Improved Measures Of Caregiving Intensity To Predict Health Outcomes

改进护理强度的测量以预测健康结果

• 批准号: 9143633
• 负责人: Katie M. Applebaum
• 金额: $ 20.35万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-15 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9143633
• 关键词: Activities of Daily Living; Address; Affect; Alzheimer' s Disease; Area; Boston; Caregiver Burden; Caregivers; Characteristics; Chronic; Chronic stress; Cognitive; Cohort Studies; Coronary heart disease; Data; Data Set; Dementia; Development; Emotional; Funding; Future; Health; Health Status; Healthcare; Healthy Worker Effect; Hour; Interview; Learning; Life; Light; Measures; Modeling; Mortality Decline; Occupational; Occupational Epidemiology; Outcome; Parkinson Disease; Participant; Pathway interactions; Persons; Physical Function; Physical activity; Process; Prospective Studies; Published Comment; Recruitment Activity; Reporting; Research; Research Methodology; Respondent; Risk; Role; Sampling; Source; Spouses; Stress; Techniques; Testing; Time; Weight; Weights and Measures; Woman; Workplace; aged; base; care recipients; caregiving; caregiving outcomes; functional decline; hazard; high risk; improved; informal caregiving; mortality; novel; older women; osteoporosis with pathological fracture; physical conditioning; prospective; response; standardize measure

 DESCRIPTION (provided by applicant): Caregivers who perform more caregiving tasks or spend more time performing these activities (i.e., greater caregiving intensity) are more stressed, and therefore should have poorer health outcomes. However, results of studies are inconsistent. This might result from operationalizing caregiving intensity as a simple count of the number of caregiving tasks performed, which ignores the fact that these tasks may vary in emotional and physical stress. Further, persons who are healthier are more likely to take on more caregiving tasks, reflecting the Healthy Caregiver Hypothesis. The proposed R21 study will adapt conventional measures of caregiving intensity to develop new measures that better reflect stress associated with specific caregiving tasks, and will use analytic approaches from occupational epidemiology for reducing the Healthy Worker Effect bias to separate the health effects of caregiving intensity from respondents' health status. We will interview 30 older (aged 60+) persons in the Boston MA area who are currently caregiving to a relative with Alzheimer's Disease (AD), Parkinson's Disease (PD), or other chronic condition. The interview will include conventional task-based measures of caregiving intensity, i.e., assisting the care recipient with each of 7 instrumental and basic activities of daily living (I/ADLs), and questions asking whether it is emotionally and/or physically difficult to help with each I/ADL task. We will use cognitive interview techniques to probe the thought processes underlying participants' responses regarding their assessment of the difficulty or stress associated with performing each I/ADL task. Using this information, an expert panel will create weighted measures of emotional and physical caregiving intensity. We will assess the validity of these new measures using general- and caregiving-specific stress scales collected from these participants, as well as data from an existing study of AD and PD caregivers. We will compare new measures to conventional measures of caregiving intensity in associations between a) current caregiving intensity, and b) cumulative and lagged cumulative caregiving intensity with mortality and functional decline in the Caregiver-Study of Osteoporotic Fractures (CG-SOF), a prospective cohort study of 1069 older women caregivers and non-caregivers who were followed for 12+ years. Hypotheses will address comparisons of the associations between new and conventional measures of caregiving intensity (current and cumulative) with mortality and functional decline, as well as associations of combinations of emotional and physical caregiving intensity on these outcomes. This study will not only shed light on the health effects of caregiving intensity, but will lay the groundwork to apply these new measures to other datasets, types of caregivers, and different health outcomes.

 描述(由申请人提供)：执行更多照料任务或花费更多时间进行这些活动(即，更大的照料强度)的照顾者压力更大，因此应该有更差的健康结果。然而，研究结果并不一致。这可能是因为将护理强度作为简单的 执行的护理任务的数量，忽略了这些任务可能在情绪和身体压力方面有所不同的事实。此外，更健康的人更有可能承担更多的护理任务，这反映了健康照顾者假说。拟议的R21研究将调整护理强度的传统衡量标准，以开发更好地反映与特定护理任务相关的压力的新指标，并将使用职业流行病学的分析方法来减少健康工作者效应偏差，将护理强度对健康的影响与受访者的健康状况分开。我们将采访波士顿马萨诸塞州地区的30名老年人(60岁以上)，他们目前正在照顾患有阿尔茨海默病(AD)、帕金森病(PD)或其他慢性病的亲属。访谈将包括传统的基于任务的照看强度测量，即帮助照顾者完成7项工具性和基本的日常生活活动(I/ADL)中的每一项，以及询问是否在情感和/或身体上难以帮助每一项I/ADL任务。我们将使用认知访谈技术来探索参与者对与执行每项I/ADL任务相关的难度或压力的评估的潜在思维过程。利用这些信息，一个专家小组将创建情感和身体护理强度的加权测量。我们将使用从这些参与者收集的一般和照看特定的压力量表，以及从现有的AD和PD照顾者研究中获得的数据来评估这些新措施的有效性。我们将比较新的护理强度测量方法和传统护理强度测量方法在a)当前护理强度，以及b)累积和滞后的累计护理强度与骨质疏松性骨折研究(CG-SOF)中死亡率和功能衰退之间的关系。CG-SOF是一项前瞻性队列研究，对1069名老年女性照顾者和非照顾者进行了12年以上的随访。假设将解决新的和传统的护理强度测量(当前和累积)与死亡率和功能衰退之间的关联的比较，以及情绪和身体护理强度的组合对这些结果的关联。这项研究不仅将阐明照顾强度对健康的影响，而且将为 为将这些新措施应用于其他数据集、照顾者类型和不同的健康结果奠定基础。

项目成果

Associations of spousal and non-spousal caregiving with six-year trajectories of depressive symptoms among older women in the Caregiver-Study of Osteoporotic Fractures study.

在骨质疏松性骨折护理者研究中，配偶和非配偶护理与老年女性抑郁症状六年轨迹的关联。

• DOI: 10.1080/13607863.2021.1950611
• 发表时间: 2022
• 期刊: Aging & mental health
• 影响因子: 3.4
• 作者: Smith,MeghanL;Heeren,TimothyC;Ranker,LynsieR;Fredman,Lisa
• 通讯作者: Fredman,Lisa