Writing to Heal: Developing an Internet-Based Cognitive-Behavioral Writing Intervention for Alzheimer’s Disease Spousal Caregivers

项目摘要/摘要 照顾患有阿尔茨海默病和相关痴呆症(ADRD)的配偶压力极大 通常延长，从3.3年到11.7年不等。对于许多照顾者来说，这段时间就像是一种生活 “丧亲之痛”，也就是哀悼在ADRD进展之前他们曾经认识的亲人的时间。更高级别 炎症及其相关疾病行为可能会对照顾者的健康和生活质量产生负面影响 生活。低心率变异性(HRV)反映迷走神经张力差，或情绪和精神状态的能力减弱 从生理上从压力中恢复，并投入到一个人的社会环境中，这可能会产生负面影响 他们给予关怀的能力。然而，目前尚不清楚旨在改善照顾者悲痛的干预措施， ADRD配偶照顾者中的炎症和HRV是可行或有效的。在NIH阶段的指导下 行为干预发展模型，候选人在阶段0的过去研究通知阶段1 这里建议的第二阶段研究，在翻译观察性研究成果方面提供有价值的培训 进行干预开发，并进行初步疗效测试。这些研究将为 未来由美国国立卫生研究院资助的随机对照试验(R01申请于第5年提交)，以测试 有针对性的写作干预可以减少照顾者的悲伤，改善HRV，减少炎症和 疾病行为，提高ADRD配偶照顾者的生活质量和照看自我效能。 专门为配合拟议项目而设计的培训活动将通过 将正式课程、指导与定向阅读、工作坊、实践培训、助学金相结合 写作和研究活动。培训将主要在莱斯大学的生物科学研究中心进行 协作性(BRC)，一个创新的空间，来自莱斯大学的科学家和教育工作者 德克萨斯医疗中心(TMC)的邻居可以聚集在一起进行合作研究，以改善 通过科学促进人类健康。建议的导师职业发展奖的五年计划是 旨在启动候选人在识别和确定目标方面的独立研究生涯 生物行为机制，告知干预发展，减少疾病负担，并促进 老龄化中的生活质量。

Project Summary/Abstract Caregiving for a spouse with Alzheimer’s Disease and Related Dementia (ADRD) is extremely stressful and often prolonged, ranging from 3.3 and 11.7 years. For many caregivers, this period serves as a “living bereavement,” or a time of grieving the loved one they once knew before the ADRD progression. Heightened inflammation and its associated sickness behaviors may negatively influence caregiver’s health and quality of life. Low heart rate variability (HRV) reflects poor vagal tone, or a diminished capacity to emotionally and physiologically recover from stress and engage in one’s social environment, which could negatively impact their ability to give care. However, it is unknown whether interventions aimed at improving caregiver grief, inflammation, and HRV among ADRD spousal caregivers are feasible or effective. Guided by the NIH Stage Model for Behavioral Intervention Development, the candidate’s past research in Stage 0 informs the Stage 1 & Stage 2 research proposed here, providing valuable training in translating observational research findings into intervention development, and testing for preliminary efficacy. These studies will lay the groundwork for a future NIH-funded randomized control trial (R01 application submitted in Year 5) to test the efficacy of the targeted writing intervention in decreasing caregiving grief, improving HRV, reducing inflammation and sickness behaviors, and improving quality of life and caregiving self-efficacy among ADRD spousal caregivers. Training activities specifically designed to coincide with the proposed project will be accomplished through a combination of formal coursework, mentorship with directed readings, workshops, hands-on training, grant writing, and research activities. The training will take place primarily at Rice University’s Bioscience Research Collaborative (BRC), an innovative space where scientists and educators from Rice University and its neighbors in the Texas Medical Center (TMC) can come together to conduct collaborative research to improve human health through science. This five-year plan for the proposed Mentor Career Development Award is aimed at launching the candidate’s independent research career in identifying and targeting biobehavioral mechanisms that inform intervention development, reduce disease burden, and promote quality of life among the aging.