College of Nursing

Office of Research & Scholarship

Caring~Web: Web-based Support for Stroke Caregivers

Linda L. Pierce, Ph.D., RN, CRRN, FAHA, FAAN - The University of Toledo
Victoria Steiner, Ph.D. - The University of Toledo

Currently over 4 million Americans live with the after-effects of stroke. There are nearly 800,000 new persons with stroke each year at a cost for care of $34 billion annually. Most persons surviving a stroke return home after initial rehabilitation treatment and are cared for by family members, usually women. Family members [relatives and friends] manage and/or influence many aspects of care for the person with stroke, e.g., helping with activities of daily living, scheduling appointments with healthcare providers, providing physical care and emotional support, etc. The profound changes that can accompany stroke create considerable challenges for those individuals and their families. The National Institutes of Health have pointed to a need for research using innovative technology to support family caregivers.

Using Friedemann's framework of systemic organization as a guide, this study investigated outcomes of Caring~Web©: a Web-based, in-home intervention of support for caregivers of persons with stroke in northern Ohio and southern Michigan during the first year after rehabilitation treatment.

Caring Web Study Final Report

Quantitative Results

Qualitative Results

Publications Resulting from Stroke Research

Dementia and Caregiver Research

Linda L. Pierce, Ph.D., RN, CRRN, FAHA, FAAN - The University of Toledo
Victoria Steiner, Ph.D. - The University of Toledo

Several studies have been completed with a focus on web-based support/education for caregivers of persons with dementia and/or cognitive disorders.

Costs of caring for people with dementia in the United States (U.S.) were between $159 billion to $215 billion, and those costs could rise dramatically
with the increase in the numbers of older people in the coming decades. As the U.S. develops new healthcare financing and delivery models focusing on
the integration and coordination of care, it is essential to recognize that for many of these people with chronic health problems such as dementia or cognitive disorders, family caregivers are the primary care coordinators in the community. These caregivers cannot be expected to do more, and to play an integral role in these new models, with too little support and education.

Publications Resulting from the Dementia/Cognitive Disorders Research

Stroke and Dementia and Caregiver Research

Linda L.Pierce, Ph.D. RN CRRN FAHA FAAN1; Victoria Steiner, Ph.D. 2 Huey-Shys Chen, Ph.D. RN MCHES FAAN3Carol Bryan, Ph.D. RN.

College of Nursing, College of Health and Human Service - The University of Toledo and School of Nursing Widener University

Feasibility of the CARREs Modules: Educating Family Caregivers of Persons with Cognitive Deficits about Potentially Avoidable Hospitalizations

2018-2019 -- One of three research support awards given in the State of Ohio by the Ohio Nurses Foundation

Background. Older persons with cognitive deficits caused by Alzheimer’s disease or stroke are more likely to be hospitalized than those without deficits. Family caregiving is an essential, yet understudied, factor that can hasten, delay, or prevent care recipients’ emergency department (ED) visits or hospital readmissions.

Purpose. Guided by Friedemann’s theory, this feasibility study uses a mixed methods design to examine Internet-based educational CARREs (Communicate, Assist, Recognize & Report Events) Modules for family caregivers of persons with cognitive deficits addressing potentially avoidable hospitalization (PAH) conditions, e.g. accidental falls, urinary tract infections. Aims are to determine: 1) caregivers’ perceptions about the use of the CARREs Modules, 2) caregivers’ self-reported value of the CARREs Modules, and 3) potential outcomes for caregivers and care recipients. Methods. Fourteen community-dwelling family caregivers will be recruited from the rehabilitation/university affiliated hospital, university aphasia/stroke education and support groups and local Alzheimer’s Association support/education programs. Caregivers will complete six to eight CARREs Modules based on the needs of their care recipients. At baseline and 30 and 90 days post-enrollment, they will complete an online survey on caregiver self-efficacy and strain plus report their care recipients’ ED visits and hospital readmissions. At 30 days, caregivers will also rate their use of the CARREs Modules. At 90 days, they will rate the value of these Modules and complete a Telephone Exit Interview. Descriptive statistics or rigorous content analysis will be performed on these data as appropriate. Conclusion. CARREs Modules may promote well-being (congruence in Friedemann’s terms), for family caregivers and older care recipients with cognitive deficits.


For more information contact:
Linda L. Pierce, Ph.D., RN, CRRN, FAHA, FAAN
E-Mail Address: 

Last Updated: 10/23/23