Targeting Knowledge and Cognition to Improve Quality of Life: An Innovative Telehealth Approach for People with Post-Traumatic Epilepsy and Their Caregivers
Abstract
This proposal aims to improve the quality of life of people with post-traumatic epilepsy (PTE) by addressing their ability to manage their epilepsy and their memory and thinking problems. Military combat troops and Veterans are at a higher risk of developing PTE after a traumatic brain injury due to the severity of the types of brain injury that occur in battle. People suffering from PTE are faced with many challenges, but one of the most common and troubling is difficulty with memory and thinking. The brain trauma, seizures that follow, and treatments used to control seizures all contribute to memory and thinking difficulties. PTE not only makes it harder for a person to think, remember, pay attention, and learn, but it also impacts their quality of life and that of their family caregivers. If a person with PTE has trouble with memory, thinking, and learning, it can make going to school, getting and keeping a job, and having good relationships difficult. This proposal addresses epilepsy management and memory problems by adapting and then delivering a program called HOBSCOTCH (HOme-Based Self-management and COgnitive Training Changes lives). HOBSCOTCH is an epilepsy self-management program that has been shown to help people with epilepsy improve how they cope with memory and thinking problems. Research has shown that this program can improve quality of life for people with epilepsy. In the program, participants work one on one with a HOBSCOTCH Coach who guides them through nine learning and skill-building sessions. The program teaches people about epilepsy and how it affects their ability to remember, pay attention, and think. HOBSCOTCH provides self-awareness training to help people understand stressors that make memory and thinking hard. It also guides them on a step by step problem-solving path to help find practical solutions for thinking and remembering problems. A “Memory Toolbox” of tried and true strategies to help boost memory and thinking is also provided. Relaxation exercises are included to help people develop skills to cope with stress and worry. The program is delivered by telehealth, so people can participate from anywhere in the country with a phone and computer or tablet. HOBSCOTCH has not yet been tested in Veterans or civilians with PTE. The overall goal of this study is to show that the HOBSCOTCH self-management program is effective in improving quality of life in a population of Service Members, Veterans, and civilians with PTE, and that it may also benefit their family caregivers. To reach this goal, the following specific aims will be carried out by the research team: Aim 1: Adapt the HOBSCOTCH program for delivery to people with PTE and cognitive challenges. The education module of the HOBSCOTCH program will be customized to include key learning needed to understand TBI, PTE, and memory problems. Aim 2: Test whether the delivery of the HOBSCOTCH-PTE program is effective. Our study method will place participants randomly into one of two groups by a computer: Group 1 will receive the HOBSCOTCH program right away, and Group 2 will wait 3 months before beginning. This allows us to compare how Group 1 does to how Group 2 does, and ensures that everyone receives the program. We believe that the program will improve quality of life, memory and thinking, and health outcomes for people with PTE. Aim 3: Include family caregivers in select parts of the HOBSCOTCH program and test if it is helpful for them. Patients with PTE receive the full HOBSCOTCH-PTE program, and caregivers receive the education module and learn relaxation skill building. We believe we can reduce caregivers’ stress in two ways: first, their loved one will participate in HOBSCOTCH and make personal progress; and second, their own participation in the HOBSCOTCH education will help them learn about their loved one’s condition and they will learn effective relaxation techniques. We expect to improve family caregivers’ stress, quality of
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 05, 2021
- Source ID
- W81XWH2110279
Entities
People
- Barbara C. Jobst
Organizations
- Dartmouth–Hitchcock Medical Center
- United States Army