Physiological Indicators of Perceived Suffering in a Loved One' Spousal Reactions

描述（申请人提供）：许多已发表的研究支持这样一个普遍结论，即疾病和残疾对家庭照顾者的情感和身体健康有负面影响，虽然痛苦的概念可能隐含在现有的疾病和残疾概念中，但实证研究并没有把病人的痛苦作为照顾者结果的独特和独立因素（Schulz等人，2007）。拟议的研究将集中在患有肌肉骨骼疾病的护理对象的痛苦表现，特别是患有骨关节炎和下背痛的个人，以及对配偶照顾者的痛苦影响。我们专注于护理接受者及其配偶照顾者，因为护理接受者的配偶可能每天都面临护理接受者疼痛和痛苦的急性情况（例如，当他们进行日常家务活动时）。我们在实验室环境中以两种方式操作暴露于痛苦中的患者：（1）观察正在执行模拟家务任务的护理接受者表达的疼痛;（2）准备关于护理接受者痛苦的演讲。我们还要求所有参与者完成自我报告措施的照顾受助人的痛苦在日常生活中，包括有关的问题的身体，心理和精神/存在的痛苦的组成部分。我们建议，照顾者的痛苦暴露可能会导致心血管应激反应加剧，操作为增加血压（BP）和心率（HR），以及低心率变异性（HRV）。我们还建议，照顾者的暴露于照顾对象的痛苦将导致个人痛苦和/或移情的关注，这将是高度相关的心血管应激反应的心理体验。此外，我们探讨如何与照顾者，照顾者，和关系的影响照顾者的心理和生理反应的照顾者的痛苦。例如，我们检验了一个假设，即目睹配偶痛苦会导致高度兴奋，以提供有关心血管疾病易感性的关键信息（例如，冠心病和高血压）。此外，由于我们正在调查目睹关系伴侣和陌生人痛苦时心血管反应的差异，这项研究不仅对家庭照顾者有意义，而且对专业帮助者（护士，医生，教师和治疗师）也有意义。

DESCRIPTION (provided by applicant): Scores of published studies support the general conclusion that illness and disability have negative effects on the emotional and physical well-being of family caregivers, and while the notion of suffering may be implicit in existing conceptualizations of illness and disability, the empirical research has not focused on patient suffering as a unique and independent contributor to caregiver outcomes (Schulz et al, 2007). The proposed research will focus on the manifestation of suffering in care recipients with musculoskeletal conditions, specifically individuals with osteoarthritis and lower back pain, and the ways suffering impacts on spousal caregivers. We focus on care recipients and their spousal caregivers, because spouses of care recipients are likely to be faced with acute instances of the care recipient's pain and suffering on a daily basis (e.g. when they are performing everyday household activities). We operationalize caregivers1 exposure to the suffering in two ways in a laboratory setting: (1) observing expressed pain from the care recipient who is performing a simulated household task and (2) preparing a speech about the care recipient's suffering. We also ask all participants to complete self-report measures of the care recipients' suffering in everyday life that incorporate questions about the physical, psychological, and spiritual/existential components of suffering. We propose that the caregiver's exposure to suffering can lead to a heightened cardiovascular stress response, operationalized as increased blood pressure (BP) and heart rate (HR), and low heart rate variability (HRV). We also propose that the caregiver's exposure to the care recipient's suffering will result in the psychological experience of personal distress and/or empathic concern, which will be highly interrelated with the cardiovascular stress response. Furthermore, we explore how factors associated with the care recipient, the caregiver, and the relationship impact caregiver's psychological and physiological reactions to the care recipient's suffering. For example, we test the hypothesis that witnessing a spouse in pain will lead to a high heighten to provide crucial information about susceptibility to cardiovascular disorders (e.g., coronary heart disease and hypertension) for older Americans. Also, because we are investigating differences in cardiovascular reactions to witnessing relationship partners and strangers' suffering, this research has implication not only for family caregivers, but also for professional helpers (nurses, doctors, teachers, and therapists).