Quality of Informal Care and Caregiving Transitions

描述(由调查人员提供)：这是一个竞争性的续签申请，以继续支持晚年家庭关系项目(FRILL；R01 AG15321)。长期目标是：(1)规定非正式照顾者可能向居住在社区的虚弱和残疾老年人提供的护理质量(QC)的预测性概况，(2)开发一种对从业者有用的简短便携工具，该工具具有QC的特征，并证明它可以广泛使用，以及(3)展示这种概况和工具在早期识别和适当治疗方面的潜在效用，以不仅改善非正式护理的质量，而且提高照顾者的幸福感(同时提供护理和在护理职责结束后)。拟议的后续研究(FRILL2)建立在现有基础设施和成就的基础上，并向几个新方向延伸。FRILL2将招募500名共同居住的照顾者-照顾者-照顾者二人组，每隔18个月进行3次纵向评估，而一个全新的组成部分将每隔6个月跟踪那些退出照顾者(例如，通过照顾者死亡或住院)的照顾者。QC评估将扩大到不仅包括虐待的指标，还包括从足够到模范的护理。使用改进的模型、方法和措施，FRILL2将：(1)确定诱因(例如，提供的护理数量)和照顾者心理健康(CGMH；(3)检验易感因素、CGMH、QC、照顾者转变和转变后照顾者幸福感之间的假设横断面和纵向关联。假设和模型匹配的测试将使用结构方程建模、潜在增长建模和潜在转变分析技术。

DESCRIPTION (provided by investigator): This is a competing renewal application to continue support for the Family Relationships in Late Life project (FRILL; R01 AG15321). Long-term objectives are to: (1) specify a predictive profile of the quality of care (QC) informal caregivers are likely to provide to community-residing frail and disabled elders, (2) develop a brief portable instrument useful to practitioners that characterizes QC and demonstrate that it can be used widely, and (3) demonstrate the potential utility of this profile and instrument in early identification and appropriate treatment to improve not only quality of informal care but also caregiver well-being (both while providing care and after caregiving duties end). The proposed follow-up study (FRILL2) builds on existing infrastructure and accomplishments and extends FRILL in several new directions. FRILL2 will enroll 500 coresiding caregiver-care recipient dyads for 3 longitudinal assessments at 18-month intervals, and an entirely new component will follow caregivers who transition out of caregiving (e.g., through care recipient death or institutionalization) at 6-month intervals. QC assessment will be expanded to include not only indicators of maltreatment but also care that ranges through sufficient to exemplary. Using refined models, methods, and measures, FRILL2 will: (1) determine the extent to which predisposing factors (e.g., amount of care provided) and caregiver mental health (CGMH; depression, anger, anxiety, and cognitive impairment) predict current and future indicators of the full range of QC, caregiving transitions, and long-term caregiver well-being, (2) over-sample African American dyads at intake to produce a sample adequate for longitudinal comparisons between Whites and African Americans in the pre- and post-transition caregiving experience, and (3) test hypothesized cross-sectional and longitudinal associations between predisposing factors, CGMH, QC, caregiving transitions, and post-transition caregiver well-being. Tests of hypotheses and model fit will employ structural equations modeling, latent growth modeling, and latent transition analytic techniques.