Comparison of the sustainability of the impact of healthcare professionals′ training in two approaches to serious illness con
Notice bibliographique
Résumé
Advance Care Planning is essential for patients with serious illnesses. A trial of the Serious Illness Care Program compared two approaches to Advance Care Planning, interprofessional and individual. We therefore compared how the two approaches affected the burden of care of family caregivers of patients with serious illnesses. We conducted a secondary post-intervention analysis of a cluster randomized controlled trial in the USA and Canada. Primary care practices were randomized to an interprofessional team-based training arm or an individual clinician-focused training. Primary care professionals were trained in the two Serious Illness Care Program approaches. Patients with serious illnesses cared for by each group were invited to refer their family caregivers. We used the Zarit Burden Interview (range: 0-48) to assess the caregiver burden immediately after intervention (T1), six months (T2) and 12 months after (T3). Statistical analysis using linear mixed model were performed to compare caregiver burden between the two arms at the three times. We included 192 family caregivers. Most were female (67.8%); aged from 65-74 (28.6%). The mean caregiver burden scores were low at the three times in both the interprofessional (T1: 11.3 ± 8.5; T2: 9.1 ± 6.8; T3: 9.9 ± 8.3) and the individual arm (T1: 10.8 ± 9.0; T2: 10.1 ± 8.2; T3: 9.2 ± 8.0). The difference in mean burden between the two study arms was 1.05 (95% CI -1.47 to 3.59; p=0.40), -0.24 (95% CI -2.57 to 2.08; p=0.82), and 0.09 (95% CI -2.61 to 2.81; p=0.94) at T1, T2 and T3 respectively. The p-value of interaction term between study arm and time was p=0.47. Mean difference between arms after performing a model with time effect was -0.16 (95% CI -2.32;2.00; p=0.88). After adjusting, the mean difference between arms was 0.90 (95% CI -0.76;2.57; p=0.28). There were no statistically significant differences in the perceived level of caregiver burden between the two arms. However, some factors were associated with higher caregiver burden (patient’s presence in emergency in past six months; caregiver feeling anxious and depressed, and others were associated with lower burden (an optimal caregiver overall mental health and having a social life. Intervention didn’t have an impact on the caregiver burden. There was no difference between the perceived caregiver burden in the two arms. Our study highlights the importance of recognizing diverse factors influencing caregiver well-being.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,013 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».