Karen S Lyons, Carol J Whitlatch, Amanda R Vest, Jenica N Upshaw, Stacy Hutton Johnson, Anna Walters, Christopher S Lee
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引用次数: 0
Abstract
Background and objectives: Despite the significant impact of heart failure on both members of the care dyad, few interventions focus on optimizing the health of the dyad. The current study examined the feasibility and acceptability of the novel Taking Care of Us (TCU) program with mid-late-life couples living with heart failure and explored preliminary efficacy.
Research design and methods: This NIH Stage I study used a 2-arm randomized controlled trial with pretest-post-test design and an additional 5-month follow-up to compare TCU with an educational counseling attention-control condition. 37 couples were randomized to TCU (18 couples) or an educational control group (19 couples). Both programs were delivered virtually over 2 months.
Results: Adults with heart failure were primarily male (mean age = 66.32, standard deviation [SD] = 13.72); partners were primarily female (mean age = 63.00, SD = 12.73). Feasibility findings were mixed with over half of the eligible couples randomized, but only 67% of TCU couples completed the post-test. Acceptability of the TCU program was strong for both adults with heart failure and their partners. Recommendations for change focused on shortening session length, offering fewer sessions, and providing alternative modes of delivery. Exploratory between-group analyses found medium effect sizes for physical and mental health and dyadic management for both members of the couple, with many effects remaining 3 months later.
Discussion and implications: Findings suggest the TCU program is acceptable to couples with heart failure and shows promise for optimizing outcomes. Recommendations and strategies for improving retention and a more diverse sample are discussed.
背景和目的:尽管心力衰竭对护理双元组的两个成员都有重大影响,但很少有干预措施关注于优化双元组的健康。本研究探讨了新型“照顾我们”(Taking Care of Us, TCU)计划在中老年心力衰竭夫妇中的可行性和可接受性,并探讨了初步疗效。研究设计和方法:美国国立卫生研究院一期研究采用两组随机对照试验,采用前测后测设计和额外的5个月随访,比较TCU与教育咨询注意控制条件。37对夫妇随机分为TCU组(18对)和教育对照组(19对)。两个项目的交付时间都超过了2个月。结果:成人心力衰竭患者以男性为主(平均年龄66.32岁,标准差[SD] = 13.72);伴侣以女性为主(平均年龄63.00,SD = 12.73)。可行性调查结果与超过一半的符合条件的夫妇随机混合,但只有67%的TCU夫妇完成了后测试。对于心力衰竭的成年人和他们的伴侣来说,TCU计划的可接受性很强。变革的建议集中在缩短会议长度,提供更少的会议,并提供替代的交付模式。探索性组间分析发现,对夫妻双方的身心健康和二元管理有中等影响,3个月后仍有许多影响。讨论和意义:研究结果表明,TCU计划对心力衰竭夫妇是可接受的,并显示出优化结果的希望。讨论了提高保留率和更多样化样品的建议和策略。临床试验注册:NCT04737759。
期刊介绍:
Innovation in Aging, an interdisciplinary Open Access journal of the Gerontological Society of America (GSA), is dedicated to publishing innovative, conceptually robust, and methodologically rigorous research focused on aging and the life course. The journal aims to present studies with the potential to significantly enhance the health, functionality, and overall well-being of older adults by translating scientific insights into practical applications. Research published in the journal spans a variety of settings, including community, clinical, and laboratory contexts, with a clear emphasis on issues that are directly pertinent to aging and the dynamics of life over time. The content of the journal mirrors the diverse research interests of GSA members and encompasses a range of study types. These include the validation of new conceptual or theoretical models, assessments of factors impacting the health and well-being of older adults, evaluations of interventions and policies, the implementation of groundbreaking research methodologies, interdisciplinary research that adapts concepts and methods from other fields to aging studies, and the use of modeling and simulations to understand factors and processes influencing aging outcomes. The journal welcomes contributions from scholars across various disciplines, such as technology, engineering, architecture, economics, business, law, political science, public policy, education, public health, social and psychological sciences, biomedical and health sciences, and the humanities and arts, reflecting a holistic approach to advancing knowledge in gerontology.