STRESS BUSTING PROGRAM FOR CAREGIVERS OF PTS WITH CHRONIC NEUROLOGIC DISEASES

慢性神经系统疾病患者护理人员的减压计划

• 批准号: 7378181
• 负责人: SHARON L. LEWIS
• 金额: $ 1.65万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-01 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7378181
• 关键词: STRESS; BUSTING; PROGRAM; CAREGIVERS; PTS

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Aging baby boomers, long life spans, and rising levels of chronic, debilitating disease will result in a major caregiver crisis in the near future. Although family caregivers perform an incredibly valuable service for their relatives and the formal health care system, they do so at a considerable cost to themselves both emotionally and physically. If the caregiving system collapses under the weight of unsupported responsibilities, increased acute care and institutionalization of the patients will be likely outcomes. New programs are vitally needed to support and sustain family caregivers. Effective stress management techniques can 1) help to decrease the caregivers' feelings of burden and stress, 2) improve the emotional and physical health of caregivers, and 3) empower caregivers to gain control of their lives. The overall goal of this randomized clinical trial is to determine the effectiveness of a stress-busting program (SBP) for caregivers of patients with chronic neurological diseases including stroke, Alzheimer's disease, multiple sclerosis, and Parkinson's disease. Specific research objectives include: 1. Prospectively determine the effects of a SBP compared to a standard support group (SSG) on quality of life and immune response in caregivers of patients with chronic neurological diseases. Subjects will be tested at baseline, at completion of 6 weeks of SBP or SSG, and at 2- and 4-month follow-up sessions. 2. Determine subjects' relaxation response as well as their response to acute laboratory stressors using bioinstrumentation. Muscle tension, electrodermal response, skin temperature, blood volume pulse, and blood pressure will be measured. Subjects will be tested at baseline, at completion of 6 weeks of a SBP or SSG, and at 2- and 4-month follow-up sessions. 3. Compare the effectiveness of SBP or SSG for adult children caregivers as compared to spousal caregivers based on quality of life measurements, immune parameters, and relaxation response. The proposed multimodal SBP will focus on a variety of approaches based on cognitive behavioral and relaxation response theories. SBP will consist of a 6-week program with 1 1/2-hour sessions per week. The setting will be an educational support group with topics related to stress, stress and challenges of caregiving, depression, coping strategies, positive thinking, and taking time for oneself. In addition, subjects will be taught simple relaxation strategies that they can practice at home. The SSG will meet for 6 weeks for 1¿ hours per session. A repeated measures design will be used to determine the effectiveness of SBP compared to SSG. Outcomes will be measured using psychosocial instruments as well as state-of-the science technology including bioinstrumentation and immune parameters to measure biological responses. Follow-up testing will be done 2 and 4 months after the end of the SBP or SSG to determine the long-term effectiveness of the intervention. The SBP is proposed as a way to decrease the level of stress experienced by caregivers and teach them effective coping strategies. The hypothesized outcome is an improvement in emotional and physical well-being. If SBP is found to be more effective than SSG in decreasing stress, improving quality of life, promoting relaxation, and/or enhancing immunocompetence in family caregivers, these findings could have important clinical significance for providing a cost effective health promotion strategy for a group of people who experience tremendous ongoing stress.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。婴儿潮一代的老龄化、寿命延长以及慢性衰弱性疾病水平的上升将在不久的将来导致一场重大的护理危机。虽然家庭照顾者为他们的亲属和正规的医疗保健系统提供了非常宝贵的服务，但他们在情感和身体上都付出了相当大的代价。如果医疗系统在没有支持的责任的重压下崩溃，可能会导致增加急诊护理和将患者机构化。迫切需要新的方案来支持和维持家庭照顾者。有效的压力管理技术可以1）帮助减轻照顾者的负担和压力，2）改善照顾者的情绪和身体健康，3）使照顾者能够控制自己的生活。 这项随机临床试验的总体目标是确定压力解除计划（SBP）对慢性神经系统疾病（包括中风，阿尔茨海默病，多发性硬化症和帕金森病）患者的照顾者的有效性。具体研究目标包括：1.普罗维登斯确定SBP与标准支持组（SSG）相比对慢性神经系统疾病患者照顾者生活质量和免疫反应的影响。将在基线、6周SBP或SSG完成时以及2个月和4个月随访时对受试者进行检测。2.使用生物仪器测定受试者的放松反应以及他们对急性实验室压力源的反应。将测量肌肉张力、皮肤电反应、皮肤温度、血容量脉搏和血压。将在基线、6周SBP或SSG完成时以及2个月和4个月随访时对受试者进行检测。3.根据生活质量测量、免疫参数和放松反应，比较SBP或SSG对成年儿童照顾者与配偶照顾者的有效性。 拟议的多模态SBP将集中在各种方法的基础上的认知行为和放松反应理论。SBP将包括一个为期6周的计划，每周1 1/2小时的会议。该设置将是一个教育支持小组，主题涉及压力，压力和挑战的成长，抑郁，应对策略，积极思考，并采取时间为自己。此外，受试者将学习简单的放松策略，他们可以在家里练习。SSG将举行为期6周的会议，每次会议1小时。 将使用重复测量设计来确定SBP与SSG相比的有效性。将使用心理社会工具以及包括生物仪器和免疫参数在内的最新科学技术来测量结果，以测量生物反应。将在SBP或SSG结束后2个月和4个月进行随访测试，以确定干预的长期有效性。SBP被认为是一种降低照顾者所经历的压力水平并教会他们有效应对策略的方法。假设的结果是情绪和身体健康的改善。如果SBP被发现在减轻压力，改善生活质量，促进放松和/或增强家庭照顾者的免疫能力方面比SSG更有效，这些发现可能具有重要的临床意义，为一组经历巨大持续压力的人提供具有成本效益的健康促进策略。