Caregiver Stress: Interventions to Promote Health and Wellbeing

描述（申请人提供）：本计划旨在促进慢性病患者的家庭照护者的健康，降低心血管风险。由于家庭照护者为患有长期和进行性健康状况的亲人提供身体、心理社会和工具性照护，他们在平衡其他生活需求的同时往往承受着巨大的负担。长期的高强度看护代表了一种慢性应激状态，它通过一系列有害的生理应激过程对健康造成损害。除了护理人员对促进自身健康缺乏关注外，患心血管疾病的风险尤其令人担忧。很少有研究探索家庭照顾者的自我护理干预措施，特别是针对改善应对压力环境和改善慢性压力最终与心血管风险相关的有害影响。在两项研究中，使用心理神经免疫学方法，我们将测试两种干预措施，心理教育和体育锻炼，单独和组合。第一项研究将针对非裔美国人痴呆症患者的家庭照顾者；第二个项目将重点关注心力衰竭患者的家庭护理人员。并行设计、干预和措施将产生协同作用，将所有数据管理和分析整合在生物行为科学和措施核心内。该核心还将提供高层次的指导，并解释由公共数据集分析产生的模型测试。合并的数据集将有助于阐明应激性心血管风险的神经内分泌机制，进一步发展模型，促进未来的研究，而共享的核心支持将提供实质性的效率；两者都不能在程序项目方法之外实现。这些集体努力将产生重要的数据，未来的护理可以显著改善家庭照顾者的生活，并最大限度地降低他们患心血管疾病的风险，心血管疾病是美国致残和死亡的头号原因。

DESCRIPTION (provided by applicant): This Program Project aims to promote health and reduce cardiovascular risk in family caregivers of persons with chronic illness. As family caregivers provide physical, psychosocial, and instrumental care to their loved ones with prolonged and progressive health conditions, they often experience tremendous burden while balancing other life demands. Chronic intense caregiving represents a situation of chronic stress, which takes a toll on health through a cascade of deleterious physiological stress processes. Along with caregivers' lack of attention to their own health promotion, risk of cardiovascular disease, in particular, is a major concern. Few studies have explored self-care interventions for family caregivers especially targeted to improve coping with the stressful circumstances and also to ameliorate the harmful effects of chronic stress ultimately associated with cardiovascular risk. In two studies, using a psychoneuroimmunological approach, we will test two interventions, psycho-education and physical exercise, individually and in combination. The first study will target family caregivers of African American dementia patients; the second will focus on family caregivers of heart failure patients. Parallel designs, interventions and measures will create synergy as will integration of all data management and analyses within a Biobehavioral Science and Measures Core. This Core will also provide high level guidance and interpretation of model testing resulting from analysis of the common data set. The combined data set will allow for elucidating the neuroendocrine mechanisms of stress-induced cardiovascular risk, further developing the model, and stimulating future research, while the shared core support will provide substantial efficiency; neither could be achieved outside of a Program Project approach. These collective efforts will generate important data whereby future care can significantly enhance the lives of family caregivers and minimize their risk of cardiovascular disease, the number one cause of disability and death in the United States.