Style and Substance: Characterizing Dementia Caregiving Styles and Associated Biopsychosocial and Health Services Utilization Outcomes

风格和实质：描述痴呆症护理风格和相关的生物心理社会和健康服务利用结果

• 批准号: 10217955
• 负责人: Amanda Noel Leggett
• 金额: $ 12.85万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10217955
• 关键词: Acute; Address; Adopted; Adult; Affect; Alzheimer' s Disease; Ambulatory Care; American; Anger; Area; Behavior; Behavior Therapy; Behavioral; Belief; Biological Assay; Biological Markers; Caregiver Burden; Caregiver well-being; Caregivers; Caring; Child Rearing; Chronic Disease; Cognitive; Collection; Communication; Competence; Decision Making; Dementia; Dementia caregivers; Distress; Emergency Care; Emergency department visit; Emotional; Evaluation; Exposure to; Family; Family Caregiver; Family Process; Future; Goals; Growth; Health; Health Care Costs; Health Services; Healthcare; Hydrocortisone; Individual; Inpatients; Intervention; Interview; Investigation; K-Series Research Career Programs; Knowledge; Laws; Lead; Link; Literature; Measures; Mental Depression; Mental Health; Mental Health Services; Mentors; Mentorship; Methodology; Methods; Modeling; Outcome; Parents; Patients; Pattern; Personal Satisfaction; Personality; Persons; Physiological; Preventive Health Services; Process; Public Health; Quality of Care; Readiness; Recording of previous events; Research; Research Personnel; Resources; Risk; Role; Science; Seminal; Sleep disturbances; Social Sciences; Stress; Structure; Time; Training; Training Programs; Typology; United States; Vulnerable Populations; Well in self; Work; acute care; age related; base; biobehavior; biopsychosocial; care outcomes; care recipients; care systems; caregiving; clinical encounter; coping; dehydroepiandrosterone; dementia care; dementia caregiving; demographics; experience; follow-up; functional outcomes; geriatric mental health; health service use; high risk; high risk population; improved; improved outcome; innovation; peer; personalized approach; personalized medicine; physical conditioning; primary caregiver; programs; psychologic; service intervention; skills; social; stressor; support network; symposium; therapy development; willingness

As the number of individuals with Alzheimer's disease and other forms of age-related dementia is increasing, millions of adults in the United States are taking on the role of caregiver for these individuals. Extending beyond existing work within the Stress Process Model, this work aims to identify caregivers at highest risk for negative psychological and physiological outcomes and increased health services utilization, by considering the understudied area of dementia caregiving styles. Dementia caregiving style may be defined by cognitive beliefs, readiness to change, and behavioral strategies toward dementia management. This mentored career development award aims to combine a program of focused research, mentorship, and didactics to enable the candidate's growth toward a long-term goal of becoming an independent researcher focused on the delineation of factors associated with the mental health and health outcomes of dementia caregivers, and developing and disseminating interventions targeted toward unique caregiving styles. Aims of the proposed training plan are to: 1) gain exposure to care challenges for persons with dementia and their families through observation of clinical encounters; 2) increase methodological knowledge of biomarker collection, assays, and statistical methodology, and latent class analysis; and 3) acquire skills to develop, implement, and evaluate future behavioral interventions utilizing the caregiving styles advanced during the proposal. The training objectives seek to develop the candidate's potential as a geriatric mental health services researcher and align closely with the research aims to: 1) characterize caregiving-style typologies through the mixed-methods assessment of dementia caregivers on cognitive beliefs, readiness to change, and behavioral strategies toward dementia management. Semi-structured qualitative interviews and latent-class analysis will be used to determine how these measures cluster within distinct caregiving styles. 2) Define high-risk groups of caregivers by the association of biomarkers of the stress process, psychological well-being, and health services utilization with caregiving styles. 3) Finally, an exploratory aim will consider the mutability of caregiving styles over 6 months. The expected results would significantly increase understanding of high-risk groups of caregivers which would benefit from interventions tailored toward these distinct caregiving styles, thereby improving outcomes for both people with age-related dementia and their caregivers.

随着患有阿尔茨海默病和其他形式的年龄相关性痴呆的人数不断增加，数百万人 美国的成年人正在承担起照顾这些人的角色。超越现有工作 在压力过程模型中，这项工作旨在确定负性心理和 生理结果和增加卫生服务利用，通过考虑未充分研究的痴呆症领域 时尚风格。痴呆症患者的生活方式可以由认知信念、改变的意愿和行为习惯来定义。 痴呆症管理策略。这个指导职业发展奖的目的是联合收割机计划的重点 研究，指导和教学，使候选人的成长朝着成为一个独立的长期目标 研究人员专注于描绘与痴呆症的心理健康和健康结果相关的因素 护理人员，并制定和传播针对独特的护理风格的干预措施。宗旨 拟议的培训计划是：1）通过以下方式接触痴呆症患者及其家人的护理挑战 观察临床遭遇; 2）增加生物标志物收集，测定和统计的方法学知识 方法论和潜在的阶级分析;和3）获得技能，以发展，实施和评估未来的行为 利用提案期间提出的辩论风格进行干预。培训目标旨在发展 候选人作为老年心理健康服务研究人员的潜力，并与研究目标紧密结合：1） 通过混合方法评估痴呆照顾者的认知功能， 信念，准备改变，以及痴呆症管理的行为策略。半结构化定性 访谈和潜在类分析将被用来确定这些措施如何在不同的学习风格集群。 2)通过压力过程的生物标志物，心理健康， 和卫生服务利用的差异。3)最后，一个探索性的目标将考虑的可变性 超过6个月的风格。预期结果将大大增加对高风险群体的了解， 照顾者将受益于针对这些不同的照顾方式定制的干预措施，从而改善 对老年痴呆症患者及其照顾者的影响。

项目成果

"It's Been a Hard Day's Night": Sleep Problems in Caregivers for Older Adults.

• DOI: 10.1007/s40675-020-00164-0
• 发表时间: 2020-03
• 期刊: Current sleep medicine reports
• 影响因子: 1.8
• 作者: Leggett AN;Morley M;Smagula SF
• 通讯作者: Smagula SF

Bright Light as a Preventive Intervention for Depression in Late-Life: A Pilot Study on Feasibility, Acceptability, and Symptom Improvement.

亮光作为晚年抑郁症的预防性干预措施：可行性、可接受性和症状改善的试点研究。

• DOI: 10.1016/j.jagp.2017.11.007
• 发表时间: 2018
• 期刊: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
• 作者: Leggett,AmandaN;Conroy,DeirdreA;Blow,FredericC;Kales,HelenC
• 通讯作者: Kales,HelenC

Care Challenges Due to COVID-19 and Mental Health Among Caregivers of U.S. Adults With a Chronic or Disabling Condition.

• DOI: 10.1093/geroni/igab031
• 发表时间: 2021
• 期刊: Innovation in aging
• 影响因子: 7
• 作者: Leggett AN;Carmichael A;Leonard N;Jackson J;Kirch M;Solway E;Kullgren JT;Singer D;Malani PN;Gonzalez R
• 通讯作者: Gonzalez R

Applying Rigor: Intervention Studies for Behavioral and Psychological Symptoms of Dementia.

严格应用：痴呆症行为和心理症状的干预研究。

• DOI: 10.1016/j.jagp.2019.02.004
• 发表时间: 2019
• 期刊: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
• 作者: Leggett,AmandaN;Kales,HelenC
• 通讯作者: Kales,HelenC