Effectiveness of a home-based nursing support and cognitive restructuring intervention on the quality of life of family caregivers in primary care: A pragmatic cluster-randomized controlled trial
Autor: | Petra García-Sanz, Mercedes Araujo-Calvo, Esperanza Escortell-Mayor, Juan A. López-Rodríguez, Soledad Frías-Redondo, Isabel Del Cura-Gonzalez, Teresa Sanz-Cuesta, Milagros Rico-Blázquez, Araceli Rivera-Álvarez, María Martín-Martín, Mariel Morey-Montalvo |
---|---|
Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Visual analogue scale Cost-Benefit Analysis Psychological intervention law.invention 03 medical and health sciences 0302 clinical medicine Cognition Randomized controlled trial Quality of life law Intervention (counseling) medicine Humans 030212 general & internal medicine General Nursing 030504 nursing Primary Health Care business.industry Family caregivers Cognitive restructuring Caregivers Physical therapy Quality of Life Health education 0305 other medical science business |
Zdroj: | International journal of nursing studies. 120 |
ISSN: | 1873-491X |
Popis: | Background Caregivers of patients with chronic conditions or disability experience fatigue, burden and poor health-related quality of life. There is evidence of the effectiveness of support interventions for decreasing this impact. However, little is known about the benefits of home-based nursing intervention in primary health care. Objectives To evaluate the effectiveness of a home-based, nurse-led-intervention (CuidaCare) on the quality of life of caregivers of individuals with disabilities or chronic conditions living in the community, measured at 12-month follow-up. Methods A pragmatic, two-arm, cluster-randomized controlled trial with a 1-year follow-up period was performed between June 2013 and December 2015. Consecutive caregivers aged 65 years or older, all of whom assumed the primary responsibility of caring for people with disabling conditions for at least 6 months a year, were recruited from 22 primary health care centers. Subsequently, 11 centers were randomly assigned to usual care group, and 11 were assigned to the intervention group. The caregivers in the intervention group received the usual care and additional support (cognitive restructuring, health education and emotional support). The primary outcome was quality of life, assessed with the EQ-5D instrument (visual analog scale and utility index score); the secondary outcome variables were perception of burden, anxiety, and depression. Data were collected at baseline, at the end of the intervention, and at the 6- and 12-month follow-up visits. We analyzed the primary outcome as intention-to-treat, and missing data were added using the conditional mean single imputation method. Results A total of 224 caregivers were included in the study (102 in the intervention group and 122 in the usual care group). Generalized Estimating Equation models showed that the CuidaCare intervention was associated with a 5.46 point (95% CI: 2.57; 8.35) change in the quality of life, as measured with the visual analog scale adjusted for the rest of the variables at 12 months. It also produced an increase of 0.04 point (95% CI: 0.01; 0.07) in the utilities. No statistically significant differences were found between the two groups at 12 months with respect to the secondary outcomes. Conclusions The findings suggest that incorporating a home-based, nurse-led-intervention for caregivers into primary care can improve the health-related quality of life of caregivers of patients with chronic or disabling conditions. |
Databáze: | OpenAIRE |
Externí odkaz: |