This longitudinal study examines family caregiving to recently-impaired older persons from the perspective of role theory. The long-term goal of this project, and a second project to be proposed at a later date, is to develop and test nursing intervention strategies to prevent or decrease family caregiver role strain, and prolong family care-giving. This proposed project has four specific aims: 1) to determine the effects of an integrated system of caregiver relief (case management, day and respite care services, and in-home services) on family caregiver role strain, duration of caregiving and utilization of services by recently-impaired older persons and the family caregivers, 2) to determine the extent to which the effectiveness of caregiver relief services varies with variation in individual and family characteristics, 3) to examine selected theoretical relationships among family caregiving concepts, and 4) to improve the measurement and longitudinal analysis of the family caregiving variables. The study will use a sample of 116 family caregiving dyads (impaired older person and family caregiver) in which the older person has recently become functionally impaired. Half (N=58) of the impaired older persons will members of Medicare Plus, a Medicare experiment of the Health Services Research Center (HSRC) of the Kaiser Permanente Medical Care Program (KPMCP), which offers health maintenance organization benefits to an over 65 years of age population, but does not offer an organized system of caregiver relief. Half (N=58) of the impaired older persons will be members of the KPMCP HSRC Medicare Plus II project, which offers an organized system of caregiver relief in addition to the standard health maintenance benefits. The study uses correlational and quasi-experimental designs to address the four aims. Data will be obtained from KPMCP records and interviews. Interview data will be collected from the impaired person six weeks and one year after hospital discharge following the illness event. Interview data will be collected from the family caregiver six weeks, six months and one year after the impaired person's hospital discharge. Treatment effects in the Medicare Plus and Plus II samples will be analyzed using analysis of variance and covariance, including repeated measures procedures. Regression analysis will be used to evaluate the contribution of subject/dyad variation on study outcomes. The analysis of the relationship between selected caregiving variables will be done using Pearson correlational procedures.
| Harvath, T A; Archbold, P G; Stewart, B J et al. (1994) Establishing partnerships with family caregivers. Local and cosmopolitan knowledge. J Gerontol Nurs 20:29-35;quiz 42-3 |
