The Mindful and Self-Compassionate Care Program (MASC): Reducing Stress for Caregivers of Persons with Dementia

正念和自我关怀护理计划 (MASC)：减轻痴呆症患者护理人员的压力

• 批准号: 10505172
• 负责人: Christine S Ritchie
• 金额: $ 45.46万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10505172
• 关键词: Adherence; Adult; Aggressive behavior; Agitation; Alzheimer' s Disease; Alzheimer' s disease related dementia; Anxiety; Behavior; Behavioral; Behavioral Sciences; Benchmarking; Bypass; Caregivers; Caring; Clinical Trials; Compassion; Complex; Data; Dementia; Dementia caregivers; Dissemination and Implementation; Distress; Effectiveness; Empathy; Enrollment; Ensure; Feasibility Studies; Focus Groups; Fostering; Funding; Geography; Goals; Guilt; Health; Health education; Home; Hybrids; Individual; Intervention; Interview; Language; Lead; Loneliness; Massachusetts; Meditation; Mental Depression; Modality; Modeling; Morbidity - disease rate; Outcome; Patient Self-Report; Patients; Perception; Personal Satisfaction; Persons; Positioning Attribute; Procedures; Public Health; Randomized; Regimen; Reporting; Research; Risk; Sampling; Science; Self Efficacy; Services; Signal Transduction; Single-Blind Study; Social support; Stress; Structure; Support Groups; Time; United States National Institutes of Health; Well in self; Work; base; behavior change; care giving burden; care recipients; caregiver stress; clinically relevant; collaborative care; community center; dementia care; depressive symptoms; design; effectiveness trial; emotion regulation; emotional distress; ethnic minority; evidence base; experience; feasibility testing; follow-up; improved; loved ones; mindfulness; mortality; physical conditioning; programs; psychologic; racial minority; recruit; secondary outcome; skills; stress management; therapy development; uptake; video delivery; virtual; virtual delivery; web platform

PROJECT SUMMARY: Within a 3-year R01 we will use the NIH stage model and principles from the Science of Behavioral Change to develop, optimize and establish proof of concept for the Mindful, Self-Compassionate Care Program (MASC) for stressed caregivers of persons with ADRD with challenging behaviors. In aim 1, we will use qualitative focus groups to develop MASC (NIH stage 1A; up to 30 caregivers; n=4 groups). In aim 2, we will optimize MASC and conduct an open pilot with exit interviews to explore feasibility benchmarks, target engagement and signal of improvement in stress, depression, anxiety and well- being (NIH stage 1A; up to 10 caregivers; n=1 group). In aim 3, we will conduct a pilot RCT of MASC versus a Health Education control to establish feasibility benchmarks and preliminary efficacy and explore evidence for potential mechanisms of improvement through the proposed mechanistic targets (N=80/c0 completers). MASC combines evidence- based skills from mindfulness programs, self-compassion programs, and behavioral management programs. MASC structure and components are designed to facilitate uptake, skill practice, and sustainability of improvements. MASC has 6 sessions and is delivered virtually in groups. MASC has an associated web platform that facilitates skills practice and is available to caregivers after the group ends. Our guiding hypothesis is that MASC skills of mindfulness, self-compassion, and behavioral management will interact and lead to decreased stress, depression and anxiety and improved well-being, through decreased loneliness, increased caregiver self-efficacy, social support, mindfulness, self-compassion, compassion and improved relationship quality. Our team is well positioned to conduct this study with specific experience in mindfulness and self-compassion programs; intervention development, feasibility testing and clinical trials; ADRD caregivers; recruitment of national, geographically diverse samples. At the end of the 3-year period of this R01 we will have clear evidence of the feasibility of study procedures, randomization, acceptability, credibility, adherence, ability to retain and recruit as well as its proof of concepts in reducing stress in caregivers of people with ADRD and proposed mechanisms. Results from this R01 study will be used to apply for funding to conduct a fully powered hybrid efficacy-effectiveness RCT. The goal is dissemination and implementation of MASC to reduce stress, among all in need caregivers of persons with ADRD.

项目概要： 在 3 年 R01 中，我们将使用 NIH 阶段模型和行为改变科学原理来开发， 为压力大的护理人员优化正念、自我关怀护理计划 (MASC) 并建立概念验证 具有挑战性行为的 ADRD 患者。在目标 1 中，我们将利用定性焦点小组来开发 MASC（NIH 阶段1A；最多 30 名护理人员； n=4组）。在目标 2 中，我们将优化 MASC 并通过离职面谈进行开放试点 探索可行性基准、目标参与度以及压力、抑郁、焦虑和健康状况改善的信号 （NIH 1A 阶段；最多 10 名护理人员；n=1 组）。在目标 3 中，我们将开展 MASC 与 Health 的试点随机对照试验 教育控制，建立可行性基准和初步功效，并探索潜力的证据 通过建议的机械目标进行改进的机制（N=80/c0 完成者）。 MASC 结合证据- 来自正念计划、自我慈悲计划和行为管理计划的基础技能。 MASC 结构和组件的设计旨在促进理解、技能实践和改进的可持续性。 MASC有6个 会议并以虚拟方式分组授课。 MASC 有一个相关的网络平台，可以促进技能练习，并且 小组结束后可供护理人员使用。我们的指导性假设是 MASC 技能包括正念、自我同情、 和行为管理将相互作用并导致压力、抑郁和焦虑的减少以及幸福感的改善， 通过减少孤独感、提高照顾者的自我效能、社会支持、正念、自我同情、同情心 并提高了关系质量。我们的团队在正念方面拥有丰富的经验，能够很好地开展这项研究 和自我同情计划；干预措施开发、可行性测试和临床试验； ADRD 护理人员； 招募国家、地域不同的样本。在 R01 的 3 年期结束时，我们将明确 研究程序的可行性、随机性、可接受性、可信度、依从性、保留能力和 招募以及减轻 ADRD 患者护理人员压力的概念证明和拟议的机制。 这项 R01 研究的结果将用于申请资金以进行全动力混合功效-效果随机对照试验。 目标是传播和实施 MASC，以减轻所有有需要的患者护理人员的压力 ADRD。