Employment Status, Psychosocial Functioning, and Chronic Inflammation Among Dementia Spousal Caregivers

痴呆症配偶照顾者的就业状况、心理社会功能和慢性炎症

• 批准号: 10710581
• 负责人: Jensine Paoletti
• 金额: $ 6.95万
• 依托单位: RICE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10710581
• 关键词: Alzheimer' s Disease; Alzheimer' s disease related dementia; Atherosclerosis; Bereavement; Cardiovascular Diseases; Caregiver Burden; Caregivers; Caring; Chronic; Chronic stress; Conflict (Psychology); Data; Dementia; Dementia caregivers; Emotions; Employee; Employment; Employment Status; Equilibrium; Exhibits; Family; Family Caregiver; Fatigue; Feeling; Foundations; Funding; Future; Health; Health Psychology; Hour; Inflammation; Inflammatory; Inflammatory Response; Intervention; Investigation; Leisures; Life; Linear Regressions; Longitudinal Studies; Malignant Neoplasms; Mediating; Mediation; Mediator; Mental Depression; Mental Health; Methods; Modeling; National Research Service Awards; Non-Insulin-Dependent Diabetes Mellitus; Occupational Health; Occupations; Osteoporosis; Outcome; Patient Self-Report; Patients; Poverty; Premature aging syndrome; Production; Psychoneuroimmunology; Psychosocial Factor; Research; Research Design; Research Personnel; Rest; Risk; Risk Factors; Role; Sampling; Social Environment; Spouse Caregiver; Spouses; Stress; Testing; Time; Widow; Widowhood; Work; Workplace; cardiovascular risk factor; care giving burden; caregiving; cytokine; dementia caregiving; effective intervention; emotion regulation; experience; family caregiving; frailty; inflammatory marker; mortality; novel; perceived stress; physical conditioning; poor health outcome; prognostic; psychosocial; retiree; stressor; theories

Project Summary/Abstract Caregiving for a spouse with Alzheimer's disease and related dementias (ADRD) is an extreme, chronic stressor. There are 16 million informal (i.e., unpaid) ADRD caregivers in America; ADRD caregivers have chronically elevated inflammation relative to their non-caregiver counterparts1–3. Chronic inflammation is a risk factor for cardiovascular disease, atherosclerosis, type II diabetes, some cancers, fatigue, depression, premature aging, mortality, and Alzheimer's disease. ADRD caregivers often need to balance their caregiving duties with their employment responsibilities, as about half of all ADRD caregivers work over 20 hours per week4,5. To understand the impact of employment on ADRD caregivers’ psychosocial functioning and chronic inflammation, researchers must utilize theories and methods from occupational health psychology and psychoneuroimmunology. Compared to retired caregivers, employed caregivers experience two chronic stressors: employment and caregiving. Therefore, employed spousal caregivers may experience higher perceived stress than retired counterparts due to an additive effect of work stress plus caregiving stress. Working necessitates various demands and takes up a significant portion of time – time that could be used to care for their spouse or for their own rest and leisure. The time associated with employment, plus caregiving, may also result in employed caregivers evaluating their caregiving as more burdensome. This study aims to test the hypothesis that employment plus caregiving is related to poorer psychosocial functioning (i.e., perceived stress and subjective caregiver burden) and higher proinflammatory cytokine markers. Although inflammation has been implicated in studies of caregivers, very few studies have examined the inflammatory responses of caregivers’ workplace experiences6. Specific Aims: (1) To examine the role of employment status for ADRD spousal caregivers’ chronic inflammation. (2) To examine the role of employment status for ADRD spousal caregivers’ psychosocial functioning (i.e., perceived stress and caregiver burden). (3) To explore psychosocial functioning as mediators between employment status and chronic inflammation. Concurrent with an R01 project funded by NIA, this project will examine employment, psychosocial functioning, and chronic inflammation in a longitudinal study of 180 ADRD spousal caregivers (90 employed, 90 retired). Investigation of the relationship between employment and inflammation would further understanding of the role of employment as a risk factor for caregivers’ health. Results will yield important information for tailoring health interventions for ADRD caregivers. This proposed project will also introduce the applicant to psychoneuroimmunology and enable her research pipeline which will integrate occupational health psychology and psychoneuroimmunology.

项目总结/摘要 照顾患有阿尔茨海默病和相关痴呆症（ADRD）的配偶是一种极端的、慢性的行为 压力源有1600万非正式（即，美国的ADRD护理人员; ADRD护理人员 相对于他们的非看护者对应者，慢性炎症升高1 -3。慢性炎症是一种风险 心血管疾病，动脉粥样硬化，II型糖尿病，某些癌症，疲劳，抑郁症， 过早衰老死亡和阿尔茨海默病ADRD护理人员通常需要平衡他们的生活， 由于约有一半的ADRD护理人员工作时间超过20小时， 第四、五周。了解就业对ADRD照顾者心理社会功能的影响， 慢性炎症，研究人员必须利用职业健康心理学的理论和方法， 和心理神经免疫学与退休的照顾者相比，受雇的照顾者经历两种慢性疾病， 压力源：就业和失业。因此，受雇的配偶照顾者可能会经历更高的 工作压力和工作压力的叠加效应使退休人员的工作压力高于退休人员。 工作需要各种各样的要求，并占用了很大一部分时间-时间可以用来 照顾他们的配偶或自己的休息和休闲。与就业相关的时间，加上失业， 也可能导致受雇的护理人员认为他们的工作负担更重。本研究旨在 检验就业加失业与较差的心理社会功能有关的假设（即， 感知的压力和主观护理者负担）和较高的促炎细胞因子标志物。虽然 对护理人员的研究中涉及炎症，但很少有研究炎症 照顾者工作经验的反应6.具体目标：（1）研究就业的作用 ADRD配偶照顾者慢性炎症状态。(2)研究就业状况在以下方面的作用： ADRD配偶照顾者的心理社会功能（即，感知压力和照顾者负担）。(3)到 探讨社会心理功能作为就业状况和慢性炎症之间的中介。 与NIA资助的R 01项目同时进行，该项目将研究就业、心理社会功能， 和慢性炎症的纵向研究180 ADRD配偶照顾者（90名就业，90名退休）。 调查就业与炎症的关系将进一步了解 就业是影响照顾者健康的一个风险因素。结果将产生重要的 为ADRD护理人员定制健康干预措施的信息。该项目还将 向申请人介绍心理神经免疫学，并使她的研究管道，将整合 职业健康心理学和心理神经免疫学。