Mindfulness-based Cognitive Coping Mobile App Intervention for caregivers of individuals with Alzheimer's Disease

项目摘要 阿尔茨海默病(AD)是一种对患者、家庭和社会都具有破坏性的疾病。AD的大部分护理 病人依靠非正式照顾者的肩膀，他们大多没有接受过承担护理角色的培训，承担着 高度痛苦，身体健康和心理健康恶化。 有1600多万美国人为阿尔茨海默病患者提供护理，经历了高抑郁率 症状(30%)，压力(59%)，心血管疾病的相关风险，以及许多其他不利健康 效果。例如，在单独的研究中，住院和急诊科就诊更有可能是 痴呆症照顾者比任何其他类型的照顾者都要好。 照顾阿尔茨海默病的严重程度受多种因素的影响，如阿尔茨海默病的痴呆症症状强度 患者，照顾者对痛苦处境的挑战程度，以及可用的资源。虽然 关于阿尔茨海默氏症的信息和程序向公众开放，一个重要的缺失工具是 如何有效地处理抑郁症状，因为这些症状非常常见，要求也很高。 因此，在这个第二阶段项目中，我们建议完成新的基于正念的认知应对 (MCC)干预，并通过我们名为关怀心灵应用(CMA)的移动应用程序轻松访问，提供 为照顾者提供有效、经济高效的干预措施，以减轻他们的压力和抑郁症状。 MCC干预建立在基于正念的认知疗法(MBCT)的基础上，该疗法已经 有效地治疗患有严重抑郁障碍的个人，并整合照顾应对策略 从我们过去的研究中帮助照顾者克服其照顾者角色中的压力情况。 创新：(1)在移动应用程序中将MBCT与照顾应对相结合；(2)匿名分享真实 护理人员使用的响应和技术；以及(3)通过高级 “众包”护理知识(在项目人员“管理”之后)，以促进最佳做法。 第一阶段论证了可行性，达到了所有里程碑，并提供了支持这一概念的证据(MCC APP格式)。广告照顾者能够使用关爱心灵移动应用程序，并非常好地接受了它。事实上, 除了展示可用性、接受度和感知到的好处外，第一阶段研究还显示出显著的积极意义 护理人员在减轻抑郁症状和心理压力方面的结果。 在第二阶段，我们将最终确定MCC课程，开发完整的APP，并在 随机临床试验；导致了一种新的干预措施，它整合了MCC内容，聚合了 社区共享经验，有效培训以减少抑郁症状和心理压力，以及 这款手机应用程序将部署在数百万患有阿尔茨海默氏症的家庭中。 商业机会：MCC计划将提供给AD照顾者(美国1600多万人)作为 移动应用订阅。这一模式在我们目前App Store的移动应用程序上非常成功。

Project Summary Alzheimer's Disease (AD) is a devastating illness for patients, families, and society. Most of the care of AD patients rests on shoulders of informal caregivers, largely untrained to undertake the caregiving role, bearing a high level of distress, and suffering deterioration in physical health and psychological well-being. There are over 16 million Americans providing care to AD patients, experiencing high rates of depressive symptoms (30%), stress (59%), associated risks for cardiovascular diseases, and many other adverse health effects. For example, in separate studies, hospitalization and emergency department visits were more likely for dementia caregivers than any other types of caregivers. The severity of AD caregiving is influenced by several factors, such as intensity of dementia symptoms in AD patients, how challenging distressful situations are perceived by caregivers, and available resources. Although information and programs about Alzheimer's Disease are available to the public, an essential missing tool is how to deal with depressive symptoms in an effective manner, as they are very common and demanding. Therefore, in this Phase II project, we propose to complete the new Mindfulness-based Cognitive Coping (MCC) intervention, and enable easy access with our mobile app, called Caring Mind App (CMA), providing an effective cost-effective intervention for caregivers to reduce their stress and depressive symptoms. The MCC intervention is built upon the Mindfulness-Based Cognitive Therapy (MBCT), which has been effective to treat individuals with major depressive disorder, with the integration of caregiving coping strategies from our past studies to help caregivers to overcome stressful situations in their caregiver role. Innovation: (1) integration of MBCT with caregiving coping in a mobile app; (2) anonymous sharing of real responses and techniques used by caregivers; and (3) automated content update through an advanced “crowdsourcing” of caregiving knowledge (after “curation” by project personnel) to promote best practices. Phase I demonstrated the feasibility, met all milestones, and provided evidence to support the concept (MCC in app format). AD caregivers were able to use the Caring Mind mobile App and accepted it very well. In fact, besides demonstrating usability, acceptance and perceived benefits, Phase I study showed significant positive outcomes for caregivers on reducing their depressive symptoms and psychological stress. In Phase II, we will finalize the MCC curriculum, develop the complete app, and evaluate its effectiveness in a randomized clinical trial; resulting in a novel intervention that integrates MCC content, aggregation of community shared experience, effective training to reduce depressive symptoms and psychological stress, and a mobile app to be deployed to millions of families struggling with Alzheimer's Disease. Commercial Opportunity: MCC program will be available to AD caregivers (16+ Million people in US) as a mobile app subscription. This model has been very successful with our current mobile apps in App Stores.