Caregiver Stress: Interventions to Promote Health and Wellbeing

描述(申请人提供)：该计划项目旨在促进慢性病患者家庭照顾者的健康和降低心血管风险。当家庭照顾者为他们长期和渐进的健康状况的亲人提供身体、心理社会和工具护理时，他们经常在平衡其他生活需求的同时经历巨大的负担。长期紧张的照顾代表了一种慢性压力的情况，这种情况通过一系列有害的生理压力过程对健康造成损害。除了照顾者缺乏对自身健康促进的关注外，心血管疾病的风险尤其令人担忧。很少有研究探索对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最终与心血管风险相关的慢性压力的有害影响。在两项研究中，我们将使用心理神经免疫学方法，分别和联合测试心理教育和体育锻炼两种干预措施。第一项研究将针对非裔美国人痴呆症患者的家庭照顾者；第二项研究将侧重于心力衰竭患者的家庭照顾者。并行的设计、干预和措施将产生协同作用，将所有数据管理和分析整合到生物行为科学和措施核心。该核心还将对通过分析公共数据集而产生的模型测试提供高级指导和解释。合并后的数据集将有助于阐明应激诱发心血管风险的神经内分泌机制，进一步开发模型，并刺激未来的研究，而共享的核心支持将提供实质性的效率；如果没有计划项目方法，这两者都无法实现。这些集体努力将产生重要的数据，使未来的护理可以显著改善家庭照顾者的生活，并将他们患心血管疾病的风险降至最低，心血管疾病是美国导致残疾和死亡的头号原因。

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.