Four million Americans live with after-effects of stroke. There are 700,000 new survivors of stroke each year with an average duration of life that exceeds 5 years at a cost of 30 billion dollars annually. Most persons surviving a stroke return home after initial rehabilitation treatment and are cared for by family members, usually women. The profound changes that can accompany stroke create considerable challenges for those individuals and their families. For urban caregivers, these problems with caring are magnified due to limited resources and support. No published studies have, as yet, focused on Web-based interventions directed at providing resources for caregivers of persons with stroke. Using Friedemann's Framework of Systemic Organization as a guide, this current study will investigate outcomes of the Caring web : a Web-based, in-home intervention of support for caregivers of persons with stroke during the first year after rehabilitation treatment at two urban hospitals. The primary aim of the study is to examine if the Caring web can: 1) improve the caregiver's well being, e.g. perceived depression and life satisfaction and 2) reduce the care recipient's use of healthcare services, e.g. emergency department and healthcare provider calls and visits, and hospital readmission and nursing home placement rates. A secondary aim of the study is to describe the caregiver's experience of caring; that is, problems and successes the caregiver encounters. One hundred twenty caregivers will be selected and randomized into two groups [60 Web users and 60 non-Web users]. The experimental group will have WebTV or an Internet connection installed in their homes and will be given access to the Caring web with Web pages specifically designed for this project. Through these pages, caregivers will be able to ask questions of a nurse specialist and rehabilitation team members, discuss issues with other caregivers and health professionals via e-mail, and obtain educational information on stroke and issues of caring. All caregivers will complete a brief, information form bi-monthly for healthcare service use and the experience of caring and asked additional questions quarterly for measures of well being. The Web and non-Web user's well being will be compared and differences between groups over time will be analyzed using a repeated measures ANOVA. Changes in the care recipients' use of healthcare services will be examined using a generalized estimating equation model. The experience of caring for all caregivers will be analyzed using Colaizzi's rigorous method for qualitative data analysis. Study outcomes have the potential to direct healthcare professionals in designing programs of care for persons with stroke and their caregivers.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Research Project (R01)
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Nursing Research Study Section (NURS)
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Phillips, Janice
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University of Toledo
Schools of Nursing
United States
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Pierce, Linda L; Steiner, Victoria; de Dios, Ann Margaret Vergel et al. (2015) Qualitative analysis of a nurse's responses to stroke caregivers on a web-based supportive intervention. Top Stroke Rehabil 22:152-9
Pierce, Linda L; Steiner, Victoria (2013) Usage and design evaluation by family caregivers of a stroke intervention web site. J Neurosci Nurs 45:254-61
Pierce, Linda L; Thompson, Teresa L; Govoni, Amy L et al. (2012) Caregivers' incongruence: emotional strain in caring for persons with stroke. Rehabil Nurs 37:258-66
Pierce, Linda L; Steiner, Victoria; Smelser, Juli (2009) Stroke caregivers share ABCs of caring. Rehabil Nurs 34:200-8
Steiner, Victoria; Pierce, Linda L; Windnagel, Felicia et al. (2009) The impact of a web-based caregiver intervention on the reasons stroke survivors use health care services during the first year post treatment. Top Stroke Rehabil 16:122-32
Pierce, Linda L; Steiner, Victoria; Pitzen, Heidi et al. (2009) Caregivers' experience: bimonthly participation in a year-long research interview process. J Neurosci Nurs 41:225-32
Pierce, Linda L; Steiner, Victoria L; Khuder, Sadik A et al. (2009) The effect of a Web-based stroke intervention on carers' well-being and survivors' use of healthcare services. Disabil Rehabil 31:1676-84
Steiner, Victoria; Pierce, Linda; Drahuschak, Sean et al. (2008) Emotional support, physical help, and health of caregivers of stroke survivors. J Neurosci Nurs 40:48-54
Pierce, Linda L; Steiner, Victoria; Havens, Heidi et al. (2008) Spirituality expressed by caregivers of stroke survivors. West J Nurs Res 30:606-19
Pierce, Linda L; Steiner, Victoria; Govoni, Amy et al. (2007) Two sides to the caregiving story. Top Stroke Rehabil 14:13-20

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