Quality of Informal Care and Caregiving Transitions

描述（由研究者提供）：这是一份竞争性续期申请，旨在继续支持晚年家庭关系项目（FRILL; R01 AG15321）。长期目标是：(1)指定非正式护理人员可能为社区居住的体弱和残疾老年人提供的护理质量（QC）的预测轮廓；(2)开发一种对从业者有用的简短便携式仪器，以表征QC并证明它可以广泛使用；(3)证明该档案和工具在早期识别和适当治疗方面的潜在效用，不仅可以提高非正式护理的质量，还可以提高护理人员的福祉（在提供护理期间和护理职责结束后）。拟议的后续研究（FRILL2）建立在现有基础设施和成就的基础上，并在几个新的方向上扩展FRILL2。FRILL2将招募500名共同居住的照顾者-被照顾者夫妇，每隔18个月进行3次纵向评估，并且一个全新的组成部分将每隔6个月跟踪照顾者从照顾中过渡（例如，通过照顾者死亡或机构化）。质量控制评估将扩大，不仅包括虐待的指标，还包括从充分到模范的护理。使用完善的模型、方法和措施，FRILL2将：(1)确定易感因素（例如，提供的护理量）和照顾者心理健康(CGMH；抑郁、愤怒、焦虑和认知障碍)预测了全方位QC、照顾过渡和长期照顾者幸福感的当前和未来指标，(2)在摄入时对非裔美国人进行了过量抽样，以产生足够的样本，用于白人和非裔美国人在过渡前后的照顾经历之间的纵向比较，(3)检验了诱发因素、CGMH、QC、照顾的转变，以及转变后照顾者的幸福感。假设和模型拟合的检验将采用结构方程建模、潜在增长建模和潜在过渡分析技术。

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.