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

Abstract

ObjectiveTo 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. DesignIn this single group pre-post intervention pilot feasibility study. SettingInpatient rehabilitation or acute care and community. ParticipantsCare 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). InterventionPST 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 MeasuresWe 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. ResultsOf 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. ConclusionsDelivering 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.