Teaching Resourcefulness to Women Caregivers of Elders with Dementia

向痴呆症老人的女性护理人员传授智谋

• 批准号: 7923324
• 负责人: JACLENE A ZAUSZNIEWSKI
• 金额: $ 19.43万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7923324
• 关键词: Adult; Adverse event; Caregiver Burden; Caregivers; Caring; Characteristics; Child Care; Chronically Ill; Clinical Trials; Cognition; Confidentiality; Data; Data Collection; Dementia; Dimensions; Disclosure; Distress; Educational Intervention; Educational process of instructing; Effectiveness; Elder Abuse; Elderly; Emotions; Goals; Health; Health Promotion; Intervention; Journals; Learning; Literature; Long-Term Care; Long-Term Effects; Measures; Mental Health; Methods; Monitor; Mothers; Outcome; Pilot Projects; Population; Problem behavior; Psyche structure; Public Health; Published Comment; Qualitative Methods; Quality of life; Randomized; Randomized Controlled Trials; Records; Reporting; Research; Research Project Grants; Safety; Stress; Teaching Method; Techniques; Testing; Time; Training; Voice; Woman; acronyms; caregiver education; caregiving; cost; depressive cognitions; depressive symptoms; design; emotional disclosure; expressive writing; follow-up; improved; insight; physical conditioning; post intervention; preference; psychological distress; public health relevance; reinforcer; skills; social; theories; time interval

DESCRIPTION (provided by applicant): Teaching Resourcefulness to Women Caregivers of Elders with Dementia The major goal of this R21exploratory research grant is to pilot test and refine an adapted intervention that teaches resourcefulness skills to women dementia caregivers (CGs). The resourcefulness training (RT) intervention has strong theoretical grounding and there is beginning empirical evidence for its effectiveness in reducing stress, minimizing depressive symptoms, and promoting optimal quality of life for populations other than women dementia CGs. The proposed 2-year pilot study will provide qualitative and quantitative data for determining the necessity, acceptability, feasibility, fidelity, safety, and effectiveness of two innovatively designed methods of RT within the context of a small partially randomized preference trial with 120 women dementia CGs. In RT, the two methods to be tested (expressive writing, EW) and verbal disclosure, VD) are used for practicing / reinforcing resourcefulness skills. However, because research has shown that both EW and VD may be effective stress-reducing techniques, we will also examine those effects without RT. We propose that RT reinforced by EW or VD will provide CGs with essential skills for managing stress and preserving mental and physical health while providing care for their elderly care recipients (CRs). Quantitative data on measures of stress, cognitions, emotions, resourcefulness, and mental and physical health will be collected at baseline (T1) and at 1 week (T2) and 6 weeks (T3) post-intervention. Qualitative data will be obtained from CG journal (EW) / recordings (VD), data collector's field notes, follow-up logs, etc. Baseline Resourcefulness Scale (RS) scores and qualitative data from journals / recordings will be used to examine the necessity of the RT. CGs will be randomized into "random" or "choice" conditions and their data (i.e., journals, recordings, field notes, follow-up logs, participation / retention logs) will be examined to determine acceptability, feasibility, and fidelity of RT. Safety of RT will be monitored for adverse events and reports of psychological distress or elder abuse. Effectiveness of RT-EW and RT-VD (compared to EW and VD without RT) will be examined in relation to specific outcomes at time intervals suggested by Resourcefulness Theory and in relation to factors within the CG, CR, and CG situation. Most importantly, we will learn whether giving CGs a choice of EW or VD with or without RT improves their outcomes. Conclusions drawn from the critical examination of the six intervention parameters will inform further refinement and testing of RT for dementia CGs in a full scale randomized, controlled trial. Once established, such interventions will be useful in promoting optimal, healthy functioning among dementia CGs so that they can continue to provide adequate care for their CRs without sacrificing their own health and avoid placement of the elder in a long term care facility. PUBLIC HEALTH RELEVANCE Dementia is one of the greatest challenges facing elders in the U.S. and the public health significance of dementia caregiving has permeated the scientific and lay literature for decades. Despite the number of clinical trials testing interventions for reducing caregiver stress, none have tested methods of teaching them resourcefulness skills and none have allowed caregivers to choose a preferred intervention. Resourcefulness Training, the intervention to be tested in this study, is a cost-effective, easy-to-use method for reducing caregiver stress and promoting their optimal mental health.

描述（由申请人提供）：向患有痴呆症的女性护理人员传授足智多谋这项 R21 探索性研究拨款的主要目标是试点测试和完善一项适应性干预措施，向女性痴呆症护理人员 (CG) 传授足智多谋的技能。足智多谋训练 (RT) 干预措施具有坚实的理论基础，并且已有实证证据表明其在减轻压力、最大程度减少抑郁症状以及促进除女性痴呆症以外的人群的最佳生活质量方面的有效性。拟议的为期 2 年的试点研究将在一项对 120 名女性痴呆症 CG 进行的小型部分随机偏好试验的背景下，提供定性和定量数据，以确定两种创新设计的 RT 方法的必要性、可接受性、可行性、保真度、安全性和有效性。在 RT 中，要测试的两种方法（表达性写作，EW）和口头披露，VD）用于练习/加强足智多谋的技能。然而，由于研究表明 EW 和 VD 都可能是有效的减压技术，因此我们还将在不进行 RT 的情况下检查这些效果。我们建议，通过 EW 或 VD 强化的 RT 将为 CG 提供管理压力和保持身心健康的基本技能，同时为老年护理接受者 (CR) 提供护理。将在基线 (T1) 以及干预后 1 周 (T2) 和 6 周 (T3) 时收集有关压力、认知、情绪、足智多谋以及身心健康指标的定量数据。定性数据将从CG期刊（EW）/记录（VD）、数据收集者的现场笔记、后续日志等中获得。基线资源量表（RS）分数和来自期刊/记录的定性数据将用于检查RT的必要性。 CG 将被随机分为“随机”或“选择”条件，其数据（即日志、录音、现场笔记、后续日志、参与/保留日志）将被检查，以确定 RT 的可接受性、可行性和保真度。将监测 RT 的安全性，以了解不良事件和心理困扰或虐待老年人的报告。 RT-EW 和 RT-VD 的有效性（与没有 RT 的 EW 和 VD 相比）将根据资源理论建议的时间间隔内的具体结果以及 CG、CR 和 CG 情况中的因素进行检查。最重要的是，我们将了解让 CG 选择 EW 或 VD（带或不带 RT）是否可以改善他们的结果。对六个干预参数进行严格检查得出的结论将为在全面随机对照试验中进一步完善和测试痴呆 CG 的 RT 提供信息。一旦建立，此类干预措施将有助于促进痴呆症 CG 的最佳、健康功能，以便他们能够继续为 CR 提供充分的护理，而不会牺牲自己的健康，并避免将老年人安置在长期护理机构中。公共卫生相关性痴呆症是美国老年人面临的最大挑战之一，数十年来，痴呆症护理的公共卫生重要性已渗透到科学和非专业文献中。尽管有很多临床试验测试了减轻护理人员压力的干预措施，但没有一个测试过教他们机智技能的方法，也没有一个允许护理人员选择首选的干预措施。足智多谋培训是本研究中要测试的干预措施，是一种经济高效、易于使用的方法，可减轻护理人员的压力并促进其最佳心理健康。