Self-Care TALK to Promote AD Spousal Caregiver Health

描述(由申请人提供)：据估计，美国目前有450万人患有阿尔茨海默病(AD)或相关痴呆症，这个数字未来将大幅增加。大多数阿尔茨海默病患者在家中由非正式照顾者照顾，他们为家人或朋友提供无偿援助。护理是具有挑战性的，照顾者往往会产生负面结果，包括抑郁、压力和其他对健康和福祉的干扰。护理人员被建议“照顾好自己，但几乎没有得到关于如何做到这一点的指导，而且可能缺乏资源来满足他们共存的个人健康需求。”为患有阿尔茨海默病的配偶承担照顾角色的老年人处于特别高风险的背景下，需要支持以维持他们的健康。在照看轨迹的早期提供自我护理指导可能会促进照顾者的健康。拟议研究的总体目标是测试高级执业护士和配偶照顾者之间的促进健康的自我护理教育和支持伙伴关系(自我护理谈话)在减轻压力、提高与健康有关的自我效能和促进改善健康观念方面的有效性。这项研究的具体目的是确定a)自我护理伙伴关系对照顾压力和自我效能的影响，以及对健康结果的影响，以及b)照顾压力和自我效能对健康的中介作用。采用随机、治疗/比较、重复测量的实验设计，与过去两年诊断为阿尔茨海默病患者的老年人(至少60岁)、配偶照顾者(n=82)的常规护理相比，测试干预的有效性。以电话为基础的方法提供自我护理谈话，以认识到照顾责任的要求。每周六次的谈话被用来发现健康信念，并确定当前和期望的自我护理活动。核心内容包括：养成健康的习惯，树立自尊，专注于积极的方面，避免角色过载，沟通，建立意义。基本内容是标准化的，但对话是针对每个照顾者的个性化的。笔记本提供了有关自我护理的附加信息。与常规护理组相比，假设干预组在8周和24周时经历更少的压力，更多的自我效能，并报告更好的健康状况。通过自我护理促进健康是对AD照顾者进行新干预的适当重点。

DESCRIPTION (provided by applicant): An estimated 4.5 million individuals in the U.S. currently live with Alzheimer's Disease (AD) or a related dementia, and this number will increase dramatically in the future. Most persons with AD are cared for at home by informal carers who provide non-paid assistance for their family member or friend. Caregiving is challenging and carers often have negative outcomes, including depression, strain and other disruptions in health and well-being. Carers are advised to 'take care of yourself, yet receive little direction regarding how to do this and may lack resources to attend to their coexisting personal health needs. Older adults who have adopted a caregiving role for a spouse with AD are in a particularly high-risk context, and need support to maintain their health. Providing guidance about self-care early in the caregiving trajectory may foster health among carers. The overall aim of the proposed study is to test the effectiveness of a health-promoting self- care education and support partnership (Self-Care TALK) between advanced practice nurses and spouse caregivers in reducing strain, enhancing self-efficacy related to health and in promoting improved perception of health. Specific aims of the study are to determine a) the effect of the self-care partnership on caregiving strain and self-efficacy, and on health outcomes, and b) the mediating effects of caregiving strain and self- efficacy on health. A randomized, treatment/comparison, repeated-measures experimental design is used to test the effectiveness of the intervention compared to usual care for older (at least 60 years), spouse caregivers (n=82) of persons diagnosed with AD in the previous 2 years. Self-Care TALK is provided using a telephone-based approach in recognition of the demands of caregiving responsibilities. Six weekly conversations are used to discover health beliefs and identify current and desired self-care activities. Core content includes: practicing healthy habits, building self-esteem, focusing on the positive, avoiding role overload, communicating, and building meaning. Basic content is standardized, but conversations are individualized for each carer. A notebook provides additional information about self-care. The intervention group is hypothesized to experience less strain, more self-efficacy, and report better health at 8 and 24 weeks, compared to the usual care group. Promoting health through self-care is an appropriate focus for new interventions with AD caregivers.