Effects of guided care on family caregivers

Research output: Contribution to journalArticle

Abstract

Purpose:Guided Care (GC) is a model of health care for multimorbid older adults that is provided by a registered nurse who works with the patients' primary care physician (PCP). The purpose of this study was to determine whether GC improves patients' primary caregivers' depressive symptoms, strain, productivity, and perceptions of the quality of care recipients' chronic illness care.Design and Methods:A cluster-randomized controlled trial of GC was conducted within 14 PCP teams. The study sample included 196 primary caregivers who completed baseline and 18-month surveys and whose care recipients remained alive and enrolled in the GC study for 18 months. Caregiver outcomes included the following: depressive symptoms (Center for Epidemiological Studies-Depression scale), strain (Modified Caregiver Strain Index), the quality of care recipients' chronic illness care [Patient Assessment of Chronic Illness Care (PACIC)], and personal productivity (Work Productivity and Activity Impairment questionnaire, adapted for caregiving).Results:In multivariate regression models, between-group differences in depression, strain, work productivity, and regular activity productivity were not statistically significant after 18 months, but GC caregivers reported the overall quality of their recipients' chronic illness care to be significantly higher (adjusted beta = 0.40, 95% confidence interval: 0.14-0.67). Quality was significantly higher in 4 of 5 PACIC subscales, reflecting the dimensions of goal setting, coordination of care, decision support, and patient activation.Implications:GC improved the quality of chronic illness care received by multimorbid care recipients but did not improve caregivers' depressive symptoms, affect, or productivity.

Original languageEnglish (US)
Pages (from-to)459-470
Number of pages12
JournalGerontologist
Volume50
Issue number4
DOIs
StatePublished - 2010

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Caregivers
Chronic Disease
Depression
Quality of Health Care
Patient Care
Primary Care Physicians
Patient Participation
Epidemiologic Studies
Randomized Controlled Trials
Nurses
Confidence Intervals
Delivery of Health Care
Surveys and Questionnaires

Keywords

  • Caregiving
  • Chronic disease
  • Guided Care
  • Nursing
  • Primary care

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Gerontology
  • Medicine(all)

Cite this

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title = "Effects of guided care on family caregivers",
abstract = "Purpose:Guided Care (GC) is a model of health care for multimorbid older adults that is provided by a registered nurse who works with the patients' primary care physician (PCP). The purpose of this study was to determine whether GC improves patients' primary caregivers' depressive symptoms, strain, productivity, and perceptions of the quality of care recipients' chronic illness care.Design and Methods:A cluster-randomized controlled trial of GC was conducted within 14 PCP teams. The study sample included 196 primary caregivers who completed baseline and 18-month surveys and whose care recipients remained alive and enrolled in the GC study for 18 months. Caregiver outcomes included the following: depressive symptoms (Center for Epidemiological Studies-Depression scale), strain (Modified Caregiver Strain Index), the quality of care recipients' chronic illness care [Patient Assessment of Chronic Illness Care (PACIC)], and personal productivity (Work Productivity and Activity Impairment questionnaire, adapted for caregiving).Results:In multivariate regression models, between-group differences in depression, strain, work productivity, and regular activity productivity were not statistically significant after 18 months, but GC caregivers reported the overall quality of their recipients' chronic illness care to be significantly higher (adjusted beta = 0.40, 95{\%} confidence interval: 0.14-0.67). Quality was significantly higher in 4 of 5 PACIC subscales, reflecting the dimensions of goal setting, coordination of care, decision support, and patient activation.Implications:GC improved the quality of chronic illness care received by multimorbid care recipients but did not improve caregivers' depressive symptoms, affect, or productivity.",
keywords = "Caregiving, Chronic disease, Guided Care, Nursing, Primary care",
author = "Jennifer Wolff and Giovannetti, {Erin R.} and Cynthia Boyd and Lisa Reider and Sara Palmer and Scharfstein, {Daniel O} and Marsteller, {Jill A} and Wegener, {Stephen T} and Katherine Frey and Leff, {Bruce A} and Kevin Frick and Chad Boult",
year = "2010",
doi = "10.1093/geront/gnp124",
language = "English (US)",
volume = "50",
pages = "459--470",
journal = "The Gerontologist",
issn = "0016-9013",
publisher = "Oxford University Press",
number = "4",

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TY - JOUR

T1 - Effects of guided care on family caregivers

AU - Wolff, Jennifer

AU - Giovannetti, Erin R.

