Sleep Depression, and Psychosocial Risk Factors in Caregivers

描述(由申请者提供)：这个指导临床职业发展奖的目标是为Lisa Meltzer博士提供成为一名独立临床研究人员所需的经验和知识，在儿科心理学和睡眠医学领域架起一座桥梁。梅尔策博士是一名临床心理学家，他将通过定向阅读、研讨会、课程作业和有指导的研究相结合的方式来实现这一目标。一支高素质的导师团队将监督她的培训和研究，确保她达到目标。梅尔策博士将检查儿科照顾者的睡眠、抑郁和心理社会风险因素。该建议的具体目的是：1)确定呼吸机依赖儿童(VDC)的照顾者和健康儿童的照顾者的睡眠模式和日间功能(情绪障碍、疲劳和执行功能)的特征；2)确定与照顾者负担和照顾者抑郁症状相关的风险和保护因素；3)研究睡眠作为照料者负担和照顾者抑郁症状之间关系的调节因素；以及4)开发和评估旨在改善照顾者睡眠的简短干预措施，间接受益于改善抑郁和疲劳的症状。这些目标将通过两项研究来实现：研究1是对依赖呼吸机的儿童的照顾者和健康对照组儿童的照顾者的睡眠、抑郁症状和心理社会风险因素的评估。研究2是一项试验性干预，旨在改善照顾者的睡眠质量和数量。这个项目将解决科学文献中的空白，这些文献涉及对患有慢性身体或心理健康障碍儿童的父母的照顾者负担的经验测量，照看对情绪、疲劳和执行功能的影响，以及慢性睡眠中断与照顾者白天功能的关系。此外，该项目将为申请者提供以下方面的专门知识：临床研究和干预研究的设计、实施和分析；将活动记录仪用作睡眠的客观衡量标准；以及睡眠剥夺、睡眠和抑郁方面的专门培训，以及与慢性身体或精神健康障碍儿童家庭研究有关的伦理问题。拟议的研究和职业发展活动将为梅尔策博士提供技能，使其成为一名独立的调查员，并开展以儿科人群照顾者为重点的研究计划。与公共卫生相关：虽然照顾亲人的人提供的服务估计价值2570亿美元，但照顾者往往会将自己的健康和福祉置于危险之中。大约8%的儿童患有将父母转变为照顾者的慢性病。这种一天24小时的工作往往会导致抑郁症状的增加。

DESCRIPTION (provided by applicant): The objective of this mentored clinical career development award is to provide Dr. Lisa Meltzer with the experience and knowledge necessary to become an independent clinical researcher, bridging the fields of pediatric psychology and sleep medicine. Dr. Meltzer, a clinical psychologist, will accomplish this goal through a combination of directed reading, seminars, coursework, and mentored research. A highly qualified team of mentors will supervise her training and research, ensuring that she meets her goals. Dr. Meltzer will be examining sleep, depression, and psychosocial risk factors in pediatric caregivers. The specific aims of this proposal are:1) to characterize sleep patterns and daytime functioning (mood disturbances, fatigue, and executive functioning) in caregivers of ventilator-dependent children (VDC) and caregivers of healthy children, 2) to identify risk and protective factors related to caregiver burden and depressive symptoms in caregivers, 3) to examine sleep as a mediator of the relationship between caregiver burden and depressive symptoms in caregivers, and 4) to develop and evaluate a brief intervention designed to improve caregiver sleep, with the indirect benefit of improving symptoms of depression and fatigue. These aims will be accomplished with two studies: Study 1 is an evaluation of sleep, depressive symptoms, and psychosocial risk factors in caregivers of children who are ventilator-dependent and caregivers of healthy control children. Study 2 is a pilot intervention to improve sleep quality and quantity in caregivers. This project will address gaps in the scientific literature related to the empirical measurement of caregiver burden for parents of children with chronic physical or mental health disorders, the impact of caregiving on mood, fatigue, and executive functioning, and how chronic sleep disruption is related to caregiver daytime functioning. In addition, this project will provide the applicant with expertise in the design, implementation, and analysis of clinical research and intervention studies, the use of actigraphy as an objective measure of sleep, and specialized training in sleep deprivation, sleep and depression, and ethical issues related to research with families of children with chronic physical or mental health disorders. The proposed study and career development activities will provide Dr. Meltzer with the skills to develop into an independent investigator with a program of research focusing on caregivers of pediatric populations. Relevance to Public Health: While the services of people who care for loved ones are estimated to be worth $257 billion, caregivers often put their own health and well-being at risk. Approximately 8% of children have a chronic condition that transforms parents into caregivers. This 24-hour a day job often results in elevated symptoms of depression.