Clinical Outcomes of VideoPhone Intervention


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Clinical Outcomes of VideoPhone Intervention

  1. 1. A Videophone Intervention with Hospice Caregivers: Clinical Outcomes Debra Parker Oliver, MSW, PhD George Demiris, PhD Brian Hensel, PhD
  2. 2. Acknowledgements <ul><li>This project was made possible through the funding of the John A Hartford Social Work Faculty Scholars Grant 2004-2006 </li></ul>
  3. 3. Background <ul><li>Family members and friends are essential caregivers for Hospice patients </li></ul><ul><li>These persons often suffer adverse effects </li></ul><ul><li>On the average they spend more than 6 hours a day assisting with care </li></ul><ul><li>Those caring for a dying person have even higher demands </li></ul><ul><li>65% of hospice caregivers are over 75yrs </li></ul>
  4. 4. Purpose <ul><li>Purpose of this study was to test the usefulness of videophones a a communication tool in hospice and gather data related to hospice caregiver anxiety and quality of life </li></ul><ul><li>Hypothesis: Videophones are a feasible tool for service delivery and allow development of an effective low cost intervention that can decrease caregiver anxiety and improve quality of life </li></ul>
  5. 5. Methods <ul><li>Setting: 2 Rural hospice agencies in Missouri </li></ul><ul><li>Videophones installed- as a Supplement to traditional care- not a replacement </li></ul><ul><li>Caregivers contacted every 2 weeks using videophone and asked instrument questions </li></ul>
  6. 6. Instruments <ul><li>CQLI-R; self report 4 question instrument using a 1-10 scale </li></ul><ul><li>S-Anxiety; self report instrument measuring caregiver anxiety- 20 item with 1-4 rating </li></ul><ul><li>Research Asst journal notes and observations </li></ul>
  7. 7. Findings <ul><li>N=12 in two sites over 18 months data collection </li></ul><ul><li>10 subjects had multiple measures </li></ul><ul><li>1 subject only had admission data </li></ul><ul><li>1 subject had 2 measures- withdrew after 4 weeks </li></ul>
  8. 8. Findings <ul><li>Findings indicated that anxiety score decreased after use of the videophone despite the continued decline of the patient </li></ul><ul><li>Quality of life scores did not change significantly </li></ul>
  9. 9. Findings <ul><li>Most valuable data were journal notes of RA </li></ul><ul><ul><li>Caregivers willing to participate </li></ul></ul><ul><ul><li>Caregivers flexible in problem solving technical issues </li></ul></ul><ul><ul><li>Caregivers perceive technology as useful communication tool </li></ul></ul><ul><ul><li>Caregivers reported technology provided ease of mind </li></ul></ul>
  10. 10. Findings <ul><li>Staff perceived that caregivers in the study called less frequently after hours. </li></ul><ul><li>Caregivers had very positive perceptions of technology- and saw benefit from visual feedback </li></ul><ul><li>Technology seen as user-friendly </li></ul><ul><li>Only isolated cases of technical problems </li></ul><ul><li>Staff reluctant to refer- Gate-keeping </li></ul><ul><ul><li>Different between programs </li></ul></ul>
  11. 11. Conclusions <ul><li>S-Anxiety and CQLI-R were useful tools with this type of study and population and indicate larger study could be beneficial </li></ul><ul><li>Coping may be another item that is worthy of being measured </li></ul><ul><li>Videophones are feasible tool and may be a delivery mechanism for further clinical interventions </li></ul>
  12. 12. Plans <ul><li>Current NCI funded study to use technology to bring caregivers into hospice interdisciplinary team meetings </li></ul><ul><li>Proposed study to deliver nursing and social work educational interventions for caregivers over the videophone </li></ul>
  13. 13. References <ul><li>Demiris, G; Parker Oliver, D ; Courtney, K; Day, M. (In Press) Use of Telehospice Tools for Senior Caregivers: A Pilot Study. Clinical Gerontologist </li></ul><ul><li>Day, M., Demiris, G., Parker Oliver, D . (2007) Exploring Underutilization of Videophones in Hospice Settings. Telemedicine and E health , 13(1)25-31. </li></ul><ul><li>Demiris, G; Parker Oliver, D ; Courtney, K. (2006). A study of the suitability of videophones for psychometric assessment. Behaviour and Information Technology , 25(3) 233-237. </li></ul><ul><li> </li></ul>