Self-Management Interventions: Considering Needs and Preferences of Dementia Caregivers

项目概要/摘要： 每过一分钟，一个家庭成员就开始了一段“谋生生涯”， 对患有阿尔茨海默病或其他痴呆症的老年人的非正式护理。在职业生涯中，这些 家庭成员（即，照顾者）的进展，通过三个不同的阶段，从主要照顾者在家里， 照顾伴侣当照顾对象需要长期安置，照顾后，他们的亲人有 去世了当家庭照顾者经历从照顾者到照顾伙伴再到照顾者的转变时，他们面临着 他们的护理对象的需求，行为和症状的变化可能会对他们自己的健康产生不利影响。 虽然初步的临床试验表明，心率变异性生物反馈（BF）和足智多谋的训练， (RT)是两个有益的健康自我管理干预痴呆症照顾者，提供的影响， 这些根据照料者的需要或偏好采取的干预措施尚未得到审查。这项随机 因此，对照试验将评估健康自我管理干预措施（BF或RT）的效果 根据照顾者的需要或偏好，与注意力控制条件相比， （感知压力，抑郁认知和负面情绪）和健康结果（健康风险和 身体和心理健康）。护理人员将被随机分配到：1）注意力控制（即，娱乐的 活动）组，2）基于需要的自我管理干预（SM-需要），或3）自我管理干预 他们的偏好（SM偏好）。SM需求将根据经确认的最低切割评分确定 测量心率变异性（BF）和应变能力（RT）。SM偏好允许护理人员 本研究的目的是：1）检验健康自我管理的效果 根据痴呆症患者家庭照顾者的需要或偏好提供的干预（BF或RT）， 随着时间的推移，评估反应和健康结果; 2）确定 照顾者，照顾伙伴和照顾者在照顾者的反应和健康结果随着时间的推移。家庭照顾者将 在基线（T1）、干预后6个月（T2）和12个月（T3）进行评估。干预将发生 在T1和T2数据收集之间。重复测量双变量和多变量分析将控制 月的照顾者的角色，痴呆症状的严重程度，并满足需求，同时解决研究的目的。 研究结果将产生新的科学知识的有效性，新颖，易于使用， 独立进行的干预措施，可以自我调整，以促进照顾者的健康， 在整个职业生涯中，一旦建立，这些健康自我管理干预措施 可以定制，以满足其他贫困家庭照顾者的需求和偏好， 患有其他慢性精神或身体疾病的人。

Project Summary/Abstract: With every passing minute, a family member begins a “caregiving career” consisting of the provision of informal care for an elder with Alzheimer's disease or other dementia. During the caregiving career, these family members (i.e., carers) progress through three distinct phases, from primary caregiver in the home, to care partner when the care recipient requires long-term placement, to caretaker after their loved one has passed away. As family carers experience transitions from caregiver to care partner to caretaker, they face changes in their care recipient's needs, behaviors, and symptoms that may adversely affect their own health. Although preliminary clinical trials show Heart Rate Variability Biofeedback (BF) and Resourcefulness Training (RT) are two beneficial health self-management interventions for dementia caregivers, the effects of delivering these interventions according to carer need or preference have not been examined. This randomized controlled trial will therefore evaluate the effects of health self-management interventions (BF or RT) delivered according to carer need or preference compared with an attention control condition on caregiving responses (perceived stress, depressive cognitions, and negative emotions) and health outcomes (health risks and physical and mental health) over time. Carers will be randomized to: 1) an attention control (i.e., diversional activity) group, 2) self-management intervention based on need (SM-need), or 3) self-management intervention of their preference (SM-preference). SM-need will be determined by the lowest cut score on validated measures of heart rate variability (for BF) and resourcefulness (for RT). SM-preference allows the carer to choose between BF and RT. The study aims to: 1) examine the effects of a health self-management intervention (BF or RT) delivered by need or preference in family carers of persons with dementia on caregiving responses and health outcomes over time; and 2) determine whether differences exist among caregivers, care partners, and caretakers in carer responses and health outcomes over time. Family carers will be assessed at baseline (T1), 6 months (T2), and 12 months (T3) post-intervention. Interventions will occur between T1 and T2 data collections. Repeated measures bivariate and multivariate analyses will control for months in carer role, dementia symptom severity, and caregiving demands while addressing the study aims. The study findings will generate new scientific knowledge about the effectiveness of novel, easy-to-use, independently performed interventions that can be self-tailored to promote the health of carers of persons with dementia throughout their caregiving career. Once established, these health self-management interventions can be tailored to match the needs and preferences of other comparably distressed family caregivers of persons with other chronic mental or physical conditions.