MBSR Intervention to reduce stress in AD caregivers

MBSR 干预可减轻 AD 护理人员的压力

• 批准号: 7360321
• 负责人: Lisa Fredman
• 金额: $ 27.87万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-03-01 至 2010-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7360321
• 关键词: Address; Affect; Alzheimer' s Disease; Area; Biological; Biological Markers; Boston; Caregivers; Caring; Chronic stress; Clinical; Clinical Research; Clinical Trials; Clinical Trials Design; Cognitive; Control Groups; Data; Data Collection; Development; Disease; Distress; Educational Curriculum; Educational Intervention; Educational process of instructing; Effectiveness; Effectiveness of Interventions; Elderly; Eligibility Determination; Equipment and supply inventories; Evaluation; Feasibility Studies; Future; Generic Drugs; Goals; Health; Heart Diseases; Immune system; Inflammatory; Inorganic Sulfates; Interleukin-6; Intervention; Investigation; Measurement; Measures; Meditation; Methods; Mind-Body Intervention; Modeling; Outcome; Pathway interactions; Patient Self-Report; Persons; Phase; Physiological; Pilot Projects; Protocols documentation; Psychoneuroimmunology; Purpose; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Rate; Recruitment Activity; Research; Research Design; Research Personnel; Respondent; Specimen; Stress; System; Techniques; Testing; Training; Universities; Unspecified or Sulfate Ion Sulfates; Week; Yoga; cancer pain; caregiving; clinically relevant; depressive symptoms; design; emotional distress; experience; immune function; improved; insight; mindfulness-based stress reduction; mortality; programs; psychologic; response; social; stress management; theories; trial comparing; willingness

DESCRIPTION (provided by applicant): Mindfulness-Based Stress Reduction (MBSR) is a mind-body technique that incorporates mindfulness meditation, yoga, and cognitive reappraisal with the goal of self-managing the psychological and physical distress resulting from stress, as well as pain, cancer and other illnesses. Although MBSR has been in existence for 20 years and has been incorporated into numerous clinical settings, few randomized clinical trials (RCTs) have evaluated its effects on stress reduction, or the physiological mechanism by which MBSR reduces stress. Caregivers to persons with Alzheimer's Disease (AD) experience high levels of stress, depressive symptoms, and adverse physical health outcomes, likely as a result of chronic stress. However, psycho-educational interventions for AD caregivers have shown only modest benefits on self-reported stress, probably because they teach techniques to deal with current caregiving problems which become less useful as the care recipient's disease progresses. In contrast, MBSR presents a conceptually effective stress reduction method for AD caregivers because of its generic approach to stress management and adaptability to various stressful situations. This revised proposed R21 study is guided by psychoneuoimmunology (PNI) theory. It aims to design and pilot-test an RCT of an 8-week MBSR intervention for older adult AD caregivers to reduce perceived stress, depressive symptoms, and improve two biological markers of PNI mechanisms: dihydroepiandrosterone-sulfate (DHEA-S) and interleukin-6 (IL-6). This study has two phases. The first phase is a development phase in which a team of MBSR experts will design the curriculum and training materials for an 8-week MBSR program adapted for elderly caregivers, and an 8-week social contact program to be used for comparison purposes. The second phase will be a pilot test of an RCT comparing this MBSR program to a social contact control group on short-term (pre-post intervention) and 6-month change in perceived stress, depressive symptoms, and biological markers among 72 elderly AD caregivers, recruited from the Boston University (BU) Alzheimer's Disease Center. Data collection will take place at the BU General Clinical Research Center. The results will provide information on rates of eligibility, participation, compliance and attrition; respondents' willingness to provide biological specimens; and the overall protocol for the future RCT. Mixed effects models will be used to test hypotheses comparing the MBSR group to the control group on changes in perceived stress, depressive symptoms, and DHEA-S and IL-6. The results will guide the design of a larger RCT of the effects of MBSR on reducing stress, and will provide insight into the physiological mechanisms of MBSR.

描述（由申请人提供）：基于正念的减压（MBSR）是一种身心技术，结合了正念冥想、瑜伽和认知重新评估，旨在自我管理因压力以及疼痛、癌症和其他疾病而导致的心理和身体困扰。尽管MBSR已经存在了20年，并且已被纳入众多临床环境中，但很少有随机临床试验（RCT）评估其对减轻压力的作用，或MBSR减轻压力的生理机制。阿尔茨海默氏病 (AD) 患者的护理人员会承受很大的压力、抑郁症状和不良的身体健康结果，这可能是由于长期压力造成的。然而，针对 AD 护理人员的心理教育干预措施对自我报告的压力仅显示出有限的益处，可能是因为它们教授了处理当前护理问题的技术，而随着护理接受者疾病的进展，这些技术变得不再那么有用。相比之下，MBSR 因其压力管理的通用方法和对各种压力情况的适应性，为 AD 护理人员提供了一种概念上有效的减压方法。 这项修订后的 R21 研究以心理神经免疫学 (PNI) 理论为指导。它的目的是设计和试点测试一项针对老年 AD 护理人员的为期 8 周的 MBSR 干预的随机对照试验，以减少感知压力、抑郁症状，并改善 PNI 机制的两个生物标志物：硫酸二氢表雄酮 (DHEA-S) 和白细胞介素 6 (IL-6)。这项研究分为两个阶段。第一阶段是开发阶段，MBSR专家团队将设计适合老年护理人员的为期8周的MBSR项目的课程和培训材料，以及用于比较目的的为期8周的社会接触项目。第二阶段将是一项 RCT 试点测试，将 MBSR 计划与社交接触对照组进行比较，以了解从波士顿大学 (BU) 阿尔茨海默氏病中心招募的 72 名老年 AD 护理人员在感知压力、抑郁症状和生物标志物方面的短期（干预前）和 6 个月的变化。数据收集将在波士顿大学综合临床研究中心进行。结果将提供有关资格率、参与率、合规率和流失率的信息；受访者提供生物标本的意愿；以及未来 RCT 的总体方案。混合效应模型将用于测试比较 MBSR 组与对照组在感知压力、抑郁症状、DHEA-S 和 IL-6 变化方面的假设。结果将指导设计关于MBSR对减轻压力的影响的更大型随机对照试验，并将深入了解MBSR的生理机制。