Caring for caregivers with mind-body exercise

照顾者（CG）经常经历严重的心理和身体痛苦，导致显着的 照顾者的健康和生活质量（QOL）下降。减少CG困扰有可能改善 CG精神和身体健康，提高整体生活质量，并导致他们提供的护理的改善。 然而，很少有有效的干预措施，可以广泛提供和容易遵守， 评估。 气功是一种越来越受欢迎的多模式身心锻炼，在解决 广泛的心理社会和身体因素与CG高度相关。有许多共同的特点， 太极，气功结合了缓慢温和的运动元素，呼吸训练，和一些认知技能 包括提高身体意识、集中精神注意力和想象力--这些加在一起可以提供 与单一模式疗法相比，对健康的益处更大。一个强大的证据基础支持，气功和 太极拳团体训练可以改善身体和情绪健康，生活质量和自我的多个领域， 在不同人群中的功效。值得注意的是，最近的全国性调查表明， 报告使用气功和太极拳健康的人群更喜欢从DVD中进行自我指导学习， 互联网资源。虽然少数研究支持基于网络或基于DVD的学习的潜力， 身心实践，这些计划的评价还没有得到很好的测试，特别是在CG。 使用癌症护理人员（CCG）作为较大CG人群的代表人群，我们的长期- 长期目标是进行一项明确的试验，评估广泛使用和以前研究的气功养生法 八段锦气功。干预措施将在社区团体中提供， 教师或通过互联网向个人提供通过录制的指导教学进行学习的机会， 来自导师的间歇性虚拟实时反馈。结局将包括QOL、疲劳、睡眠障碍， 心理困扰、照顾者负担和身体功能。R34的短期目标是 进行一项混合方法的试点随机对照试验（RCT），以了解 最终审判我们将通过将42个CCG（1：1：1）随机分配到以下三种情况之一来实现这些目标：（1）a 基于社区的气功计划;（2）基于互联网的气功计划;或（3）候补名单对照组。 具体目标1是最终确定气功干预内容和交付协议.具体目标2将评估 气功的“可学性”在基于社区的小组课程和通过基于网络的协议使用 新的熟练工具。具体目标3将评估招募和保留CCG到 12-周的临床试验，并完成所有结果测试方案。研究的可行性和优点将进一步 通过对研究完成者、退出研究的参与者的退出访谈进行正式定性分析， 气功导师。

Caregivers (CGs) often experience significant psychological and physical distress leading to marked reductions in caregivers' health and quality of life (QOL). Reducing CG distress has the potential to improve CG mental and physical health, improve overall QOL, and lead to improvements in the care they provide. However, few effective interventions that can be widely delivered and easily adhered to have been rigorously evaluated. Qigong is an increasingly popular multi-modal mind-body exercise that shows promise in addressing a broad range of psychosocial and physical factors highly relevant to CGs. Sharing many characteristics with Tai Chi, Qigong incorporates elements of slow gentle movement, breath training, and number of cognitive skills including heightened body awareness, focused mental attention, and imagery—which collectively may afford greater benefits to health compared to unimodal therapies. A robust evidence base supports that Qigong and Tai Chi training in groups can improve multiple domains of physical and emotional health, QOL, and self- efficacy in diverse populations. Of note, recent national surveys indicate that a significant proportion of the US population that report using Qigong and Tai Chi for health preferred self-directed learning from DVDs and internet resources. While a handful of studies support the potential for web-based or DVD-based learning of mind-body practices, evaluations of such programs have not been well-tested, especially in CGs. Using cancer caregivers (CCGs) as a representative population of the larger CG population, our long- term goal is to conduct a definitive trial evaluating a widely accessible and previously studied Qigong regimen (Eight Brocades, Baduanjin Qigong). Interventions will be delivered either in community-based groups led by instructors or via internet to individuals learning through recorded guided instruction supplemented with intermittent virtual live feedback from instructors. Outcomes will include QOL, fatigue, sleep disturbances, psychological distress, caregiver burden, and physical function. The short-term goals of this R34 are to conduct a mixed-methods pilot randomized controlled trial (RCT) to inform the feasibility and design of a definitive trial. We will address these goals by randomizing (1:1:1) 42 CCGs to one of three conditions: (1) a community-based qigong program; (2) an internet-based qigong program; or (3) a wait-list control group. Specific Aim 1 is to finalize Qigong intervention content and delivery protocols. Specific Aim 2 will assess the 'learnability' of Qigong delivered in community-based group classes and via a web-based protocol using a novel proficiency instrument. Specific Aim 3 will evaluate the feasibility of recruiting and retaining CCGs into a 12-week clinical trial, and completing all outcomes testing protocols. Study feasibility and merit will be further informed by formal qualitative analysis of exit interviews of study completers, participants that withdraw, and Qigong instructors.