Comparison of two psycho-educational family group interventions for improving psycho-social outcomes in persons with spinal cord injury and their caregivers: a randomized-controlled trial of multi-family group intervention versus an active education control condition.

Dennis G Dyck,Aimee J Wallace,Crystal Lederhos Smith,Douglas L Weeks,Sarah Gross,Hilary A Lott,Sonya M Wood

doi:10.1186/s40359-016-0145-0

Dennis G Dyck, Aimee J Wallace + Show 5 more

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https://doi.org/10.1186/s40359-016-0145-0

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Abstract

BackgroundOver 12,000 individuals suffer a spinal cord injury (SCI) annually in the United States, necessitating long-term, complex adjustments and responsibilities for patients and their caregivers. Despite growing evidence that family education and support improves the management of chronic conditions for care recipients as well as caregiver outcomes, few systematic efforts have been made to involve caregivers in psycho-educational interventions for SCI. As a result, a serious gap exists in accumulated knowledge regarding effective, family-based treatment strategies for improving outcomes for individuals with SCI and their caregivers. The proposed research aims to fill this gap by evaluating the efficacy of a structured adaptation of an evidence-based psychosocial group treatment called Multi-Family Group (MFG) intervention. The objective of this study is to test, in a randomized-controlled design, an MFG intervention for the treatment of individuals with SCI and their primary caregivers. Our central hypothesis is that by providing support in an MFG format, we will improve coping skills of persons with SCI and their caregivers as well as supportive strategies employed by caregivers.MethodsWe will recruit 32 individuals with SCI who have been discharged from inpatient rehabilitation within the previous 3 years and their primary caregivers. Patient/caregiver pairs will be randomized to the MFG intervention or an active SCI education control (SCIEC) condition in a two-armed randomized trial design. Participants will be assessed pre- and post-program and 6 months post-program. Intent to treat analyses will test two a priori hypotheses: (1) MFG-SCI will be superior to SCIEC for SCI patient activation, health status, and emotion regulation, caregiver burden and health status, and relationship functioning, and (2) MFG will be more effective for individuals with SCI and their caregivers when the person with SCI is within 18 months of discharge from inpatient rehabilitation compared to when the person is between 19 and 36 months post discharge.DiscussionSupport for our hypotheses will indicate that MFG-SCI is superior to specific education for assisting patients and their caregivers in the management of difficult, long-term, life adjustments in the months and years after SCI, with increased efficacy closer in time to the injury.Trial registrationClinicalTrials.gov NCT02161913. Registered 10 June 2014.

Highlights

Over 12,000 individuals suffer a spinal cord injury (SCI) annually in the United States, necessitating longterm, complex adjustments and responsibilities for patients and their caregivers
Support for our hypotheses will indicate that MultiFamily Group (MFG)-SCI is superior to specific education for assisting patients and their caregivers in the management of difficult, long-term, life adjustments in the months and years after SCI, with increased efficacy closer in time to the injury
This project will address this gap by conducting a randomized, controlled study to evaluate the effectiveness of the MFG intervention tailored for persons with SCI and their caregivers

Summary

Introduction

Over 12,000 individuals suffer a spinal cord injury (SCI) annually in the United States, necessitating longterm, complex adjustments and responsibilities for patients and their caregivers. The vast array of loss that ensues is life-shattering and includes loss of mobility, loss of functional abilities, changes in sensory and autonomic functioning, multisystem impairment, risk of serious secondary complications, and decrease in life expectancy [4, 5] Are those who experience SCI largely young–between the ages of 15 and 35 years– they are most frequently single young men [3, 4, 6] who find themselves unable to maintain employment [4] as a result of related disability [7] and suddenly dependent upon others for their care [8]. Each of these stressors contributes to extremely high levels of psychological distress and morbidity [8], including increased risk for substance abuse [11], decreased life satisfaction [12], decreased social integration, and increased loneliness [9, 10]

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