title: Home Telehealth and Caregiving Appraisal in Chronic Illness.
abstract: Remote health monitoring applications are being adopted to improve the health of chronically ill individuals. Little work has focused on the effects of these technologies on informal caregivers (CG) of patients with chronic illnesses.
  
  
  
  To examine differences in caregiving appraisal between CG of enrolled and nonenrolled Veterans in the home telehealth (HT) program.
  
  
  
  Cross-sectional survey methodology in 244 dyads (Veteran and CG) from 6 rural Midwestern Veterans Affairs Medical Centers. Survey variables were derived from the 2004 National Alliance for Caregiving survey, along with measures of caregiving strain, burden, and satisfaction.
  
  
  
  We found no differences when comparing HT and non-HT CG. In multivariate analyses combining the two groups, CG characteristics associated with CG strain included younger age, providing help with activities of daily living and instrumental activities of daily living, use of coping skills, depressive symptoms, and less use of unpaid help (all p ≤ 0.001). Burden was associated with CG use of coping skills, caregiving confidence, and relationship quality with the Veteran (all p < 0.0001). CG satisfaction was associated with presence of social support (p < 0.0001). High CG strain was associated with Veteran hospitalization in the combined group (p = 0.03). Burden (p = 0.0002) was significantly associated with CG satisfaction.
  
  
  
  Existing HT infrastructure provides an opportunity to incorporate training and support programs for CG of chronically ill patients. Such programs could improve CG confidence and use of positive coping skills, lower strain and burden, and potentially improve the health of both the care recipient and CG.
authors.affiliation: 1 Center for Comprehensive Access & Delivery Research and Evaluation , Iowa City Veteran's Affairs Healthcare System, Iowa City, Iowa.|2 Rural Health Resource Center-Central Region , Iowa City Veteran's Affairs Healthcare System, Iowa City, Iowa.|3 Sinclair School of Nursing, University of Missouri , Columbia, Missouri.
authors.forename: Bonnie J
authors.initials: BJ
authors.lastname: Wakefield
authors.affiliation: 1 Center for Comprehensive Access & Delivery Research and Evaluation , Iowa City Veteran's Affairs Healthcare System, Iowa City, Iowa.|2 Rural Health Resource Center-Central Region , Iowa City Veteran's Affairs Healthcare System, Iowa City, Iowa.|4 Department of Internal Medicine, University of Iowa Roy and Lucille Carver College of Medicine , Iowa City, Iowa.
authors.forename: Mary
authors.initials: M
authors.lastname: Vaughan-Sarrazin
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003863:Depression / Q000517:prevention & control / Q000628:therapy; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D017060:Patient Satisfaction; D020377:Self Efficacy; D012737:Sex Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000517:prevention & control* / Q000628:therapy*; D017216:Telemedicine / Q000379:methods*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans
keywords: e-health; home health monitoring; telehealth; telemedicine