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，导致明显的 护理人员的健康和生活质量 (QOL) 下降。减少 CG 困扰有可能改善 CG 心理和身体健康，提高整体生活质量，并改善他们提供的护理。 然而，很少有可以广泛实施且易于遵守的有效干预措施得到严格遵守。 评价。 气功是一种日益流行的多模式身心锻炼，有望解决以下问题： 与 CG 高度相关的广泛的社会心理和身体因素。与以下人员共享许多特征 太极、气功融合了缓慢柔和的运动、呼吸训练和认知技能的元素 包括增强的身体意识、集中的精神注意力和意象——这些共同可以提供 与单模式疗法相比，对健康有更大的益处。强有力的证据基础支持气功和 团体太极拳训练可以改善身心健康、生活质量和自我保健等多个领域 在不同人群中的功效。值得注意的是，最近的全国调查表明，很大一部分美国 报告使用气功和太极拳来保健的人群更喜欢通过 DVD 和太极拳进行自我指导学习 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 由于身心实践，此类项目的评估尚未经过充分测试，尤其是在 CG 方面。 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 学期目标是进行一项明确的试验，评估一种广泛使用且先前研究过的气功养生法 （八段锦、八段锦气功）。干预措施将由以下人员领导的社区团体进行： 教师或通过互联网向个人通过录制的指导说明进行学习，并辅以 来自讲师的间歇性虚拟实时反馈。结果将包括生活质量、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 进行混合方法试点随机对照试验（RCT），以告知可行性和设计 最终审判。我们将通过将 (1:1:1) 42 个 CCG 随机分配到以下三个条件之一来实现这些目标：(1) 以社区为基础的气功项目； （二）网络气功项目； (3) 等待名单对照组。 具体目标1是最终确定气功干预内容和实施方案。具体目标 2 将评估 气功的“可学习性”通过基于网络的协议在基于社区的团体课程中提供 新颖的熟练度工具。具体目标 3 将评估招募和留住 CCG 的可行性 为期 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、退出参与者的退出访谈进行正式定性分析，以及 气功教练。

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.