Caregivers of Prolonged Mechanical Ventilation: Mind-Body Interaction Model

长时间机械通气的护理人员：身心互动模型

• 批准号: 7945296
• 负责人: JiYeon Choi
• 金额: $ 3.63万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-01 至 2010-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7945296
• 关键词: Acute; Admission activity; Area; Behavioral; Behavioral Sciences; Biological; Cardiovascular system; Caregiver Burden; Caregivers; Caring; Characteristics; Chronic; Chronic Disease; Chronic Phase; Chronic stress; Chronically Ill; Comorbidity; Critical Care; Critical Illness; Data Collection; Dementia; Disabled Persons; Distress; Emotional; Endocrine; Enrollment; Face; Family; Family Caregiver; Family member; Feasibility Studies; Friends; Future; Generations; Health; Immune system; Incidence; Individual; Intensive Care Units; Interleukin-1; Intervention; Link; Longitudinal Studies; Malignant Neoplasms; Measures; Mechanical ventilation; Medical; Mission; Modeling; Morbidity - disease rate; Neurocognitive; Nursing Homes; Outcome; Patients; Pattern; Persons; Population; Public Health; Quality of life; Recovery; Reporting; Research; Research Methodology; Scientist; Services; Sleep; Source; Staging; Stress; Stressful Event; Symptoms; Technology; Time; Uncertainty; Weaning; acute stress; aged; base; biobehavior; biological adaptation to stress; body-mind; care delivery; career; caregiving; cost; cost effective; design; effective intervention; experience; high risk; improved; meetings; mind body interaction; mortality; multidisciplinary; new technology; physical conditioning; prevent; prospective; psychologic; psychological distress; research study; response; statistics; stressor; trend

DESCRIPTION (provided by applicant): The broad long-term objective of this proposal is to gain in-depth experience in biobehavioral research focusing on improving outcomes in persons on prolonged mechanical ventilation (PMV) and their family caregivers to strengthen the applicant's ability to launch a competitive and independent research career. Persons on PMV often suffer from long-term physical and psychological sequelae after surviving in the intensive care unit (ICU) and therefore require significant assistance from family caregivers. Research has shown that negative psychological and behavioral responses in caregivers of persons with chronic disease (e.g., dementia) are associated with negative caregiver health outcomes. Despite reports of psychological distress and burden in caregivers of persons on PMV, there is limited understanding of the extent of this stress responses, including psychological, behavioral and biological responses over the continuum of illness (ICU admission to post discharge). The purposes of this pilot feasibility study using a multidisciplinary, integrative biobehavioral model, the Pittsburgh Mind-Body Center Model are: 1) to evaluate the feasibility of conducting a longitudinal biobehavioral study in caregivers of persons on PMV and 2) to explore the interactions among caregivers' psychological (e.g., burden), behavioral (e.g., sleep) and biological (e.g., IL1) responses of acute and chronic stress over time and how those interactions are related to characteristics of care recipients. A longitudinal prospective descriptive repeated measure design will be used. A total of 40 dyads of caregivers and persons on PMV (care recipient) who spent >=4 days on mechanical ventilation will be enrolled in the study. Data collection will occur three times (baseline [ICU admission], ICU discharge, and 2 months after ICU discharge). Feasibility will be evaluated using descriptive statistics including recruitment and retention rates, and caregivers' acceptability of behavioral and biological data collection. To explore the potential longitudinal changes in caregivers' responses and relationships among responses, trends of changes in descriptive statistics and correlation coefficients will be used. This study is consistent with NINR's mission to integrate the biological and behavioral sciences, employ new technologies to research questions, improve research methods, and develop scientists of the future. The proposed research also meets one of NINR's areas of research emphasis on family caregiving. The relevance of this research to public health is to identify specific time-points to prevent and intervene to improve caregivers' emotional and physical health over the care recipient's illness trajectory. Improving caregivers' emotional and physical health may also improve the delivery of care as well as quality of life for the care recipient.

描述（由申请人提供）：该提案的广泛长期目标是获得生物行为研究方面的深入经验，重点是改善长期机械通气（PMV）患者及其家庭护理人员的结局，以加强申请人开展有竞争力和独立研究事业的能力。接受PMV治疗的患者在重症监护室（ICU）生存后往往会出现长期的身体和心理后遗症，因此需要家庭护理人员的大力帮助。研究表明，慢性病患者的照顾者的负面心理和行为反应（例如，痴呆症）与消极的照顾者健康结果有关。尽管报告的心理困扰和负担的人对PMV的照顾者，有有限的了解，这种压力反应的程度，包括心理，行为和生物反应的疾病的连续性（ICU入院后出院）。这项试点可行性研究的目的是使用多学科的综合生物行为模型，匹兹堡身心中心模型：1）评估在PMV患者的照顾者中进行纵向生物行为研究的可行性; 2）探索照顾者心理（例如，负担），行为（例如，睡眠）和生物（例如，IL-1）随着时间的推移急性和慢性应激反应，以及这些相互作用如何与护理对象的特征相关。将使用纵向前瞻性描述性重复测量设计。总共40对护理者和接受PMV的人（护理接受者）（接受机械通气>=4天）将入组本研究。数据收集将进行三次（基线[ICU入院]、ICU出院和ICU出院后2个月）。可行性将使用描述性统计进行评估，包括招募和保留率，以及护理人员对行为和生物数据收集的可接受性。为了探讨照顾者的反应和反应之间的关系的潜在纵向变化，将使用描述性统计和相关系数的变化趋势。这项研究与NINR的使命是一致的，即整合生物科学和行为科学，采用新技术研究问题，改进研究方法，培养未来的科学家。拟议中的研究也符合NINR的研究重点之一，家庭负担。这项研究与公共卫生的相关性是确定具体的时间点，以预防和干预，以改善照顾者的情绪和身体健康的照顾者的疾病轨迹。改善照顾者的情绪和身体健康也可以改善护理的提供以及护理接受者的生活质量。