Improving Caregiver Knowledge of Support Resources

During the veteran’s clinic appointment, the caregiver was given an implied consent letter, pre- and postquestionnaire forms, and a caregiver resource manual. The manual included information on caregiver support resources at the Durham VA Health Care System and in the community (eg, adult day care centers; home-based primary care, hospice care, skilled care, and telehealth; homemaker and home health aide programs; respite care). Other information was provided, such as the Caregiver Support Program application process, contact names, numbers, and helpful websites. Before reading the manual, participants completed the prequestionnaire form and returned it the day of the veteran’s visit. After reading the manual, the caregiver was instructed to complete the postquestionnaire form.

The project coordinator (PC) collaborated with the Veteran Health Education coordinator in developing the caregiver resource manual and questionnaires to ensure that the material met the requirements set forth by the educational program within the Durham VA Health Care System. The PC also collaborated with the Caregiver Support Program subject experts, the chief and acting assistant chief of social work when formulating the contents of the manual and questionnaires. The questionnaires were used to assess the effectiveness of the manual.

The 3 questions on the prequestionnaire and 3 questions on the postquestionnaire were geared to measure the caregiver’s knowledge. There also were 4 questions on the postquestionnaire that were used to address manual revisions.

On the prequestionnaire form, the following questions were asked: (1) If you needed to find caregiver support resources, how much knowledge do you have finding the resources that fit your needs as well as the veteran’s needs? (2) Rate how aware you are with knowing what caregiver support resources are available at the VA and within the community; and (3) Would knowing which caregiver support resources to choose from at the VA and within the community decrease your stress level and give you “peace of mind?”

The same questions were asked postintervention, and the participants were asked to rate their knowledge after reviewing the manual. The participant’s responses on the questionnaires were measured using a 5-point Likert scale.

Participant Demographics

Demographic information was obtained from the cover letter distributed to each participant. The demographic information included age, gender, relationship to the veteran, and number of years to date in the current caregiving role. Participants eligible for inclusion in this project were primary caregivers of veterans with disabilities from all eras of conflict, aged ≥ 18 years.

Fifteen caregivers participated by returning the cover letter containing the implied consent, reading the manual, and completing the pre- and postquestionnaires. There was a wide age range of caregivers who participated, from 29 to 77 years. Of those who responded, there also was a wide range in time in their current caregiving role, ranging from 1 to 41 years. The mean number of years in the current caregiving role was 7 years.

Of the 15 participants, most were female spouses. There were no husbands who participated. The relative’s category included a cousin, a son, and a daughter. The “other” category included a son-in-law and a fiancé.

Data Analysis

Both outcomes were measured using the responses from questions 1 through 3 with the use of running a descriptive statistical analysis. In addition, a t test was used to determine statistical significance, set at α level < .05 of knowledge increase from pre- to postintervention data. Based on the facility, educational benchmarks were set at 80% with the 80% equal to 4 on the Likert scale. Therefore, 80% was the identified benchmark for this project. The goal was that > 70% of the participants would score 80% or better on the postquestionnaire.

Results

Both outcomes were met: (1) increasing the caregiver’s knowledge regarding resources available at the VA and within the community to decrease caregiver burden; and (2) assisting the caregiver in deciding which caregiver resources located in the manual were the right fit for the caregiver and the veteran for whom they were caring. The percentage of participants who scored 80% or better on the prequestionnaire was 54% (n = 8). The postquestionnaire outcomes were considered an improvement based on caregiver’s knowledge of support resources as well as whether the information in the manual decreased their stress level and gave them peace of mind. The intended outcome for the postquestionnaire was that > 70% of the participants would score ≥ 80% after the intervention. This goal was met as final results revealed 73% (n = 11) of the participants scored > 80% on the postquestionnaire.

The postresults supported that caregivers’ knowledge increased, they had peace of mind, and stress levels were decreased with the use of an educational intervention, a comprehensive Caregiver Resource Manual. The postquestionnaire revealed that all of the participants found the Caregiver Resource Manual easy to navigate, and 93% of participants found the Caregiver Resource Manual useful. Out of 15 participants, 8 provided comments. Seven provided positive comments, reporting that the information in the manual was interesting, the manual was simple/easy to read, and the outside resources listed were helpful.

The participant who provided a negative comment was one of the caregivers who did not meet the benchmark of 80% on the pre- or postquestionnaire. The participant was a 33-year-old wife of a veteran with disabilities who had been in the current caregiving role for 9 years. This participant reported that the Caregiver Resource Manual was not geared to younger caregivers, so she would not benefit from using the manual. This caregiver also was the only participant who reported that the Caregiver Resource Manual neither gave her peace of mind nor decreased her stress level.

Comments or suggestions would have been helpful from the other 8 individuals. Because it was not written in the IRB proposal to contact the participants other than to follow-up with telephone calls regarding unreturned questionnaires, no further contact was made with the participants.