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

项目摘要/摘要： 随着每一分钟的过去，家庭成员开始了“护理生涯”，包括提供 为患有阿尔茨海默病或其他痴呆症的老年人提供非正式护理。在护理生涯中，这些 家庭成员（即照顾者）经历三个不同的阶段，从家庭的主要照顾者，到 当被照顾者需要长期安置时，照顾伙伴，在其亲人去世后，向照顾者提供 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 护理接受者的需求、行为和症状的变化可能对其自身健康产生不利影响。 尽管初步临床试验显示心率变异性生物反馈 (BF) 和足智多谋训练 (RT) 是对痴呆症护理人员来说两种有益的健康自我管理干预措施， 这些根据照顾者需要或偏好而采取的干预措施尚未经过审查。这个随机 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照顾反应的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）随着时间的推移。护理人员将被随机分配到：1) 注意力控制（即转移注意力） 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 需求将由经过验证的最低分数确定 心率变异性（对于 BF）和足智多谋（对于 RT）的测量。 SM 偏好允许护理人员 在 BF 和 RT 之间选择。该研究旨在：1）检查健康自我管理的效果 根据痴呆症患者家庭护理人员的需要或偏好进行干预（BF 或 RT） 随着时间的推移护理反应和健康结果； 2）确定之间是否存在差异 随着时间的推移，护理人员、护理伙伴和护理人员的护理反应和健康结果。家庭照顾者将 在干预后基线 (T1)、6 个月 (T2) 和 12 个月 (T3) 进行评估。将会发生干预措施 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 在实现研究目标的同时，照顾者角色、痴呆症状严重程度和照顾需求的月数。 研究结果将产生关于新颖、易于使用、 独立执行的干预措施，可以自我定制，以促进患者护理人员的健康 痴呆症贯穿他们的护理生涯。这些健康自我管理干预措施一旦建立， 可以根据其他同样陷入困境的家庭照顾者的需求和偏好进行定制 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.