Technology Enhanced Self-Management Interventions for Fatigue and Pain: The Symptoms Self Management Center

项目总结/摘要 本补充研究的目的是测试自我管理（SM）、电子/移动的 健康（e/mHealth）瑜伽干预，以减少老年护理人员（CG）的压力症状（负担） 阿尔茨海默病和相关痴呆症（PWD）。CG负担可能会加剧无数的身体和 CG中的心理社会共病以及PWD神经精神症状。这些影响可能会进一步 在有潜在健康问题的老年CG中放大，或者那些无法获得 有效管理自己的医疗或自我护理需求。低影响的体力活动，如温和的 瑜伽（戈伊）对老年人的情绪和疼痛及疲劳症状有积极的影响 居民和数字电子/移动健康平台有很大的潜力，以克服金融和医疗 提供服务的障碍SM强调跨越人口界限的干预措施。在这项研究中，我们将研究 为期12周的e/mHealth温和瑜伽+瑜伽呼吸（GYYB）干预的可行性 PWD老化CG中的负担症状（目的1）;测量CG中压力和QoL指标的初始变化 和PWD（干预后vs.干预前），以提供足够把握度的未来疗效试验（目标2）; 在护理学院和P20内为MUSC教师建立二元分析培训计划 症状自我管理中心（SSMC），以支持未来的研究评估护理的影响- 接受者对健康结果的互动（目标3）。将使用RE-AIM框架评估可行性， 并将包括招募，坚持，治疗满意度，自然减员和反馈等措施， 干预措施的完善。与CG身体功能、疲劳、抑郁、社交孤立、孤独、 关系质量、负担和压力生物标志物以及PWD和CG QoL将通过每日 电子练习日志和研究开始和结束时的访谈。老年（> 55岁）男性和女性CG 将从现有研究中招募（N=20）例定期参加喘息护理（RCC）计划的PWD 参与CG-RCC餐时伙伴关系以改善残疾人营养的人口（R 01 NR 016466） 结果。符合HIPAA的GYYB干预将采用“平板电脑”，允许CG在 跟着沿着录制的课程回家。CG最初将接受平板电脑使用培训， 研究协调员（在家）进行GYYB实践，在研究期间每周进行随访（Skype/电话） study.本研究与母SSMC（P20 NR 016575）的目标理想一致， 为SM的设计和生态有效性测试提供基础设施和社区资源 对慢性病患者的干预措施。

PROJECT SUMMARY/ABSTRACT The goal of this study within the supplement is to test the feasibility of a self-managed (SM), electronic/mobile Health (e/mHealth) yoga intervention for reducing stress symptoms (burden) in older caregivers (CG) of people with Alzheimer’s Disease and related dementia’s (PWD). CG burden can exacerbate a myriad of physical and psychosocial comorbidities in CGs as well as PWD neuropsychiatric symptoms. These effects may be further amplified in older CG with underlying health concerns or those who are not able to access programs for effective management of their own medical or self-care needs. Low-impact physical activities such as gentle Yoga (GY) have shown positive effects on mood and symptoms of pain and fatigue in older community dwellers, and digital e/mHealth platforms have a great deal of potential to overcome financial and medical barriers for the delivery SM stress interventions across demographic boundaries. In this study, we will examine the feasibility of a 12-week e/mHealth gentle yoga+yogic breathing (GYYB) intervention for alleviating symptoms of burden in aging CG of PWD (Aim 1); measure initial changes in stress and QoL indicators in CG and PWD (post- vs. pre-intervention) to inform an adequately-powered, future efficacy trial (Aim 2), and; establish a Dyadic Analysis Training Program for MUSC faculty within the College of Nursing and P20 Symptom Self-Management Center (SSMC) to support future research evaluating the influence of care- recipient interactions on health outcomes (Aim 3). Feasibility will be assessed using the RE-AIM framework, and will include measures such as recruitment, adherence, treatment satisfaction, attrition, and feedback for intervention refinement. Data related to CG physical function, fatigue, depression, social isolation, loneliness, relationship quality, burden, and stress biomarkers, as well as PWD and CG QoL, will be collected via daily electronic practice logs and interviews at study beginning and end. Older (> 55 yrs. old) male and female CG (N=20) of PWD regularly attending respite care (RCC) programs will be recruited from an existing study population (R01 NR016466) participating in CG-RCC mealtime partnerships for improved PWD nutritional outcomes. The HIPAA-compliant GYYB intervention will employ ‘tablets’ that allow CG to practice GYYB at home by following along with recorded lessons. CG will initially be trained on the use of the tablet and proper GYYB practices by the study coordinator (in-home), with weekly follow up (Skype/phone) for the duration of the study. This investigation is ideally aligned with the aims of the parent SSMC (P20 NR016575) that are focused on providing infrastructure and community-based resources for design and ecologically-valid testing of SM interventions for individuals with chronic conditions.