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Telephone Assessment and Skill-Building Kit for Stroke Caregivers: A Randomized Controlled Clinical Trial
Tamilyn Bakas1, Joan K Austin2, Barbara Habermann2
1From the Indiana University School of Nursing, Indianapolis (T.B., J.K.A., S.M.M.); University of Cincinnati College of Nursing, OH (T.B.); College of Health Sciences, University of Delaware, Newark (B.H.); Indiana University Melvin and Bren Simon Cancer Center, Indianapolis (N.M.J.); School of Nursing, University of Washington, Seattle (P.H.M.); Indianapolis Economics Department, Indiana University Purdue University (G.M.); Richard M. Fairbanks School of Public Health, Indianapolis, IN (Z.Y., T.E.S.); and College of Nursing, University of Florida, Gainesville (M.T.W.). tamilyn.bakas@uc.edu.
Background And Purpose:
There are few evidence-based programs for stroke family caregivers postdischarge. The purpose of this study was to evaluate efficacy of the Telephone Assessment and Skill-Building Kit (TASK II), a nurse-led intervention enabling caregivers to build skills based on assessment of their own needs.
Methods:
A total of 254 stroke caregivers (primarily female TASK II/information, support, and referral 78.0%/78.6%; white 70.7%/72.1%; about half spouses 48.4%/46.6%) were randomized to the TASK II intervention (n=123) or to an information, support, and referral group (n=131). Both groups received 8 weekly telephone sessions, with a booster at 12 weeks. General linear models with repeated measures tested efficacy, controlling for patient hospital days and call minutes. Prespecified 8-week primary outcomes were depressive symptoms (with Patient Health Questionnaire Depressive Symptom Scale PHQ-9 ≥5), life changes, and unhealthy days.
Results:
Among caregivers with baseline PHQ-9 ≥5, those randomized to the TASK II intervention had a greater reduction in depressive symptoms from baseline to 8, 24, and 52 weeks and greater improvement in life changes from baseline to 12 weeks compared with the information, support, and referral group (P<0.05); but not found for the total sample. Although not sustained at 12, 24, or 52 weeks, caregivers randomized to the TASK II intervention had a relatively greater reduction in unhealthy days from baseline to 8 weeks (P<0.05).
Conclusions:
The TASK II intervention reduced depressive symptoms and improved life changes for caregivers with mild to severe depressive symptoms. The TASK II intervention reduced unhealthy days for the total sample, although not sustained over the long term.
Clinical Trial Registration:
URL: https://www.clinicaltrials.gov. Unique identifier: NCT01275495.
