Sleep: Effect on Dementia Caregiver Mastery, Perceived Stress & Depression

描述(由申请人提供)：这项研究的广泛、长期目标是改善痴呆症患者非正式照顾者的健康状况，使他们能够成功地继续提供护理。这是一项重要的研究，因为随着人口老化，对残疾人士非正式照顾的需求将会继续增长。照料的经历是有压力的，经常会给照顾者带来负面结果，如抑郁或身体衰退。人力/物力资源的耗尽导致残疾人的制度化。照顾者需要资源来满足照看的需求。这些资源中的两个是充足的睡眠和掌握，这是他们感觉到他们对生活中重要的力量施加的控制感和效能感。睡眠质量和掌握程度都与抑郁呈负相关，但关于掌握程度与感知到的压力的关系，或者睡眠如何影响掌握与抑郁和感知到的压力之间的关系的研究有限。本研究的具体目的是：1)检验睡眠质量、掌握、总体压力知觉与抑郁之间的关系；2)探讨睡眠质量对掌握、感觉压力、掌握与抑郁的直接和间接影响。对这些关系的进一步了解可以导致制定有针对性的干预措施，以改善睡眠质量和掌握，以防止负面结果。这与国家护理研究所预防或延迟疾病和残疾以及促进健康生活方式的使命是一致的。研究设计将是一项非实验性的重复措施。数据将在基线、第4周和第8周收集，以观察照顾压力的动态体验。使用的工具将包括人口统计数据和痴呆症严重程度评定表，以分析性别和照顾者对PWD状况的感知的混淆变量，匹兹堡睡眠质量指数，皮林的掌握程度量表，流行病学研究中心抑郁量表和科恩的感知压力量表。分析将由检验相关性和多元回归组成，从而产生通径分析。这项研究的相关性是与两个主要的公共健康问题--照顾和睡眠质量--保持一致。我们的社会依赖于非正式照料的成功，《老年美国人法案》中针对照顾者支持的具体立法就是明证。2006年，睡眠医学和医学研究所研究委员会承认，照顾者经历的睡眠障碍和睡眠剥夺是一个未得到满足的公共卫生问题。

DESCRIPTION (provided by applicant): The broad, long-term objective of this research is to improve the health outcomes of informal caregivers of persons with dementia PWD so they are able to successfully continue providing care. This is important research because the demand for informal caregiving of PWD will continue to grow as our population ages. The experience of caregiving is stressful and often results in negative outcomes for the caregiver such as depression or physical decline. Depletion of personal/physical resources results in institutionalization of the PWD. Caregivers need resources to meet the demands of caregiving. Two of these resources are adequate sleep and mastery which is the sense of control and efficacy they feel they exert over forces that are important in their lives. Both sleep quality and mastery have an inverse relationship with depression but there is limited research on the relationship of mastery and perceived stress, or how sleep impacts mastery in relation to depression and perceived stress. The specific aims of this research are to 1) test the relationship between sleep quality, mastery, perceived global stress, and depression and 2) explore the direct and indirect effect of sleep quality on mastery and perceived stress; mastery and depression. Further understanding of these relationships can lead to development of targeted interventions to improve sleep quality and mastery in order to prevent negative outcomes. This is consistent with the National Institute of Nursing Research's mission to prevent or delay disease and disability, and to promote healthy lifestyles. The research design will be a non-experimental repeated measure. Data will be collected at baseline, week 4 and week 8 to observe the dynamic experience of caregiving stress. Instruments used will include demographic data and the Dementia Severity Rating Scale to analyze confounding variables of gender and the caregiver's perception of PWD status, the Pittsburgh Sleep Quality Index, Pearlin's mastery scale; Center for Epidemiolgical Studies Depression Scale, and Cohen's Perceived Stress Scale. Analysis will consist of testing correlations and multiple regression resulting in a path analysis. The relevance of this research is the alignment with two major public health issues, caregiving and sleep quality. Our society is dependent on the success of informal caregiving evidenced by specific legislation in the Older Americans Act targeting caregiver support. Sleep disorders and sleep deprivation experienced by caregivers are recognized as an unmet public health problem by the Committee on Sleep Medicine and Research from the Institute of Medicine in 2006.