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| Vol. 23, No. 18 |
| October 1, 2001 |
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Collaborative Study Aims to Help Stroke Survivors and Spousal Caregivers By PAMELA LEWIS Health Science Center at Houston Stroke survivors used to spend days, weeks or months in rehabilitation. Today, cuts in dollars available for rehabilitation result in patients being sent home much more quickly with less discharge preparation for the caregiver and the person who had the stroke, said Dr. Sharon Ostwald, who is also a registered nurse and the Isla Carroll Turner Chair in Gerontological Nursing and director of the Center on Aging of The University of Texas Health Science Center at Houston.
"The 570,000 stroke survivors each year are often left with devastating physical, psychosocial and cognitive disabilities that affect their daily activities and decision making," said Dr. Ostwald. "So, the spouse frequently has to deal with household duties, care for a formerly vibrant spouse who may now be both mentally and physically handicapped, and keep up with various rehabilitation appointments and medications."
Not surprisingly, she said, caregiving spouses frequently experience prolonged stress that affects their own psychological and physical well being, including depression and immune system imbalances. That's where Dr. Ostwald's new research study comes in.
"CARES: Committed to Assisting with Recovery after Stroke" is an interdisciplinary and inter-institutional research study funded by a $2,226,000 grant from the National Institute of Nursing Research to test ways to help ease this home healthcare burden.
"Recovery from a stroke can go on for at least a year," Dr. Ostwald said.
The study will provide education, support, skill training, and social and community links to stroke survivors and their spouses for the first six months immediately following hospital discharge, the period when stroke survivors have the most potential for improvement - which is also the time spousal caregivers experience the highest level of stress.
The randomized intervention study will compare stroke survivors and their spouses who receive the interventions at home with a control group of stroke survivors and spouses receiving only written information by mail. Both groups will receive usual care from their health care providers.
Participants for the study will be recruited from the Memorial Hermann Healthcare System, the Houston Veterans Affairs Medical Center and The Institute for Rehabilitation and Research. They are expected to be representative of the Houston-area's ethnically diverse population.
The 24 weekly interventions over the first six months following discharge will include in-home and telephone contacts by an advanced nurse practitioner and an occupational therapist. Occupational, physical and speech therapists will work with the study participants as needed.
"The intervention is unique in the number and length of family contact and the use of a rehabilitation team. No other studies have correlated immune function in caregivers of stroke survivors with other self-report and observational data," Dr. Ostwald said.
Improving stroke survivors' function, quality of life and perceived health, decreasing depression, reducing unplanned emergency room visits, re-hospitalizations and nursing home admissions, and decreasing spousal caregivers' depression, burden and stress are the study's aims, said Dr. Ostwald, while improving health, and decreasing cytokine imbalances related to caregiving spouse's chronic stress.
UT-Houston co-investigators on the study are Drs. James Turley, associate dean for research, University of Texas School of Health Information Sciences at Houston (database integrity); Gailen Marshall, associate professor in allergy and clinical immunology, Medical School (correlating immune system levels with times of stress); and Paul Swank, professor in developmental pediatrics, University of Texas Medical School at Houston (statistical analysis).
Co-investigators from other health care institutions are Dr. Susan Robinson-Whelan, psychologist, Baylor College of Medicine and the Veterans' Medical Affairs Center; and Dr. Gayle Hersch, occupational therapy, and Carolyn Kelley, occupational therapist, both from Texas Woman's University.
The three consultants who will provide specialized information are Dr. Elizabeth Protas, TWU; and from Baylor, Dr. Trilok Monga, physical medicine, and Carol Stach, speech therapist.
©2006 Texas Medical Center E-Mail: tmcinfo@texmedctr.tmc.edu URL: http://www.tmc.edu/tmcnews/10_01_01/page_29.html |