Quality of Informal Care and Caregiving Transitions

描述（由研究者提供）：这是一份竞争性续期申请，旨在继续支持晚年家庭关系项目（FRILL; R 01 AG 15321）。长期目标是：（1）明确非正式护理人员可能向居住在社区的体弱和残疾老年人提供的护理质量（QC）的预测概况，（2）开发一种对从业人员有用的简要便携式工具，用于描述QC并证明它可以广泛使用，以及（3）展示这种概况和工具在早期识别和适当治疗方面的潜在效用，不仅可以提高非正式培训的质量，照顾，但也照顾者的福祉（无论是在提供照顾和照顾责任结束后）。拟议的后续研究（FRILL 2）以现有的基础设施和成就为基础，并将FRILL扩展到几个新的方向。FRILL 2将招募500名共同居住的护理接受者配对，每隔18个月进行3次纵向评估，一个全新的组成部分将跟踪从护理过渡出来的护理人员（例如，通过护理接受者死亡或机构化）每6个月一次。质量控制评估将扩大到不仅包括虐待指标，而且包括从足够到模范的照顾。使用改进的模型，方法和措施，FRILL 2将：（1）确定易感因素（例如，提供的护理量）和照顾者的心理健康（CGMH;抑郁、愤怒、焦虑和认知障碍）预测当前和未来的QC、过渡期和长期护理者幸福感的全部指标，（2）在摄入时对非裔美国人二对进行过采样，以产生足以在过渡期前和后的护理经历中对白人和非裔美国人进行纵向比较的样本，以及（3）检验易感因素、CGMH、QC、过渡期和过渡期后照顾者幸福感之间假设的横截面和纵向关联。假设和模型拟合的检验将采用结构方程建模、潜在增长建模和潜在转换分析技术。

DESCRIPTION (provided by investigator): This is a competing renewal application to continue support for the Family Relationships in Late Life project (FRILL; R01 AG15321). Long-term objectives are to: (1) specify a predictive profile of the quality of care (QC) informal caregivers are likely to provide to community-residing frail and disabled elders, (2) develop a brief portable instrument useful to practitioners that characterizes QC and demonstrate that it can be used widely, and (3) demonstrate the potential utility of this profile and instrument in early identification and appropriate treatment to improve not only quality of informal care but also caregiver well-being (both while providing care and after caregiving duties end). The proposed follow-up study (FRILL2) builds on existing infrastructure and accomplishments and extends FRILL in several new directions. FRILL2 will enroll 500 coresiding caregiver-care recipient dyads for 3 longitudinal assessments at 18-month intervals, and an entirely new component will follow caregivers who transition out of caregiving (e.g., through care recipient death or institutionalization) at 6-month intervals. QC assessment will be expanded to include not only indicators of maltreatment but also care that ranges through sufficient to exemplary. Using refined models, methods, and measures, FRILL2 will: (1) determine the extent to which predisposing factors (e.g., amount of care provided) and caregiver mental health (CGMH; depression, anger, anxiety, and cognitive impairment) predict current and future indicators of the full range of QC, caregiving transitions, and long-term caregiver well-being, (2) over-sample African American dyads at intake to produce a sample adequate for longitudinal comparisons between Whites and African Americans in the pre- and post-transition caregiving experience, and (3) test hypothesized cross-sectional and longitudinal associations between predisposing factors, CGMH, QC, caregiving transitions, and post-transition caregiver well-being. Tests of hypotheses and model fit will employ structural equations modeling, latent growth modeling, and latent transition analytic techniques.