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

项目摘要/摘要： 每过一分钟，一位家庭成员就会开始一份由以下内容组成的“照顾职业生涯” 对患有阿尔茨海默氏症或其他痴呆症的老年人的非正式护理。在看护职业生涯中，这些 家庭成员(即照顾者)经历了三个不同的阶段，从家中的主要照顾者，到 当护理对象需要长期安置时，由照顾者照看后其所爱的人 去世了。随着家庭照顾者经历从照顾者到照顾者伙伴再到照顾者的转变，他们面临 他们接受护理的人的需求、行为和症状的变化可能会对他们自己的健康造成不利影响。 尽管初步临床试验显示心率变异性生物反馈(BF)和足智性训练 (RT)是两种有益于痴呆症照顾者的健康自我管理干预措施，交付的效果 根据照顾者的需要或偏好，这些干预措施尚未得到检查。这是随机的 因此，对照试验将评估提供的健康自我管理干预(BF或RT)的效果 根据照顾者的需要或偏好与注意控制条件对照顾者的反应进行比较 (感知到的压力、抑郁认知和负面情绪)和健康结果(健康风险和 身心健康)随着时间的推移。照顾者将被随机分为：1)注意力控制(即，转移注意力 活动)小组，2)基于需要的自我管理干预(SM-Need)，或3)自我管理干预 他们的偏好(SM-偏好)。SM-Need将由已验证的最低CUT分数确定 测量心率变异性(对于BF)和足智性(对于RT)。SM-首选项允许照顾者 在高炉和RT之间选择。这项研究的目的是：1)检查健康自我管理的效果 根据需要或偏好对痴呆症患者家庭照顾者的干预(BF或RT) 随着时间的推移，护理反应和健康结果；以及2)确定 随时间推移，照顾者、照顾者和照顾者对照顾者反应和健康结果的影响。家庭照顾者会 在干预后基线(T1)、6个月(T2)和12个月(T3)进行评估。干预将会发生 在T1和T2数据集合之间。重复测量、双变量和多变量分析将控制 在解决研究目标的同时，在照顾者角色、痴呆症症状严重程度和护理需求方面有数月的经验。 研究结果将产生新的科学知识，关于新颖、易用、 独立实施的干预措施，可以根据自己的情况量身定做，以促进患有癌症患者的照顾者的健康 痴呆症贯穿了他们的照看生涯。一旦确立，这些健康自我管理干预措施 可以量身定做，以匹配其他类似痛苦的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.