AU - Boyd, Cynthia

AU - Reider, Lisa

AU - Palmer, Sara

AU - Scharfstein, Daniel O

AU - Marsteller, Jill A

AU - Wegener, Stephen T

AU - Frey, Katherine

AU - Leff, Bruce A

AU - Frick, Kevin

AU - Boult, Chad

PY - 2010

Y1 - 2010

N2 - Purpose:Guided Care (GC) is a model of health care for multimorbid older adults that is provided by a registered nurse who works with the patients' primary care physician (PCP). The purpose of this study was to determine whether GC improves patients' primary caregivers' depressive symptoms, strain, productivity, and perceptions of the quality of care recipients' chronic illness care.Design and Methods:A cluster-randomized controlled trial of GC was conducted within 14 PCP teams. The study sample included 196 primary caregivers who completed baseline and 18-month surveys and whose care recipients remained alive and enrolled in the GC study for 18 months. Caregiver outcomes included the following: depressive symptoms (Center for Epidemiological Studies-Depression scale), strain (Modified Caregiver Strain Index), the quality of care recipients' chronic illness care [Patient Assessment of Chronic Illness Care (PACIC)], and personal productivity (Work Productivity and Activity Impairment questionnaire, adapted for caregiving).Results:In multivariate regression models, between-group differences in depression, strain, work productivity, and regular activity productivity were not statistically significant after 18 months, but GC caregivers reported the overall quality of their recipients' chronic illness care to be significantly higher (adjusted beta = 0.40, 95% confidence interval: 0.14-0.67). Quality was significantly higher in 4 of 5 PACIC subscales, reflecting the dimensions of goal setting, coordination of care, decision support, and patient activation.Implications:GC improved the quality of chronic illness care received by multimorbid care recipients but did not improve caregivers' depressive symptoms, affect, or productivity.

AB - Purpose:Guided Care (GC) is a model of health care for multimorbid older adults that is provided by a registered nurse who works with the patients' primary care physician (PCP). The purpose of this study was to determine whether GC improves patients' primary caregivers' depressive symptoms, strain, productivity, and perceptions of the quality of care recipients' chronic illness care.Design and Methods:A cluster-randomized controlled trial of GC was conducted within 14 PCP teams. The study sample included 196 primary caregivers who completed baseline and 18-month surveys and whose care recipients remained alive and enrolled in the GC study for 18 months. Caregiver outcomes included the following: depressive symptoms (Center for Epidemiological Studies-Depression scale), strain (Modified Caregiver Strain Index), the quality of care recipients' chronic illness care [Patient Assessment of Chronic Illness Care (PACIC)], and personal productivity (Work Productivity and Activity Impairment questionnaire, adapted for caregiving).Results:In multivariate regression models, between-group differences in depression, strain, work productivity, and regular activity productivity were not statistically significant after 18 months, but GC caregivers reported the overall quality of their recipients' chronic illness care to be significantly higher (adjusted beta = 0.40, 95% confidence interval: 0.14-0.67). Quality was significantly higher in 4 of 5 PACIC subscales, reflecting the dimensions of goal setting, coordination of care, decision support, and patient activation.Implications:GC improved the quality of chronic illness care received by multimorbid care recipients but did not improve caregivers' depressive symptoms, affect, or productivity.

KW - Caregiving

KW - Chronic disease

KW - Guided Care

KW - Nursing

KW - Primary care

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U2 - 10.1093/geront/gnp124

DO - 10.1093/geront/gnp124

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