Maintaining and improving functional abilities are vital for the quality of life of older adults. In the United States, approximately 340,000 older adults experience hip fractures yearly, leading to increased mortality, prolonged disabilities, and subsequent hip fractures. Unlike other debilitating illnesses, however, hip fracture is an acute episode; with proper interventions, older adults can recover to their baseline. Moreover, a hip fracture can serve as a unique opportunity to prevent further disabilities through improving health behaviors and implementing environmental safety measures. Immediately after hip fracture, many older adults become more dependent on informal caregivers (e.g., family). The role of caregivers is particularly important during recovery because they are a significant source of motivation for older adults to follow their rehabilitation regimens and to improve their health behaviors. While extensive resources are available to the caregivers of persons with several debilitating illnesses (e.g., Alzheimer's disease), few resources are available to the caregivers of hip fracture patients. With the increasing number of online users, an online resource program could be an effective method for providing necessary support to these caregivers. In this R21 exploratory/ developmental application, the investigators propose a study that will (1) develop a theory-based Online Hip Fracture Resource Center (OHRC) for caregivers, and (2) test the feasibility of the OHRC intervention for a future randomized controlled trial (RCT) that will examine the effects of the program on both caregivers and patients. The OHRC is an 8-week program that includes self-learning modules, moderated discussion boards, Ask the Experts, and a virtual library. This study is innovative in that (1) the OHRC will be developed in conformance with two strong theories (i.e., the stress, appraisal, and coping theory/self-efficacy theory); and (2) it will focus on maximizing the care relationship in the caregiver-care recipient dyad, with the goals of providing support to caregivers and preventing further disabilities in hip fracture patients. Once the OHRC is developed, we will conduct a feasibility study on 33 caregiver-care recipient dyads with two data collection points (baseline, end- of-treatment [EOT, 8 wks]). The feasibility of the OHRC program will be assessed by the amount of usage, participant comments about the OHRC content and its usability. The feasibility of the OHRC protocol for the future trial will be assessed by implementing the protocol. The main analysis will be descriptive and content analysis. Additionally, we will compute inferential statistics for outcome measures piloted in this study to ascertain whether changes from baseline to the EOT assessment are statistically significant and to estimate an optimal sample size for the future trial. The findings will serve as preliminary work for the future RTC. If the OHRC proves effective, it can be used as a supplementary intervention for caregivers and patients. Moreover, the method used in the OHRC may serve as a model for other programs. This proposed study focuses on the use of an interactive online resource program for caregivers of older adults who have had a hip fracture, a debilitating injury. Through provision of specific information and psychosocial support, this program will help caregivers cope with caregiving situations and become a source of motivation and information for their care recipients to improve their recovery. Considering the increasing numbers of online users and the aging population, this innovative program has significant potential as a practical and accessible method to promote health in older adults and their caregivers and is a model for other online caregiver programs for older adults. ? ? ?
| Nahm, Eun-Shim; Resnick, Barbara; Plummer, Lisa et al. (2013) Use of discussion boards in an online hip fracture resource center for caregivers. Orthop Nurs 32:89-95; quiz 96-7 |
| Nahm, Eun-Shim; Resnick, Barbara; Orwig, Denise et al. (2012) A theory-based online hip fracture resource center for caregivers: effects on dyads. Nurs Res 61:413-22 |
| Nahm, Eun-Shim; Orwig, Denise; Resnick, Barbara et al. (2012) Recruitment of Older Adult Patient-Caregiver Dyads for an Online Caregiver Resource Program: Lessons Learned. Ageing Int 37:489-504 |
