Self-Care TALK to Promote AD Spousal Caregiver Health

描述（由申请人提供）：美国目前估计有450万人患有阿尔茨海默病（AD）或相关痴呆症，未来这一数字将急剧增加。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薪援助。照顾是具有挑战性的，照顾者往往有负面的结果，包括抑郁，紧张和其他健康和福祉的破坏。照顾者被建议“照顾好自己，但很少得到关于如何做到这一点的指导，可能缺乏资源来满足他们共存的个人健康需求。老年人谁采取了一个与AD的配偶的替代作用是在一个特别高的风险的情况下，需要支持，以保持他们的健康。在护理轨迹的早期提供有关自我护理的指导可能会促进护理人员的健康。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健康促进自我护理教育和支持伙伴关系（Self-Care TALK）在减少压力，增强与健康相关的自我效能和促进改善健康感知方面的有效性。本研究的具体目的是确定a）自我护理伙伴关系对缓解压力和自我效能以及对健康结果的影响，以及B）缓解压力和自我效能对健康的中介作用。一个随机的，治疗/比较，重复测量的实验设计用于测试干预的有效性相比，通常的照顾老年人（至少60岁），配偶照顾者（n=82）的人诊断为AD在过去的2年。自我保健谈话是使用基于电话的方法提供的，以认识到履行职责的要求。每周六次对话用于发现健康信念，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，建立自尊，关注积极的一面，避免角色过载，沟通，建立意义。基本内容是标准化的，但谈话是个性化的每个照顾者。笔记本提供了有关自我护理的其他信息。假设干预组与常规护理组相比，在8周和24周时经历更少的压力，更多的自我效能感，并报告更好的健康状况。通过自我保健促进健康是AD护理人员新干预措施的适当重点。

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.