Abstract
Objectives
The Helping Invested Families Improve Veterans’ Experiences Study (HI-FIVES) evaluated a skills training program to support family caregivers of cognitively or functionally impaired persons. HI-FIVES demonstrated sustained improvements in caregivers’ and patients’ experiences of VA care. The aim of this distinct, secondary qualitative study was to explore the potential processes related to the individual tailored skills-based telephone training underpinning HI-FIVES intervention effects. We explored topics caregivers selected, characteristics of action items created, patterns of action or inaction, and barriers to action item completion across topics.
Methods
Qualitative data was analysed from 118 dyads randomized into the HI-FIVES intervention which included three weekly facilitated training calls covering five education topics and action items developed by caregivers for each topic. Qualitative analysis of text responses to questions from the training calls was used.
Results
Three of the top four most selected topics were caregiver-oriented and caregivers created an action item most often for self-care topics. Caregiver-oriented topics also had the highest action item completion rates. The majority of action items created met SMART guidelines for goal setting and simple structure. With regard to barriers to action item completion, caregivers commonly reported still contemplating/pending.
Conclusion
Our findings identify motivational interviewing as an effective technique to identify critical intervention content and address barriers to achieving caregiving goals. We suggest that caregivers felt more empowered to create and complete an action item when they had more control over completing the action item, such as in topics related to their own self-care.
Acknowledgements
We thank the other authors on the main HI-FIVES study paper: Valerie A. Smith, Jennifer H. Lindquist, Cristina Hendrix, Susan N. Hastings, Eugene Oddone, and Morris Weinberger. We also thank the members of the study’s advisory board: Peggy Becker, Dayna Cooper, Darlene Davis, Thomas Edes, Margaret Kabat, Christy Knight, Jennifer Martindale-Adams, Linda Nichols, Kenneth Shay, Scott Trudeau, and Laura Wray. We thank our interventionist, Shirley Barnhart, and Josh D'Adolf who taught class 4 from the VA Caregiver Support Program. We thank Laurie Marbrey our research assistant who provided high quality data collection and was a valuable team member. We sincerely thank the caregivers and Veteran patients who participated in the study. We also wish to acknowledge Karen Staman, Senior Science Writer at CHB Wordsmith and for the Duke University School of Medicine Department of Population Health, for her editorial support on this particular manuscript.
Disclaimer
The content is solely the responsibility of the authors and does not necessarily reflect the position or policy of the U.S. Department of Veterans Affairs, U.S. government, or Duke University.
Disclosure statement
No potential conflict of interest was reported by the authors.