Physiological Indicators of Perceived Suffering in a Loved One' Spousal Reactions

描述（由申请人提供）：大量已发表的研究支持疾病和残疾对家庭照顾者的情绪和身体健康有负面影响的一般结论，虽然痛苦的概念可能隐含在现有的疾病和残疾概念中，但实证研究并未将患者痛苦作为照顾者结果的独特和独立贡献者（Schulz et al, 2007）。拟议的研究将集中在患有肌肉骨骼疾病的护理对象的痛苦表现，特别是患有骨关节炎和腰痛的个体，以及痛苦对配偶照顾者的影响方式。我们的重点是照顾者及其配偶照顾者，因为照顾者的配偶很可能在日常生活中（例如，当他们从事日常家务活动时）面对照顾者的急性疼痛和痛苦。我们在实验室环境中以两种方式使护理者接触痛苦：(1)观察正在执行模拟家务任务的护理者表达的痛苦；(2)准备关于护理者痛苦的演讲。我们还要求所有的参与者完成自我报告，测量照顾者在日常生活中的痛苦，包括关于身体、心理和精神/存在的痛苦的问题。我们认为，照顾者遭受痛苦会导致心血管应激反应加剧，表现为血压（BP）和心率（HR）升高，以及心率变异性（HRV）降低。我们还提出，照顾者对被照顾者痛苦的暴露会导致个人痛苦和/或共情关注的心理体验，这将与心血管应激反应高度相关。此外，我们探讨了与照顾者、照顾者和关系相关的因素如何影响照顾者对照顾者痛苦的心理和生理反应。例如，我们测试了这样一种假设，即目睹配偶处于痛苦之中会导致对老年人心血管疾病（如冠心病和高血压）易感性的高度关注。此外，由于我们正在调查目睹伴侣和陌生人遭受痛苦时心血管反应的差异，这项研究不仅对家庭照顾者有意义，而且对专业帮助者（护士、医生、教师和治疗师）也有意义。

DESCRIPTION (provided by applicant): Scores of published studies support the general conclusion that illness and disability have negative effects on the emotional and physical well-being of family caregivers, and while the notion of suffering may be implicit in existing conceptualizations of illness and disability, the empirical research has not focused on patient suffering as a unique and independent contributor to caregiver outcomes (Schulz et al, 2007). The proposed research will focus on the manifestation of suffering in care recipients with musculoskeletal conditions, specifically individuals with osteoarthritis and lower back pain, and the ways suffering impacts on spousal caregivers. We focus on care recipients and their spousal caregivers, because spouses of care recipients are likely to be faced with acute instances of the care recipient's pain and suffering on a daily basis (e.g. when they are performing everyday household activities). We operationalize caregivers1 exposure to the suffering in two ways in a laboratory setting: (1) observing expressed pain from the care recipient who is performing a simulated household task and (2) preparing a speech about the care recipient's suffering. We also ask all participants to complete self-report measures of the care recipients' suffering in everyday life that incorporate questions about the physical, psychological, and spiritual/existential components of suffering. We propose that the caregiver's exposure to suffering can lead to a heightened cardiovascular stress response, operationalized as increased blood pressure (BP) and heart rate (HR), and low heart rate variability (HRV). We also propose that the caregiver's exposure to the care recipient's suffering will result in the psychological experience of personal distress and/or empathic concern, which will be highly interrelated with the cardiovascular stress response. Furthermore, we explore how factors associated with the care recipient, the caregiver, and the relationship impact caregiver's psychological and physiological reactions to the care recipient's suffering. For example, we test the hypothesis that witnessing a spouse in pain will lead to a high heighten to provide crucial information about susceptibility to cardiovascular disorders (e.g., coronary heart disease and hypertension) for older Americans. Also, because we are investigating differences in cardiovascular reactions to witnessing relationship partners and strangers' suffering, this research has implication not only for family caregivers, but also for professional helpers (nurses, doctors, teachers, and therapists).