Culture and Caregiving Need for Chinese Elderly with Cognitive Impairment

描述(由申请人提供)：我们感谢来自先前审查的建设性意见和建议，以改进这项申请。这项重新提交研究(R01NR014846)的总体目标是对300名成年儿童照顾者进行人群水平的三波纵向调查，以量化中国认知障碍老年人代际团结与照顾者需求之间的关系。更具体地说，我们将进行三波数据收集，并使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痛苦的轨迹之间的关系；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为有显著认知障碍的老年人提供护理时寻求帮助的行为之间的关系。我们的次要目标是：4)检查上述目标1-3的性别差异；5)探索成年子女期望和坚持代际团结在照顾有认知障碍的中国老年人方面存在的障碍、挑战和文化差异 减损。尽管中国人口快速增长，但我们目前对照顾者对患有严重认知障碍的中国老年人的需求了解很少。由于文化信仰，许多家庭认为痴呆症是精神疾病的一种形式。痴呆症这个词的字面意思是两个字：“疯狂的和紧张症的”。患者和家属经历的耻辱、羞耻和负面反应干扰了他们寻求适当医疗服务的意愿。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显着差距。此外，缺乏必要的社区支持，使华人社区能够作为平等伙伴充分参与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)原则来量化重要文化因素与中国认知障碍老年人护理需求之间的关系。在这项申请中，一名双语和双文化首席研究员和一支经验丰富的跨机构跨学科团队将在我们之前由NIH资助的CBPR项目的基础上与芝加哥华人社区团体合作。这项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 在这方面，儿童基金会将为护理人员的需求提供信息；(C)为今后的预防和干预研究提供信息；以及(D)为改善护理人员的健康和福祉的做法和政策提供信息。

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 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.