(Press-News.org) Three West Virginia University nursing faculty know firsthand the difficulties faced by family caregivers and their chronically ill loved ones.
With a $2.7 million award from the National Institutes of Health’s National Institute of Nursing Research that is one of the largest ever for the WVU School of Nursing, the faculty researchers aim to support these families while increasing access to care in the rural reaches of the Mountain State by testing an integrated, nurse-led intervention for family home care management of end-stage heart failure and palliative care.
“We want to know if there’s a way we can help relieve the suffering for these individuals and how we can support family caregivers,” said Ubolrat “Diu” Piamjariyakul, associate dean for research and associate professor in the WVU School of Nursing and principal investigator for the study. “We will evaluate a combination of evidence-based nursing interventions that have proven effective in palliative home care.”
The project resonates professionally and personally for Piamjariyakul and colleagues Stephanie Young, clinical assistant professor in the Family/Community Health Department, and Angel Smothers, associate dean of community engagement and clinical associate professor. All three have served as primary caregivers in the homes of their chronically ill family members.
Through their lived experiences, as well as their previous studies using nursing science to develop and test nurse-led interventions, the three said they hope to improve family caregivers’ and their loved ones’ overall health and well-being, including reducing depression and anxiety, and monitoring and managing end-of-life symptoms.
“That’s what drives us to this type of project because we want the result to be meaningful and improve the health of others who have similar experiences,” Piamjariyakul said.
Piamjariyakul’s previous research tested interventions supporting quality of life improvements for individuals experiencing lung disease and heart failure, as well as effects on their caregivers. The current clinical trial brings together those intervention components and tests the sustainability of the interventions by incorporating a volunteer visitor program and faith community nurses.
The volunteer visitor component utilizes trained, nonclinical community volunteers to help reinforce health care plans and help family members connect with local resources. These volunteers also work in tandem with faith community nurses, who are registered nurses with additional training to improve access to care in their communities.
Smothers, who grew up in the southern coalfields of West Virginia, has observed how the lack of access to health care in rural areas has contributed to poor health outcomes.
“In the rural parts of West Virginia, many families can’t connect with health care specialists,” Smothers said. “This clinical trial is designed to equip families with the skills they need to have palliative care at home and learn how to connect with available resources, like hospice.”
Young explained that caregiver burden is widely recognized, and research has shown those individuals have higher mortality and morbidity rates than their non-caregiving peers.
“Although caregivers are happy to take care of their loved ones, oftentimes it’s 24/7 work and it can be hard, depending on the needs,” Young said. “It’s not just home health care. It can be shopping, taking care of finances and hygiene. It’s important to address caregiver burden for these families because when the caregiver is in a better place, health outcomes are better for the patient.”
Researchers have collaborated with others from throughout the University, including physicians and biostatisticians in the WVU School of Medicine and health economists in the WVU School of Public Health.
Across the four-year study, the primary goal is improving the quality of life and well-being of the patients and their caregivers. Additionally, the study will track hospitalization rates and positively impacted health outcomes. The researchers also plan to help patients and their families gain a better understanding of end-of-life care.
“Because of the personal nature of end-of-life care, some people only discuss this within their family,” Piamjariyakul said. “But if we at least know they’re talking about it, that is a positive step. Patients should have a say in the type of care they want to receive before they are unable to speak for themselves.”
Student nurses will work with the project as research assistants and will have the opportunity to shadow faith community nurses during home visits. “This will be a new set of skills that students will learn and apply for other chronic illness conditions,” Piamjariyakul said.
Although the current intervention focuses on patients with heart failure, a common disease in West Virginia, it could also potentially be adapted for patients with other chronic illnesses.
END
WVU nursing faculty aim to enhance rural home care for chronically ill through NIH award
2025-02-27
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