Qualitative Evaluation of Caregiving Outcome and Process Measures among Latino/a Caregivers

拉丁裔/a 护理人员护理结果和过程措施的定性评估

• 批准号: 10729418
• 负责人: MILDRED RAMIREZ
• 金额: $ 42.57万
• 依托单位: HEBREW HOME FOR THE AGED AT RIVERDALE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10729418
• 关键词: Address; Adherence; Adverse effects; Age; Alzheimer' s Disease; Alzheimer' s disease caregiver; Alzheimer' s disease related dementia; Area; Attention; Caregivers; Characteristics; Clinic; Code; Cognitive; Complex; Comprehension; Dementia; Dementia caregivers; Disparity; Doctor of Philosophy; Dominican; Elderly; Epidemiology; Ethnic Origin; Exercise; Family; Family Caregiver; Generations; Geriatrics; Gerontology; Goals; Growth; Health Professional; Individual; Internal Medicine; Knowledge; Latina; Latina Population; Latino; Latino Population; Life Expectancy; Measurement; Measures; Mental Depression; Methodology; Methods; Modeling; Modification; Motivation; Neurosciences; New York City; Online Systems; Outcome; Outcome Measure; Personal Satisfaction; Persons; Phase; Population; Population Heterogeneity; Presbyterian Church; Process; Process Measure; Protocols documentation; Puerto Rican; Qualifying; Qualitative Evaluations; Qualitative Methods; Race; Research; Research Methodology; Review Literature; Sampling; Site; Source; Stress; Structure; Surveys; System; Testing; Underrepresented Populations; Work; Writing; caregiving; caregiving outcomes; cognitive interview; commune; comparative; concept mapping; experience; health care disparity; informal caregiving; insight; instrument; interest; method development; migration; recruit; response; satisfaction; statistics

Abstract Limited culture-specific and comparative research available documents that Latino family caregivers of persons with dementia bear a heavier burden and suffer more adverse effects on well-being than their counterparts of other race and ethnic backgrounds. However, there is a paucity of studies examining empirically putative measurement-related sources of these disparities. Thus, the following gap in knowledge remains: Could a contributing factor to the disparities in caregiving outcomes be due to a lack of appropriate measures or to measurement non-equivalence, i.e., measurement bias attributable to culture-specific conceptualization of constructs and/or interpretation of items? The proposed effort will focus on Latina/o caregivers living in the New York City area. The immediate goal is to identify areas that are not represented well in outcome and process measures extant, and to examine systematically existing measures that are used with Latino/a caregivers to determine if measure modification may be needed. A goal is to generate an item pool for use in developing measures of emerging constructs identified in the proposed qualitative process. The proposed specific aims are: Aim 1: to conduct a literature review of the previous 10-years and important earlier studies to document the qualitative work extant on caregiving outcome measures used with Latina/o family caregivers, particularly those used in the context of people with Alzheimer’s disease and related disorders; Aim 2: to extend the qualitative work performed by our team and others with respect to key outcome and process measures such as depression, stress, and burden, frequently used in culture-specific and/or comparative caregiving for persons with dementia research with Latinos/as; Aim 3: to identify additional, emerging constructs that might need to be included in conceptual caregiving models in order to enhance inclusive, culturally sensitive assessments among diverse populations. For Aims 2 and 3, a sample of 50 individuals will be recruited to participate in concept mapping exercises, 10 of whom will be health professionals with expertise on caregiving, to identify additional cultural-relevant constructs. Structured cognitive interviews will be conducted with an additional purposive sample of Latino/a caregivers (n=30) equally representing the 2 largest Latina/o groups in NYC (Puerto Rican and Dominican), recruited from the Columbia-Presbyterian System Associates in Internal Medicine (AIM) clinic. Structured cognitive interviews will be implemented to assess item-level comprehension and interpretation, and to identify emergent constructs inherent to the Latino/a caregiving experience. Findings could result in suggestive explanatory mechanisms and putative sources for divergence in caregiving outcomes due to measurement bias and determination if measurement adjustments are needed. It can additionally be instrumental in identifying emergent constructs that might be culture-specific, and not represented in theoretical caregiving models extant.

摘要 有限的特定文化和比较研究可获得的文件表明，拉丁裔家庭照顾者 痴呆症患者的负担比他们的同龄人更重，对健康的不利影响也更大 其他种族和民族背景。然而，检验经验性推定的研究很少。 这些差异的测量相关来源。因此，知识上的差距仍然存在：一个 造成照料结果差异的因素是由于缺乏适当的措施或 测量不等价性，即可归因于特定文化概念化的测量偏差 物品的构造和/或解释？拟议的努力将重点放在生活在 纽约市地区。近期目标是找出在结果和结果方面没有得到很好体现的领域 现有的处理措施，并系统地审查用于拉丁裔/a的现有措施 护理人员以确定是否需要修改测量方法。目标是生成一个项目池，用于 在拟议的定性过程中确定的新结构的开发措施。建议数 具体目标是：目标1：对过去10年和重要的早期研究进行文献回顾，以 记录关于拉丁裔/o家庭照顾者使用的照顾结果衡量标准的现有定性工作， 特别是在阿尔茨海默病和相关疾病的背景下使用的那些； 目标2：扩展我们的团队和其他人在关键成果和 过程测量，如抑郁、压力和负担，经常用于特定文化和/或 与拉丁裔/AS对痴呆症患者的比较护理研究；目标3：确定其他， 可能需要包括在概念性护理模型中的新兴结构，以增强 在不同人群中进行包容性的、对文化敏感的评估。对于目标2和目标3，样本为50 个人将被招募参加概念图绘制练习，其中10人将是健康的 具有护理专业知识的专业人士，以确定其他与文化相关的概念。结构化 认知访谈将与另一个有目的的拉丁裔/a照顾者样本(n=30)进行。 平均代表纽约市最大的两个拉丁裔/O群体(波多黎各人和多米尼加人)，从 哥伦比亚-长老会系统内科协会(AIM)诊所。结构化认知面试将 用于评估项目级别的理解和解释，并识别新出现的结构 拉丁裔人固有的/照顾经验。这些发现可能会导致提示性的解释机制。 以及由于测量偏差和确定是否存在偏差而导致照料结果差异的推定来源 需要测量调整。它还可以用来识别新出现的构造 这可能是特定于文化的，在现有的理论照料模型中没有体现出来。