CAREGIVER STRESS: PILOT STUDY WITH AMERICAN INDIANS

看护者压力：针对美洲印第安人的试点研究

• 批准号: 7378131
• 负责人: Kristen H Sorocco
• 金额: $ 0.05万
• 依托单位: UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-03-01 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7378131
• 关键词: CAREGIVER; STRESS; PILOT; STUDY; AMERICAN

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. Background: There is evidence to suggest that a dysregulation of cortisol might lead to poor physical and mental health functioning among dementia caregivers under chronic stress. To date a majority of this research has been conducted on European American samples. This pilot study proposes to examine the relationship between caregiver stress and cortisol response to stress in spousal and adult children American Indian (AI) caregivers by comparing salivary cortisol levels in caregivers compared to non-caregivers in a natural setting. We hypothesize that American Indian caregivers will demonstrate a dysregulation in diurnal cortisol secretion in comparison to AI controls. Additionally, a dysregulation in diurnal cortisols will be correlated with measures of health problems and psychological distress. Research Plan/Method: Thirty participants (15/group: AI caregivers, AI noncaregivers) will be recruited by the Special Populations Unit through the GCRC. Part one of the study will consist of a psychosocial interview to obtain background demographic information, as well as measures of psychological distress. The second part of the study will consist of two test days in the participant's natural environment. Participants will be beeped by a Timex Ironman Triathlon wristwatch 5 times/day between 0800 and 1200 (Wake-up; 9am; noon; dinner (5pm); evening (9 pm)) to take a salivary cortisol sample and complete a mood questionnaire. Cortisol samples will be taken at the same time across both days of the study. Self-reports of affect will be obtained at the end of each period using the PANAS (a measure of affective states; Watson et al., 1988). A 2 (caregiver; control) between X 2 (home day 1; home day 2) X 5 (cortisol measurement: awakening; mid morning; mid-afternoon; dinner; evening; bedtime) within repeated measures design will be used. Clinical Relevance: A dysregulation in diurnal cortisol levels among caregivers under chronic stress suggests a possible disruption in both physiological and psychological functioning. Caregivers under chronic stress are more likely to have both physical and psychological health problems due to the chronic stress associated with caregiving, which in turn could negatively impact the quality and longevity of the caregiving relationship. Findings from this study might lead to new pharmacological and behavioral interventions designed to decrease caregiver stress. Specific Aim The primary aim of this grant is to collect pilot data examining diurnal cortisol variation among American Indian dementia caregivers in comparison to controls. Background and Significance Understanding the impact of stress on endocrine function is important because the continuous release of cortisol may leave individuals experiencing chronic stress susceptible to illness (Lovallo, 1997). The studies examining diurnal/metabolic cortiol levels among caregivers have yielded mixed findings. Several studies have found higher basal cortiol levels among caregivers (Da Roza amp; Cowen 2001; Bauer et al., 2000; and Vedhara et al., 1999), while some studies have found no difference in cortisol levels among caregivers and noncaregivers (Cacioppo et al., 2000; Irwin et al., 1997). Elevated neuroendocrine levels are of concern because one of the roles of cortisol is to suppress immune function. While harmless in the short-term, the consequences of long- term immune system suppression can be quite serious. Among elderly spousal caregivers, caregiving has been demonstrated to be a risk factor for mortality (Schulz amp; Beach, 1999). The mixed findings in cortisol level among dementia caregivers suggests the role of mediating factors, such as culture, social support, and other psychosocial variables. No research to date has specifically examined endocrine function among American Indian dementia caregivers.

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。背景：有证据表明，皮质醇的失调可能导致慢性压力下痴呆护理者的身心健康功能不佳。到目前为止，大多数研究都是在欧洲和美国人身上进行的。本初步研究旨在通过比较自然环境下照顾者与非照顾者的唾液皮质醇水平，研究配偶和成年子女美国印第安人（AI）照顾者压力与皮质醇对压力反应之间的关系。我们假设，与人工智能对照组相比，美国印第安人护理人员将表现出昼夜皮质醇分泌失调。此外，昼夜皮质醇的失调将与健康问题和心理困扰的测量相关。研究计划/方法：特殊人群组将通过GCRC招募30名参与者（15人/组：人工智能护理人员，人工智能非护理人员）。研究的第一部分将包括一个社会心理访谈，以获得背景人口统计信息，以及心理困扰的措施。研究的第二部分将包括在参与者的自然环境中进行两天的测试。天美时铁人三项腕表每日5次（早上9点起床、中午9点起床、下午5点吃饭）；晚上（晚上9点）采集唾液皮质醇样本并完成一份情绪问卷。皮质醇样本将在研究的两天内同时采集。在每个阶段结束时，使用PANAS（一种情感状态的测量方法；Watson等人，1988）获得情感的自我报告。在重复测量设计中，x2（回家第1天；回家第2天）x5（皮质醇测量：醒来；上午中段；下午中段；晚餐；晚上；就寝时间）之间的2（照顾者；对照组）将被使用。临床相关性：在慢性压力下的照顾者中，皮质醇水平的昼夜失调表明生理和心理功能可能受到破坏。慢性压力下的照顾者更有可能出现身心健康问题，这反过来又会对照顾关系的质量和寿命产生负面影响。这项研究的发现可能会导致新的药理学和行为干预措施，旨在减少照顾者的压力。这项资助的主要目的是收集试验数据，检查美洲印第安人痴呆症护理者与对照组之间的皮质醇日变化。背景与意义了解应激对内分泌功能的影响很重要，因为皮质醇的持续释放可能使经历慢性应激的个体容易患病（Lovallo, 1997）。对照顾者日间/代谢皮质醇水平的研究得出了不同的结果。一些研究发现照顾者的皮质醇水平较高（Da Roza等，Cowen 2001； Bauer等，2000；and Vedhara等，1999），而一些研究发现照顾者和非照顾者的皮质醇水平没有差异（Cacioppo等，2000；Irwin等，1997）。神经内分泌水平升高引起关注，因为皮质醇的作用之一是抑制免疫功能。虽然短期内无害，但长期免疫系统抑制的后果可能相当严重。在老年配偶照顾者中，照顾已被证明是死亡率的一个危险因素（Schulz amp; Beach, 1999）。痴呆症护理人员皮质醇水平的混合结果表明，文化、社会支持和其他社会心理变量等中介因素的作用。到目前为止，还没有研究专门检查了美国印第安人痴呆症护理人员的内分泌功能。