Caregiver, Caregiver Resilience and Stress, Caregiver Stress
Conditions
Keywords
Caregiver, Caregiver burden, Caregiver stress, Digital health, Caregiver support
Brief summary
We are evaluating the caregiver support initiatives at a tertiary hospital in Singapore (Tan Tock Seng Hospital - TTSH) provided to caregivers caring for older patients. The evaluation will focus on 1) evaluating the process / delivery / implementation of these initiatives to caregivers and 2) the outcomes of caregivers and their care recipients after receiving these caregiver support services at TTSH. Research questions are as follows: Process evaluation: 1. How are the bundle(s) of caregiver support initiatives at TTSH delivered to caregivers? 2. What and how was impact achieved for these initiatives? Outcome evaluation: 3. Did caregivers (and patients) benefit from these support initiatives and how? 4. Which aspects of the caregiver support initiatives are most beneficial to caregivers (and patients)? Eligible caregivers will be invited to take part in the study and to complete 3 surveys and an optional interview over the period of their care recipients' hospital stay at TTSH, and 2 months after discharge. During their care recipients' stay, they may be introduced to any of the caregiver support initiatives, based on their needs. Caregivers enrolled in this study will take part in 3 surveys - 1 conducted at the beginning of care recipients' hospital stay, 1 conducted around the discharge period and 1 conducted one month after discharge. The aim of the surveys is to find out if caregivers have attended or used any of these services and whether they benefited from them.
Detailed description
This is a mixed method study that seeks to evaluate the bundle of caregiver support initiatives being provided to caregivers at TTSH, based on their needs. The evaluation will focus on 1) evaluating the process / delivery / implementation of these initiatives to caregivers and 2) the outcomes of caregivers and their care recipients after receiving these caregiver support services at TTSH. Research questions are as follows: Process evaluation: 1. How are the bundle(s) of caregiver support initiatives at TTSH delivered to caregivers? 2. What and how was impact achieved for these initiatives? Outcome evaluation: 3. Did caregivers (and patients) benefit from these support initiatives and how? 4. Which aspects of the caregiver support initiatives are most beneficial to caregivers (and patients)? Quantitative methods: Eligible caregivers will be invited to take part in the study and to complete 3 surveys and an optional interview over the period of their care recipients' hospital stay at TTSH, and 2 months after discharge. During their care recipients' stay, they may be introduced to any of the caregiver support initiatives, based on their needs. Caregivers enrolled in this study will take part in 3 surveys - 1 conducted at the beginning of care recipients' hospital stay, 1 conducted around the discharge period and 1 conducted one month after discharge. The aim of the surveys is to find out if caregivers have attended or used any of these services and whether they benefited from them. We hypothesise that caregivers outcomes, for e.g. caregivers' knowledge, preparedness to provide care and well-being will be increased for those who have used or attended the initiatives recommended for them by the hospital and caregivers' stress, anxiety, depression, will decrease after receiving these caregiver support initiatives. We also hypothesise that the time spent on caregiving will decrease for those who have used or attended the hospital's caregiver support services and initiatives. As some of the caregiver initiatives may be progressively implemented at TTSH over the study period, the study will capture data from caregivers who did not receive these initiatives with those who have received them when these initiatives were made available at the hospital. We will also seek patients' consent to use their data in EPIC for research purposes. We hypothesise that patients' re-admission and visits to the ED post-discharge will be reduced. Qualitative Methods: Through the optional interviews with caregivers, either before or after discharge of the care recipients, we aim to ask the following research questions: 1. How were the caregiver support initiatives introduced and carried out at TTSH? 2. How did caregivers respond to these initiatives and what were their perceptions towards these interventions? Which aspects of these initiatives benefit them the most and why? 3. What are the barriers and facilitators faced by the healthcare professionals who implemented these initiatives to caregivers?
Interventions
1. CarePal: A one-stop resource library for caregivers of older adults 2. Nasogastric tube (NGT) webapp: An electronic training platform to learn NGT feeding and management 3. Carer OnBoard programme 4. Caregiver resources in NHG Health App (NHA): Relevant healthcare professionals or TTSH staff will introduce caregivers to the resources they may need in the NHA app. 5. Carer guide, a resource booklet providing information and community resources for caregivers. 6. Group Caregiver Training, for caregivers who are able to attend group caregiver training (instead of learning at the bedside); 7. NHG Care Telephonic team to provide telephonic support to caregivers post-discharge. 8. Nurses or other healthcare professionals providing relevant information on community programmes
OTHERStandard caregiver support
Participants are provided standard bedside caregiver education as appropriate and information reinforcement through leaflets and booklets
Sponsors
Tan Tock Seng Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* 21 years of age and above * Main or secondary caregiver of an older person receiving home-based care * Able to read and converse in English * Has a mobile smartphone and is able to navigate basic functionalities on mobile apps
Exclusion criteria
* Participants who are cognitively impaired * Unwilling to download and utilise app * Unable to read or converse in English comfortably
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Preparedness for Caregiving Scale | 1 month | 8-item scale measuring caregiver preparedness for caregiving. Average score ranges from 0 - 4, higher score indicating better preparedness for caregiving |
| Caregiver Resourcefulness Scale | 1 month | 8-item scale measuring caregiver resourcefulness. Total score calculated ranging from 8 - 40 with higher scores indicating higher resourcefulness |
| Zarit Burden Scale - 12 Item | 1 month | 12-item scale measuring caregiver burden. Total score calculated range from 0-48, with higher scores indicating higher burden |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hospital Anxiety and Depression Scale | 1 month | 14-item scale measuring anxiety and depression. Anxiety measured over 7 items, with score ranging from 0-21, with higher scores indicating higher anxiety. Depression measured over 7 items, with score ranging from 0-21, with higher scores indicating higher depression |
| EQ5D-5L | 1 month | 5-level EQ-5D version to measure mobility, self-care, usual activities, pain/discomfort and anxiety/depression of participants. This includes the EQ VAS, recording self-rated health on a vertical visual analogue scale where the endpoints are labelled 'The best health you can imagine' and 'The worst health you can imagine'. |
Countries
Singapore
Contacts
Primary ContactGeorge Glass
Outcome results
None listed