XD GrantTransfer #6 from Rush to Rutgers PHS Grant #R01NR014846: Culture and Caregiving Need for Chinese Elderly with Cognitive Impairment

 描述（由申请人提供）：我们非常感谢从先前的审查，以改善此应用程序的建设性意见和建议。本重新提交研究（R 01 NR 014846）的总体目标是对300名成年儿童照顾者进行人群水平的3波纵向调查，以量化代际团结与中国老年人严重认知障碍的照顾者需求之间的关系。具体而言，我们将进行三波数据收集，并采用混合效应模型来检验三个主要目标：1）量化代际团结与照顾者心理困扰轨迹之间的关系; 2）量化代际团结与照顾者准备之间的关系;（3）量化代际团结与照顾者在照顾有显著认知障碍的老年人时的求助行为之间的关系。本研究的第二个目的是：（4）检验上述目标1-3的性别差异;（5）探讨成年子女在为有认知障碍的中国老年人提供照顾时，对代际团结的期望和坚持的障碍、挑战和文化差异。 损伤 尽管中国人口快速增长，但我们目前对中国老年人的护理需求的了解非常缺乏，这些老年人患有严重的认知障碍。由于文化信仰，许多家庭认为痴呆症是一种精神疾病。痴呆症（dementia）这个词从字面上翻译成两个字符：“疯狂和紧张症”。病人和家属所经历的耻辱、羞耻和消极反应干扰了他们寻求适当医疗的意愿。在研究这些问题时，语言和文化的复杂性和细微差别进一步加剧了我们知识上的这一明显差距。此外，社区支持不足，使华人社区能够作为平等伙伴充分参与对文化敏感问题的研究。因此，我们将利用基于社区的参与性研究（CBPR）的原则，量化重要的文化因素和中国老年认知障碍患者的医疗需求之间的关系。在此申请中，一名双语和双文化的首席研究员和一个经验丰富的多机构跨学科团队将在我们之前的NIH资助的CBPR项目的基础上与芝加哥华人社区团体合作。该提案的结果将告知临床医生，研究人员，社区，社会服务和 政策制定者：a）确定风险/保护因素; B）更好地了解解决 照顾者的需要; c）为未来的预防和干预研究提供信息; d）为改善护理人员群体的健康和福祉的实践和政策提供信息。

 DESCRIPTION (provided by applicant): We are grateful for the constructive comments and suggestions from the prior review to improve this application. The overall objective of this resubmission study (R01NR014846) is to conduct a population-level 3-waves longitudinal investigation of 300 adult children caregivers in order to quantify the relations between intergenerational solidarity and needs for caregivers of Chinese older adults with significant cognitive impairment. More specifically, we will conduct three waves of data collection and employ mixed effects models to examine three primary objectives: 1) Quantify the relations between intergenerational solidarity to the trajectory of caregivers' psychological distress; 2) Quantify the relations between intergenerational solidarity and caregivers' preparedness; 3) Quantify the relations between intergenerational solidarity and caregiver's help seeking behaviors in providing care for Chinese older adults with significant cognitive impairment. Our secondary objectives are to: 4) examine the gender differences in the above aims 1-3; and 5) explore the barriers, challenges, and cultural variations in adult children's expectation and adherence of intergenerational solidarity in providing care for Chinese older adults with cognitive impairment. Despite the rapid growth of Chinese populations, there is great paucity in our current understanding of caregivers' needs for Chinese older adults with significant cognitive impairment. Due to cultural beliefs, many families believe dementia is a form of mental illness. The word dementia (¿F) literally translates into two characters: "Crazy and Catatonic". The stigma, shame and negative responses experienced by patients and families interfere with their willingness to seek appropriate medical care. This marked gap in our knowledge is further exacerbated by the linguistic and cultural complexities and nuances when studying these issues. Moreover, there has been inadequate community support necessary to empower the Chinese community to be fully engaged as equal partners in research on culturally sensitive issues. Accordingly, we will leverage principles of community-based participatory research (CBPR) to quantify the relationship between important cultural factors and caregiving needs for Chinese older adults with cognitive impairment. In this application, a bilingual and bicultural principal investigator and an experienced multi-institutional interdisciplinary team will build on our prior NIH funded CBPR projects to collaborate with Chicago Chinese community groups. The findings from this proposal will inform clinician, investigator, community, social services and policy makers to: a) identify risk/protective factors; b) better understand pathways for addressing caregiver needs; c) inform future prevention and intervention studies; and d) inform the practice and policy to improve health and wellbeing in caregiver populations.