MUTUAL SUPPORT OF CAREGIVERS: TEST OF A PREVENTIVE MODEL

这项研究是一项纵向对照试验， 成人家庭照顾者的相互支持干预：一个认知的 适应性干预和传统的教育支持自助 干预认知适应干预的评价 提供了泰勒（1983）调整模型的实证检验， 威胁生命的事件，认为适应的中心是 三个认知任务的解决：（a）寻找意义， 事件，（B）试图掌握它，（c）努力 通过自我提升的观念来增强自尊，特别是 通过向下的社会比较和向上的社会接触。相互 假设支持提供了一个独特的机会来测试这种 模型，因为：a）组成员资格的常见标准涉及 经历常见的威胁生命事件（通常威胁 B）在此基础上组织的团体已经包含 促进解决所确定的认知任务的活动。 6-16岁儿童的母亲， 照顾家中年迈的父母或姻亲是主要的 研究中的目标群体。双重主要照顾者在 精神障碍和行为障碍的风险相当大， 特别是抑郁症、焦虑症和健康相关问题。 这项研究中的第二组是那些照顾者的孩子， 因为父母的风险增加而导致行为问题的风险。的 这项拟议中的研究将是第一个系统地检查健康状况的研究。 父母照顾对孙子孙女的影响。 该研究有三个具体目标：（1）预防精神障碍， 行为障碍和促进成年女儿的心理健康 （2）预防问题行为， 促进照顾者子女的适应能力;（3） 测试对威胁生命事件的认知适应模型， 使相互支持的预防作用概念化。共240 将招募护理人员，并随机分配到三个 条件：（1）认知适应互助小组，（2） 常规互助组;（3）无干预对照组 组每次干预将包括12次会议-每周提供 六个星期，然后每月一次，持续六个月--由受过训练的护理人员。 精神、健康和心理社会功能评估 照顾者及其子女将在前测，后测， 以及六个月的随访。

The proposed study is a controlled, longitudinal trial of two preventive mutual support interventions for adult family caregivers: a cognitive adaptation intervention and a conventional educational-support self-help intervention. Evaluation of the cognitive adaptation intervention provides an empirical test of Taylor's (1983) model of adjustment to threatening life events which maintains that adaptation centers around the resolution of three cognitive tasks: (a) a search for meaning in the event, (b) attempts at gaining mastery over it, and (c) efforts to bolster self-esteem through self-enhancing perceptions, particularly through downward social comparisons and upward social contacts. Mutual support is hypothesized to provide a unique opportunity to test such a model because: a) a frequent criteria for group membership involves the experience of a common threatening life event (which usually threatens self-esteem), and b) groups organized on this basis already contain activities which promote resolution of the cognitive tasks identified. Mothers of children between the ages of 6-16 who are also the primary caregiver of an elderly parent or in-law in the home are the major target group in the proposed study. Dual primary caregivers are at considerable risk for mental disorders and behavioral dysfunction, particularly depression, anxiety disorders, and health-related problems. A second group in this study are the children of caregivers who are at risk for behavior problems because of the increased parental risk. The proposed study would be the first to examine systematically the health impact of parent-care on the grandchildren. The study has three specific aims: (1) to prevent mental disorders and behavioral dysfunctions and promote mental health among adult daughter and daughter-in-law caregivers; (2) to prevent problem behaviors and promote adaptive capabilities in the children of caregivers; and (3) to test a model of cognitive adaptation to threatening life events used to conceptualize the preventive impact of mutual support. A total of 240 caregivers will be recruited and randomly assigned to one of three conditions: (1) a cognitive adaptation mutual support group, (2) a conventional mutual support group, and (3) a no-intervention control group. Each intervention will consist of 12 sessions --delivered weekly for six weeks and then monthly for six months--with a trained caregiver. Assessments of psychiatric, health, and psychosocial functioning for caregivers and their children will be conducted at pretest, posttest, and six months follow-up.