further test the intervention