Feasibility Study of Problem-Solving Training for Care Partners of Adults With Traumatic Brain Injury, Spinal Cord Injury, Burn Injury, or Stroke During the Inpatient Hospital Stay

Shannon B Juengst; Candice L Osborne; Radha Holavanahalli; Valeria Silva; Chung Lin Kew; Andrew Nabasny; Kathleen R Bell

doi:10.1016/j.arrct.2019.100009

Feasibility Study of Problem-Solving Training for Care Partners of Adults With Traumatic Brain Injury, Spinal Cord Injury, Burn Injury, or Stroke During the Inpatient Hospital Stay

Arch Rehabil Res Clin Transl. 2019 Jun 27;1(3-4):100009. doi: 10.1016/j.arrct.2019.100009. eCollection 2019 Dec.

Authors

Shannon B Juengst^{1

2}, Candice L Osborne¹, Radha Holavanahalli¹, Valeria Silva¹, Chung Lin Kew^{1

2}, Andrew Nabasny^{1

2}, Kathleen R Bell¹

Affiliations

¹ Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas.
² Department of Rehabilitation Counseling, University of Texas Southwestern Medical Center, Dallas, Texas.

Abstract

Objective: To determine the feasibility of delivering an evidence-based self-management intervention, problem-solving training (PST), to care partners of individuals with traumatic brain injury (TBI), spinal cord injury (SCI), burn injury, or stroke during the inpatient hospital stay.

Design: In this single group pre-post intervention pilot feasibility study.

Setting: Inpatient rehabilitation or acute care and community.

Participants: Care partners (spouse or partner, family member, friend who is in any way responsible for the health or well-being of the care recipient) of individuals with TBI, SCI, burn injury, or stroke (N=39).

Intervention: PST is a metacognitive self-management intervention that teaches individuals a global strategy for addressing self-selected problems. Participants received up to 6 sessions of PST in person or via telephone during their care recipient's inpatient stay.

Main outcome measures: We measured feasibility of recruitment, intervention delivery, and postintervention use of a smartphone app (Care Partner Problem Solving [CaPPS]) and participant satisfaction (Client Satisfaction Questionnaire [CSQ]) and engagement (Pittsburgh Rehabilitation Participation Scale [PRPS]) with the intervention.

Results: Of 39 care partners approached, n=10 (25.6%) were ineligible. Of n=29 (74.4%) who were eligible, n=17 (58.6%) refused, and n=12 (41.4%) consented, of whom n=8 (66.7%) completed ≥3 PST sessions. Not perceiving any benefit was the most common reason for refusal, followed by no interest in research. Participants were very satisfied with PST (CSQ mean=3.35, SD=0.60), reported strong working alliance (Working Alliance Inventory mean=6.8, SD=3.1), and demonstrated very good engagement (PRPS mean=4.75, SD=1.41). CaPPS was downloaded and used by only n=3 participants.

Conclusions: Delivering a self-management intervention to care partners during the care recipient's acute hospital stay is feasible for a subset of potential participants. Short lengths of stay, language fluency, and perceiving no potential benefit were noted barriers. Boosters via smartphone app have potential, but several barriers must first be overcome.

Keywords: Brain injury; Burns; CSQ, Client Satisfaction Questionnaire; CaPPS, Care Partner Problem Solving; Caregiver; PRPS, Pittsburgh Rehabilitation Participation Scale; PST, problem-solving training; Rehabilitation; SCI, spinal cord injury; Self-management; Spinal cord injury; Stroke; TBI, traumatic brain injury; WAI, Working Alliance Inventory.

Abstract

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