Caring Light for Family Caregivers

为家庭护理人员提供关爱之光

• 批准号: 9348119
• 负责人: BRUNO KAJIYAMA
• 金额: $ 29.91万
• 依托单位: PHOTOZIG, INC.
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2018-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9348119
• 关键词: Address; Adopted; Adoption; Adult; Adverse effects; Age; Alzheimer' s Disease; American; Anxiety; Behavior; Breathing; Caregiver Burden; Caregiver support; Caregivers; Caring; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Chronic stress; Climacteric; Clinical; Complement; Coping Skills; Data; Dementia; Dementia caregivers; Depressive Syndromes; Development; Distress; Educational Curriculum; Effectiveness; Emotional; Exercise; Family; Family Caregiver; Family member; Focus Groups; Fostering; Funding; Health; Health Care Costs; Healthcare; Hour; Incidence; Individual; Institutionalization; Intervention; Learning; Left; Light; Location; Long-Term Care; Medical; Meditation; Mental Depression; Mental Health; Methods; Moods; Neurodegenerative Disorders; Notification; Outcome; Patients; Persons; Pharmaceutical Preparations; Phase; Prevalence; Procedures; Protocols documentation; Publishing; Quality of life; Randomized; Randomized Clinical Trials; Recruitment Activity; Relaxation; Research; Research Project Grants; Resources; Scanning; Side; Stream; Stress; Stretching; Symptoms; Techniques; Testing; Time; Training; United States National Institutes of Health; Universities; Ursidae Family; Yoga; base; care burden; caregiving; chronic pain; coping; cost; cost effective; dementia care; dementia caregiving; design; economic cost; effective intervention; evidence base; experience; flexibility; high risk; hospice environment; improved; innovation; mindfulness; mindfulness intervention; mindfulness-based stress reduction; mobile application; novel; physical conditioning; prevent; programs; prototype; psychoeducation; public health relevance; skills; usability

Project Summary: Every 66 seconds, someone in US develops Alzheimer’s Disease, a progressive irreversible neurodegenerative disease, causing distress not only to dementia patients, but also to caregivers (15+ million), who are the hidden patients with high incidence of stress (60%) and depression (30%+). Due to this significant problem, effective, low-cost, and accessible interventions are needed to help dementia caregivers to deal with the caring demands, heavy emotional toll, life changes, and overwhelming experiences. A promising delivery mechanism is the smartphone, because: a) adoption is very high and growing (e.g. during our Phase II in 2019, 84% to 95% of adults ages 18-64 are expected to own smartphones – and according to CDC, most of dementia caregivers (77%) are younger than 65 years, which is a fairly large group); and b) 98% of Americans nationwide have access to mobile broadband (according to the White House). Therefore, we propose a unique intervention by integrating our Coping with Caregiving (CWC) curriculum, mindfulness (MBSR), self-paced approach, and mobile app delivery, which has not been created before, called Caring Light App (CLA) to enhance caregiver coping skills, reduce stress, and alleviate depression. Our project will have a high impact because: 1) the blending of CWC and mindfulness is expected to be very effective, based on our preliminary studies and other research results; 2) the proposed program is low-cost ($4.99/year per person); and 3) CLA intervention will be accessible to a large group of caregivers as a mobile app, allowing its broad dissemination to innumerous families struggling with Alzheimer’s and related dementia. CWC was developed in evidence-based procedures by Dr. Gallagher-Thompson and associates, evaluated in many randomized clinical trials (e.g. as a component of the NIH-funded national research project REACH, “Resources for Enhancing Alzheimer’s Caregiver Health”), enhanced throughout the years, and successfully converted into effective self-paced passive programs, such as iCare and Webnovela. Mindfulness-based Stress Reduction (MBSR) was developed by Dr. Kabat-Zinn and adopted in many settings. It includes the practice of mindfulness, breathing, and meditation; and it was applied in innumerous programs to reduce stress, anxiety, depression, chronic pain, and other symptoms for several medical conditions. By integrating mindfulness practice with our proven CWC curriculum in a new mobile app, we will create a novel program for caregivers, blending training (coping skills, techniques to deal with dementia, practical tips on difficult behaviors, etc.) with stress reducing strategies (e.g. guided meditation, gentle stretches, and other mindfulness exercises), which is expected to be well accepted and easy to use by caregivers. In partnership with the Alzheimer’s Association, Stanford University, and caregivers, we will develop and evaluate a prototype in Phase I. We will assess the effectiveness of the complete CLA (with all modules) in improving well-being, and alleviating stress with a randomized clinical trial in Phase II.

项目摘要：每 66 秒，美国就有一个人患上阿尔茨海默病，这是一种进行性的疾病 不可逆的神经退行性疾病，不仅给痴呆症患者带来痛苦，也给护理人员带来痛苦 （15+万），他们是压力（60%）和抑郁（30%+）高发的隐性患者。 由于这一重大问题，需要有效、低成本且易于获得的干预措施来帮助痴呆症 护理人员要应对护理需求、沉重的情感负担、生活变化和压倒性的经历。 智能手机是一种很有前途的交付机制，因为：a）采用率非常高并且不断增长（例如在 在 2019 年的第二阶段，预计 84% 至 95% 的 18-64 岁成年人将拥有智能手机 – 根据 CDC，大多数痴呆症护理人员（77%）年龄在 65 岁以下，这是一个相当大的群体）； b) 98% 全国 的美国人可以使用移动宽带（根据白宫的说法）。 因此，我们提出了一种独特的干预措施，整合我们的应对护理 (CWC) 课程， 正念（MBSR）、自定进度的方法和移动应用程序交付，这是以前从未创建过的，称为 Caring Light 应用程序 (CLA) 可增强护理人员的应对技能、减轻压力并缓解抑郁。 我们的项目将产生很大的影响，因为：1）CWC 和正念的融合预计会非常有效。 根据我们的初步研究和其他研究成果，有效； 2）所提出的方案成本低 （每人每年 4.99 美元）； 3) CLA 干预将作为移动设备可供大量护理人员使用 应用程序，使其能够广泛传播给无数患有阿尔茨海默氏症和相关痴呆症的家庭。 CWC 是由 Gallagher-Thompson 博士及其同事通过循证程序开发的，并在 许多随机临床试验（例如，作为 NIH 资助的国家研究项目 REACH 的一部分， “增强阿尔茨海默病护理人员健康的资源”），多年来不断增强，并成功 转化为有效的自定进度的被动计划，例如 iCare 和 Webnovela。 基于正念的减压 (MBSR) 由 Kabat-Zinn 博士开发，并在许多环境中采用。 它包括正念、呼吸和冥想的练习；并且它被应用在无数的程序中 减轻压力、焦虑、抑郁、慢性疼痛和多种疾病的其他症状。 通过在新的移动应用程序中将正念练习与我们经过验证的 CWC 课程相结合，我们将创建一个 针对护理人员的新颖计划、混合培训（应对技巧、应对痴呆症的技巧、实用技巧 困难行为等）与减压策略（例如引导冥想、温和的伸展运动和其他 正念练习），预计会被护理人员广泛接受且易于使用。 我们将与阿尔茨海默病协会、斯坦福大学和护理人员合作，开发和 评估第一阶段的原型。我们将评估完整 CLA（包含所有模块）的有效性 通过 II 期随机临床试验改善健康并减轻压力。