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Tailored Health Self-Management Interventions for Highly Distressed Family Caregivers

为高度痛苦的家庭护理人员量身定制健康自我管理干预措施

基本信息

批准号：
9234352
负责人：
JACLENE A ZAUSZNIEWSKI
金额：
$ 53.66万
依托单位：
CASE WESTERN RESERVE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-27 至 2020-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9234352
关键词：
Accounting Address Adult Adverse effects Affect Affective American Asthma Biofeedback Bipolar Disorder Caregivers Caring Chronic Chronic stress Control Groups Dementia Diabetes Mellitus Diagnosis Distress Dose Education Educational Intervention Effectiveness Family Family Caregiver Family member Family psychotherapy General Population Health Healthcare Hospitalization Hypertension Individual Individual Differences Intervention Knowledge Lead Longevity Malignant Neoplasms Measures Mental Depression Mental Health Modeling Moods Multivariate Analysis Neurologic Persons Population Precision Medicine Initiative Primary Health Care Process Psyche structure Randomized Randomized Controlled Trials Reaction Relapse Research Risk Role Self Care Self Management Services Severities Stress Symptoms Testing Time Training United States base behavioral health care recipients caregiver interventions caregiving clinically significant contextual factors cost design disability-adjusted life years disorder prevention early onset empowered experience help-seeking behavior informal caregiver innovation novel physical conditioning preference response self help skills skills training stress management theories treatment as usual

项目摘要

Tailored Health Self-Management Interventions for Highly Distressed Family Caregivers In the United States, family members serve as unpaid informal caregivers for more than 10 million adults with bipolar disorder. These family caregivers are highly distressed as they experience the fluctuating moods, intensity, and unpredictability associated with bipolar disorder. Bipolar symptom exacerbation, relapse, inability to manage daily activities, and need for ongoing treatment for the person with bipolar disorder, put family caregivers at great risk for compromised mental and physical health. These caregivers have been found to experience greater distress than caregivers of persons with diabetes, hypertension, asthma or dementia and have significantly more mental and physical health problems than the general population, leading to greater use of mental health and primary care services. When their health declines, symptom exacerbation, affective episodes, and re-hospitalization of the diagnosed family member increase. Existing family therapy and education interventions for these caregivers have had little effect on their own health. Health self-management interventions, particularly those tailored to address caregivers' needs and preferences for education, stress management, or resourcefulness skills, have not been examined in this population. This randomized controlled trial will evaluate how varying levels of participation by family caregivers in selecting self-management interventions (ranging from no input into the selection to selection based on caregiver need or preference) affect their health risks and physical and mental health over time. Caregivers will be randomized to: 1) a control group (no intervention); 2) education (usual care); 3) self-management intervention based on need (SM-need); or 4) self-management intervention of their preference (SM-preference). The study aims to: 1) examine differences across the four groups on caregiver health over time; 2) explore relationships between caregiver needs and preferences and relevant contextual factors (care recipient symptoms, caregiver reactions, and caregiving involvement); and 3) build caregiver profiles that are associated with their needs and preferences for intervention. Caregivers in the SM-need and SM-preference groups will receive one of three interventions tailored to match their need or preference: 1) education; 2) biofeedback; or 3) resourcefulness training. Family caregivers will be assessed at baseline (T1), 6 months (T2) and one year (T3). Repeated measures multivariate analyses will address the study aims. The findings from this study will generate new scientific knowledge about the effectiveness of novel, easy to use, independently performed interventions that can be self-tailored to promote caregiver health through education, biofeedback, or resourcefulness. Once established, these health self-management interventions can be tailored to match the needs and preferences of other comparably distressed family caregivers of persons with other chronic mental or physical conditions.

量身定制的健康自我管理干预高度痛苦的家庭照顾者