Family caregiving transitions and sleep among double- and triple-duty caregivers

 描述(申请人提供)：家庭护理过渡和双重和三重照顾者的睡眠项目摘要/摘要睡眠越来越被认为是一个重要的公共卫生问题。1据估计，美国有5000万至7000万成年人长期患有睡眠或觉醒障碍，与越来越多的健康问题有关，包括心脏病、中风、糖尿病、肥胖、癌症和高血压。1、2与睡眠相关的问题会影响生活的各个领域，其中之一是就业。一项针对美国员工的全国性调查发现，有工作的美国人的睡眠时间少于他们在工作中正常工作所需的睡眠时间；当他们睡觉时，员工表示睡眠质量不佳。3尽管睡眠障碍对任何员工都有害，但鉴于他们的职责是提供高质量的护理和维护患者安全，它们对医疗保健员工尤其重要。然而，由于长时间的工作和对身体和心理要求很高的工作任务，医护人员通常会感到疲惫和睡眠质量不佳。4-6此外，医护人员在家里可能有照顾老年人的责任，这会干扰睡眠。4，7在文献中，在家里提供老年人护理的医护人员被称为双重职责照顾者，这是一个预计将在医疗保健行业变得更加普遍的未被充分研究的人群。8-13双重职责照顾者面临情绪疲惫的风险，12极端的身心疲惫，7，10-13睡眠不足，7和工作与家庭的冲突。8然而，双重职责护理研究包含的研究主体很少，有限。从概念上讲，双重职责护理忽略了妇女可能在家里平衡的其他家庭护理角色，特别是提供儿童护理和老年护理，或“夹心”护理。14此外，先前的研究只是横向的，主要基于在美国以外工作的妇女，以及相对较小的样本。8-13拟议的培训计划解决了在该领域取得进展的这些关键障碍，并通过使用创新的研究设计来扩展科学知识，使用创新的研究设计来检查在美国养老院工作的妇女的工作、家庭和健康研究的大量、独特的样本。15-18具体地说，这项工作将利用现有的数据来回答新的经验性问题，并加强双重职责护理的研究，目的如下：(1)纵向考察家庭护理角色的连续性和转变如何影响在家中扮演儿童(双重职责儿童护理)、老年人(双重职责老人护理)和夹心(三重职责护理)护理角色的医护人员的主观和手腕活动睡眠指数，以及(2)在日常水平上对双重和三职责照顾者的压力经历和时间使用进行深入调查，以加强对每个因素与睡眠持续时间、潜伏期、干扰和质量的关系的理解。这项工作将为致力于研究双重和三重护理的研究项目奠定坚实的基础，并为未来对结合正式和非正式照料角色的妇女的调查铺平道路。这项研究的结果还将为为这一特定的工作照料者小组制定干预措施提供信息，并更广泛地优化对工作照顾者的干预措施。

 DESCRIPTION (provided by applicant): Family Caregiving Transitions and Sleep among Double- and Triple-Duty Caregivers PROJECT SUMMARY/ABSTRACT Sleep is increasingly recognized as a significant public health issue.1 An estimated 50 to 70 million adults in the US chronically suffer from sleep or wakefulness disorders linked to a rising number of health problems, including heart disease, stroke, diabetes, obesity, cancer, and high blood pressure.1,2 Sleep-related problems can affect all areas of life, one of which is employment. A national survey of American workers found that employed Americans get less sleep than they need to function adequately at work; when they do sleep, workers indicate poor sleep quality.3 Although the implications of sleep disturbances are detrimental for any employee, they are particularly important for healthcare employees given their responsibilities of providing quality care and maintaining patient safety. Yet, healthcare employees commonly experience fatigue and poor sleep quality due to long work hours and exposure to physically and psychologically demanding work tasks.4-6 Additionally, healthcare employees may have caregiving responsibilities at home that interfere with sleep.4,7 In the literature, healthcare workers who provide elder care at home are referred to as double-duty caregivers, an understudied population projected to become more prevalent in the healthcare industry.8-13 Double-duty caregivers are at risk for emotional burnout,12 extreme physical and mental exhaustion,7,10-13 sleep deprivation,7 and work-family conflict.8 Double-duty care studies, however, comprise a small and limited body of research. Conceptually, double-duty care overlooks other family care roles women may be balancing at home, especially the provision of both child care and elder care, or 'sandwiched' care.14 Further, prior research has only been cross-sectional and primarily based on qualitative data, women working outside of the US, and relatively small samples.8-13 The proposed training plan addresses these critical barriers to progress in the field and extends scientific knowledge by using an innovative study design to examine a large, unique sample of women working in nursing homes in the US from the Work, Family and Health Study.15-18 Specifically, this work will draw on existing data to answer new empirical questions and strengthen double-duty care research with the following aims: (1) Conduct a longitudinal examination of how family caregiving role continuity and transitions affect subjective and wrist actigraphic indices of sleep among healthcare employees with child (double-duty child care), elder (double-duty elder care), and sandwiched (triple-duty care) care roles at home, and (2) Perform an in-depth examination of stressful experiences and time use among double- and triple-duty caregivers at the daily level to enhance understanding of how each relates to sleep duration, latency, disturbances, and quality. This work will serve as a strong foundation for a research program committed to the study of double- and triple-duty care and pave the way for future investigation into women who combine formal and informal caregiving roles. Findings from this research will also inform the development of interventions for this specific subgroup of working caregivers as well as optimize interventions for working caregivers more generally.