SAGE LEAF: Reducing Burden in Alzheimer's Disease Caregivers through Positive Emotion Regulation and Virtual Support

项目摘要 阿尔茨海默氏病（AD）和其他痴呆症的患病率正在稳步攀升，预计将影响 到2050年将达到1600万美国人2016年，59%的痴呆症护理人员报告说， 情绪和身体压力的水平，以及痴呆症的慢性压力对 大量文献记载了护理人员对发展一系列身心健康问题的影响。 与照顾有关的压力会导致社会孤立，孤独和身体疾病，并增加风险 看护者死亡的案例对痴呆症照顾者的干预主要集中在减少消极的 情绪和负担。然而，在过去的几十年里，人们已经清楚地看到，积极的情绪是 与更好的心理和身体健康密切相关，独立于负面影响 这表明，专门针对积极情绪的干预有望改善 照顾者的福祉，并最终与AD患者的护理质量。我们最近随机 由训练有素的促进者通过网络在N = 170个家庭中进行积极情绪技能干预试验 痴呆症患者的照顾者导致照顾者心理健康的显着改善。 然而，辅导员提供的干预措施成本高昂，难以大规模忠实实施。 此外，由训练有素的辅导员提供的行为干预措施的主要挑战是 确保忠诚。我们已经开发了一个自我指导的在线版本的干预，已经显示出可行性 和可接受性，但这个版本没有捕捉到关键的社会联系方面， 引导者的干预。我们建议采取下一步措施，关闭科学- 积极情绪调节干预的实践差距，通过定制自我指导的在线版本 专门针对痴呆症护理人员，包括社会联系组件，以打击 孤独和孤立的经验，许多阿尔茨海默氏症的照顾者。这项名为SAGE LEAF的干预措施 （为家庭照顾者提供的生活改善活动的自我指导电子交付的社会增强） 国家老龄化研究所的PAR-18-588“辅助技术的人的， 阿尔茨海默氏症和相关痴呆症及其护理人员。SAGE LEAF干预利用 从最初的LEAF项目中吸取教训，并将其积极情绪干预适应于AD 照顾者在自我指导的格式，同时纳入社会联系的组成部分和适应系统 反馈机制，以促进干预措施的遵守。

PROJECT SUMMARY The prevalence of Alzheimer’s Disease (AD) and other dementias is steadily climbing and predicted to affect as many as 16 million Americans by 2050. In 2016, 59% of dementia caregivers reported experiencing high levels of emotional and physical stress, and the risk that the chronic stress of dementia caregiving places on caregivers for developing a range of physical and mental health issues is extensively documented. Caregiving-related stress contributes to social isolation, loneliness, and physical illness and increases the risk of caregiver death. Interventions for dementia caregivers have primarily focused on reducing negative emotions and burden. However, over the past few decades, it has become clear that positive emotions are uniquely related to better psychological and physical well-being, independent of the effects of negative emotion suggesting that an intervention that specifically targets positive emotion holds promise for improving caregiver well-being and, ultimately, quality of care for the individual living with AD. Our recent randomized trial of the positive emotion skills intervention, delivered by trained facilitators via the web in N = 170 family caregivers of people with dementia resulted in significant improvements in caregiver psychological well being. However, facilitator-delivered interventions are costly and difficult to implement with fidelity on a large scale. Furthermore, a major challenge to advancing behavioral interventions delivered by trained facilitators is assuring fidelity. We have developed a self-guided online version of the intervention that has shown feasibility and acceptability in several samples, but this version does not capture the critical social connection aspects of the facilitator-delivered intervention. We propose to take the next step toward closing the science-to- practice gap for the positive emotion regulation intervention by tailoring the self-guided online version specifically for dementia caregivers that incorporates the social connection components to combat the loneliness and isolation experienced by many Alzheimer’s caregivers. The intervention, called SAGE LEAF (Social Augmentation of self-Guided Electronic delivery of the Life Enhancing Activities for Family caregivers) is in response to the National Institute on Aging’s PAR-18-588 “Assistive Technology for Person’s with Alzheimer’s Disease and Related Dementias and Their Caregivers.” The SAGE LEAF intervention leverages the lessons learned from the original LEAF project and adapts its positive emotion intervention to AD caregivers in a self-guided format while incorporating social connection components and adaptive system feedback mechanisms to promote intervention adherence.