Dual Process Intervention for Recently Bereaved Spouses

描述（由申请人提供）：老年寡妇的长期丧亲调整过程会影响他们生活的方方面面。本研究将测试一种新的，有前途的干预方法的基础上的双过程模型（Dual Process Model）的处理丧亲之痛，包括传统的悲伤支持小组的重点，但增加了教育，日常生活技能建设，并在多维调整过程中所需的能力要素。这种模式强调需要适应两种与丧亲有关的压力源，每种压力源都有其独特的过程：损失取向（LO），它解决与损失本身相关的心理情感压力源，以及恢复（R），它侧重于应对与一个人的新丧偶状态有关的次要压力源。这两个进程之间的振荡是一个关键因素，因为有效的适应需要在不同的时间出现一个方面比另一个方面更重要、更相关或更紧迫。本研究的目的是（1）比较丧亲定向干预与传统支持小组在提高丧亲适应方面的有效性，以及（2）确定丧亲定向干预在多大程度上可以促进丧失定向和恢复之间的振荡。样本包括330名寡妇（或鳏夫），年龄在50岁以上，基线时丧亲2-4个月。将采用随机的前/后实验设计，并进行随访（后测试后3和9个月），其中将参与者分配到交替治疗条件（14周一次，重点是丢失定向、恢复和振荡）或LO对照组。LO的结果包括抑郁，悲伤，应对自我效能，和孤独与R的结果衡量的能力，掌握和个人成长。振荡将通过日常生活清单进行评估。自我管理的问卷还包括健康状况、社会支持、自尊、社区资源的使用和宗教/精神资源的测量。据推测，与LO对照组相比，在一段时间内，在低血糖干预条件下的受试者在所有适应和振荡测量方面的改善程度更大。分析策略包括重复测量方差分析（ANOVA）与“时间”的主题内因素和“组分配”的主要主题间因素。这项研究的结果可能会刺激的内容和提供丧亲之痛的干预措施，为成年人扩大重点超越传统的心理情感的方法的范式转变的开始。

DESCRIPTION (provided by applicant): The long-term bereavement adjustment process for older widow(er)s can impact every aspect of their lives. This study will test a new, promising intervention approach based on the Dual Process Model (DPM) of coping with bereavement that includes the traditional grief support group focus but adds educational, daily life skill-building, and competency elements needed in the multidimensional adjustment process. This model emphasizes the need for adaptation to two types of bereavement-related stressors, each having its own unique process: loss orientation (LO), which addresses psycho-emotional stressors associated with the loss itself, and restoration (R), which focuses on coping with secondary stressors related to one's new widowhood status. Oscillation between the two processes is a key element because effective adaptation requires one aspect to emerge with greater importance, relevance, or urgency over the other at different times. The aims of this study are to (1) compare the effectiveness of the DPM intervention versus a traditional support group in enhancing bereavement adaptation, and (2) determine the extent to which oscillation between loss orientation and restoration can be facilitated by the DPM intervention. The sample includes 330 widow(er)s, aged 50+ who are bereaved 2-4 months at baseline. A randomized pre/post experimental design will be employed with follow-up (3 & 9 months after post-test) in which participants will be assigned to either the DPM treatment condition (14 weekly sessions focusing on loss orientation, restoration, and oscillation) or the LO comparison group. LO outcomes include depression, grief, coping self-efficacy, and loneliness with R outcomes measured by competencies, mastery, and personal growth. Oscillation will be assessed by an inventory of daily life. Self-administered questionnaires also include measures of health status, social support, self-esteem, use of community resources, and religious/spiritual resources. It is hypothesized that subjects in the DPM intervention condition will demonstrate greater improvements on all adaptation and oscillation measures over time than those in the LO comparison group. Analytical strategy consists of repeated measures analysis of variance (ANOVA) with "time" the within-subject factor and "group assignment" the primary between-subjects factor. Findings from this study may stimulate the beginning of a paradigm shift in the content and delivery of bereavement interventions for adults by broadening the focus beyond the traditional psycho-emotional approach.