The RESCUE problem solving intervention for stroke caregivers: A mixed-methods pilot study.

Abstract

Purpose/Objective: Stroke caregivers face many challenges after a family member experiences stroke. Because caregivers play such a crucial role in health care, there is a need for more interventions in webbased formats that focus on caregiver psycho-education and skills building. A pilot study was devised to determine the feasibility, acceptability, and value of an active, 4-week telephone and web-based intervention for stroke caregivers. Method/Design: A one-group, pretest-posttest design with a mixed-methods approach was used. Qualitative data supplemented the quantitative findings. Community-dwelling caregivers of stroke patients were recruited from the Veterans Health Administration. Quantitative data were collected pre and postintervention. Semistructured interviews were completed with a subsample of caregivers to capture more detail about the acceptability and value of the intervention. Results: Ninety-three caregivers were recruited; 72 caregivers completed the intervention and 21 withdrew (77% completion rate). From pre-to posttest, caregiver depression (p = .008) and caregiver burden (p = .013) decreased. Problem-solving abilities and health-related quality of life showed no change. Seventy-eight percent of caregivers rated the intervention sessions with the nurses as very helpful or extremely helpful, and 76% reported using the problem-solving strategies a moderate amount to extremely often. Interviews suggest that the intervention was valuable and led to new strategies to relieve stress and prioritize health. Conclusions/Implications: The intervention was feasible to implement and acceptable to caregivers. This intervention shows promise for fulfilling a need for more web-based interventions that focus on skills building and psycho-education, but more rigorous testing is needed to determine effectiveness. Impact and ImplicationsThere is a shortage of active, tailored interventions for family stroke caregivers that focus on skills building and psychoeducation that can also be delivered in telehealth formats and accommodate caregivers' busy lives. An intervention was developed to meet these needs, with the goal of reducing caregiver depressive symptoms and caregiver burden. Theoretically grounded in stress and coping theory and using a systematic approach to problem-solving, we offer a brief yet comprehensive intervention to reduce

Impact of Strokes: The Burden of Care, Post-CVA Fatigue & Caregiver Role Strain

“…Topics included in the training and discussion included education for stroke care, factsheets about strokes, after strokes, personality changes associated with strokes, rapport building strategies, communication techniques, fall prevention, and managing medicines to name a few of the covered topics. The identified interviews did show a promise for other web-based instruction as the individuals experienced a feasible intervention with valuable instruction that led to new strategies to relieve stress and to prioritize their health needs, however, the study showed no change in the problem-solving or health-related quality of life itself showed no change [14]. Denno et al [15] identified in a study conducted with 153 caregivers 18 years or older who cared for stroke survivors during a two-year period, that there was an increase in caregiver burden was associated with significantly poorer mental health of informal caregivers of stroke survivors with spasticity.…”

“…A pilot study was devised by Jordan et al [14] to determine the feasibility, acceptability, and value of an active, 4-week telephone and web-based intervention for stroke caregivers. The study consisted of one group, who underwent pretest and posttest designs using a mixed-methods approach for online web-based training to evaluate problem-solving abilities and health-related quality of life topics.…”

“…Expanded leave options may optimize job per-formance and contribute to securing daughters' jobs in times of prolonged absence, thereby reducing the need to permanently disengage from an employment opportunity [8]. Because there is a need for more interventions in web-based formats that focus on caregiver psycho-education and skills building research has focused on this formatting intervention [14].…”