Acquired Brain Injury
Conditions
Keywords
Acquired Brain Injury, Inpatient Rehabilitation, Family Caregivers, Caregiver Stress, Caregiver Self-Efficacy
Brief summary
The goal of this clinical trial is to compare effectiveness of two interventions for family caregivers of patients with acquired brain injury who are transitioning home after inpatient rehabilitation. The main question it aims to answer is whether these interventions reduce caregiver stress and burden, compared to usual care. Secondary effects include the impact on caregivers' depressive symptoms and perceived self-efficacy as a caregiver. The study will also try to determine if caregivers will engage in these interventions during the acute (inpatient rehabilitation) stage of injury. Participants in the study are family members of the ABI patient, aged 18 year or older, who will be responsible for the patient's care and supervision once discharged home from inpatient rehabilitation. The two interventions, one clinician-led and one peer-led, will be compared to usual care.
Detailed description
This study will evaluate effectiveness of two problem-solving training interventions on caregivers' emotional health and well-being (stress, depressive symptoms, caregiving self-efficacy). Participants are family members of patients with acquired brain injuries (ABI) admitted for inpatient rehabilitation, with a planned discharge home. Caregivers who agree to participate will be randomly assigned to one of three family support interventions. The Building Better Caregiver program is a peer-led group intervention. Problem Solving Training is an individual clinician-led intervention. Both interventions aim to equip caregivers with problem solving tools. The third intervention is existing support and assistance for family members who will be caregivers for patients discharged home after inpatient rehabilitation. This Usual Care is available to all three groups and consists of nurse instruction in care routines, case management family support for discharge, referral to family counseling and community services as indicated, and general information resources about brain injury. Caregiver-reported outcome measures (CROs) will be collected in three domains: 1) caregiver stress/burden and emotional health, 2) caregiver perceived self-efficacy in managing their loved-one's care needs, and 3) healthcare utilization by patient and caregiver. We will use three standardized outcome measures: 1) Kingston Caregiver Stress Scale (KCSS), 2) Patient Health Questionnaire (PHQ-9), and 3) Revised Scale for Caregiving Self-Efficacy (SCS-E). The measures will be collected at four timepoints: upon enrollment in the study (Pre), within 72 hours of discharge (D/C), and 30 and 90 days post-discharge. The impact of each intervention on the rate of patients' 30-day, unplanned hospital readmissions will also be examined.
Interventions
BEHAVIORALBuilding Better Caregivers
Peer-led, group intervention for caregivers focused on problem-solving
BEHAVIORALProblem Solving Training
Clinician-led, one-to-one intervention for caregivers focused on problem-solving
BEHAVIORALUsual Care
Usual discharge training and support offered to family caregivers of ABI patients
Sponsors
Shepherd Center, Atlanta GA
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
Evaluation of two interventions to usual care, comparing change over time in three outcome measures: caregiver stress, caregiver depression, caregiver perceived self-efficacy in care management
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Family member of patients admitted to inpatient rehabilitation for acquired brain injury, with a planned discharge to home. * Able to begin intervention before discharge * Able to speak and understand English or Spanish
Exclusion criteria
* Patient's discharge location is not to home
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Kingston Caregiver Stress Scale (KCSS) | 1) baseline, at time of enrollment in the study and prior to randomization; 2) within 72 hours of discharge to home; 3) 30-days post-discharge; 90-days post-discharge | Caregiver stress and burden; scores range from 10-50; higher score reflects higher stress |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient Health Questionnaire - 9 (PHQ-9) | 1) baseline, at time of enrollment in the study and prior to randomization; 2) within 72 hours of discharge to home; 3) 30-days post-discharge; 90-days post-discharge | Caregiver depressive symptoms; scores range from 0-27; higher score reflects higher depression |
| Revised Scale for Caregiving Self-Efficacy (SCS-E). | 1) baseline, at time of enrollment in the study and prior to randomization; 2) within 72 hours of discharge to home; 3) 30-days post-discharge; 90-days post-discharge | Contains 15 items within 3 subscales (self-efficacy for obtaining respite, responding to disruptive patient behaviors, and controlling upsetting thoughts about caregiving). Items are rated on a 0-100 scale. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Patient unplanned hospital readmissions | Assessed by telephone follow-up interview 30-40 days post-discharge | Hospital-wide assessment of number and duration of unplanned hospital readmissions in the 30 days post-discharge |
Countries
United States
Outcome results
None listed