REDUCING STRESS AND SLEEP DISTURBANCES IN CAREGIVERS OF ALZHEIMER'S PATIENTS

减轻阿尔茨海默病患者护理人员的压力和睡眠障碍

• 批准号: 7432560
• 负责人: Martica Helon Hall
• 金额: $ 13.31万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-06-01 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7432560
• 关键词: Affective; Age; Alzheimer' s Disease; Attention; Audiotape; Blood; Caregiver Burden; Caregivers; Condition; Control Groups; Data; Data Collection; Depth; Diet; Disease; Disruption; Eating; Elderly; Equipment; Health; Home environment; Immune system; Immunosuppression; Individual; Intervention; Life; Literature; Measures; Mediator of activation protein; Medical; Monitor; Morbidity - disease rate; Numbers; Outcome; Patient Self-Report; Patients; Personal Satisfaction; Physical Function; Play; Polysomnography; Predisposition; Primary Health Care; Procedures; Psyche structure; Quality of life; Questionnaires; Randomized; Rate; Relative (related person); Reporting; Risk; Role; Saliva; Sampling; Self Management; Signal Transduction; Sleep; Sleep disturbances; Sleeplessness; Spouse Caregiver; Stress; Symptoms; Testing; Therapeutic immunosuppression; Time; Time Study; Translating; Treatment Efficacy; Visit; Widow; Widower; caregiving; follow-up; improved; mortality; programs; skills training; stress management; therapy design; Affective; Age; Alzheimer' s Disease; Attention; Audiotape; Blood; Caregiver Burden; Caregivers; Condition; Control Groups; Data; Data Collection; Depth; Diet; Disease; Disruption; Eating; Elderly; Equipment; Health; Home environment; Immune system; Immunosuppression; Individual; Intervention; Life; Literature; Measures; Mediator of activation protein; Medical; Monitor; Morbidity - disease rate; Numbers; Outcome; Patient Self-Report; Patients; Personal Satisfaction; Physical Function; Play; Polysomnography; Predisposition; Primary Health Care; Procedures; Psyche structure; Quality of life; Questionnaires; Randomized; Rate; Relative (related person); Reporting; Risk; Role; Saliva; Sampling; Self Management; Signal Transduction; Sleep; Sleep disturbances; Sleeplessness; Spouse Caregiver; Stress; Symptoms; Testing; Therapeutic immunosuppression; Time; Time Study; Translating; Treatment Efficacy; Visit; Widow; Widower; caregiving; follow-up; improved; mortality; programs; skills training; stress management; therapy design

The stress of caregiving is associated with a number of adverse health outcomes including psychiatric morbidity, immune system dysregulation, increased susceptibility to illness and disease, and increased risk for mortality. Sleep complaints are common among caregivers, and stress-related sleep disruptions may signal vulnerability to, or play a causal role in, the adverse health consequences of caregiving. The general aim of this revised study is to test the efficacy of an intervention designed to reduce stress and improve sleep in a sample of spousal careqivers of patients with Alzheimer Disease (AD). The intervention will be compared to an attention-only control condition. Specific aims of this study are: 1. To characterize stress-related sleep disruptions in spousal caregivers of AD patients. 2. To test the short-term efficacy of a stress management+healthy sleep practices (SM+HSP) intervention for improving sleep and health outcomes in AD caregivers. 3. To test the durability of SM+HSP in AD caregivers. The study will include 60 spousal caregivers of AD patients who will be randomly assigned to one of two treatment conditions. The SM+HSP intervention will consist of eight weekly in-home sessions that will focus on information support, skills training, affective self-management, and healthy sleep practices. Individually, these components have been shown to be efficacious for reducing stress or improving subjective sleep complaints in AD caregivers. The control condition will include eight weekly in-home sessions which will focus on diet and food intake. Treatment integrity will be monitored by audiotape recordings. The program project measures battery (Agebat) and additional measures specific to caregiving will be administered at four time points: prior to randomization, immediately post-intervention, and at 6- and 12-month follow-up visits. Project -specific data will be used to evaluate treatment efficacy and relationships among caregiver stress and sleep. Relationships among stress, sleep, and health will be more fully evaluated using program-wide data collected in Project 1-5. Our program-wide aim is: to characterize the impact of stress-related sleep disruptions on health in older adults, including AD caregivers, recent widows/widowers, patients with insomnia in primary care settings, and healthy elders above the age of 75 years. The main hypotheses to be tested within the individual project are that the stress of caregiving has a detrimental effect on sleep and that stress-related sleep disruptions, in turn, negatively impact health and well-being. It is hypothesized that, relative to the attention-only control condition, the active intervention (SM+HSP) will result in improvements in sleep and subsequent improvements in health and well-being.

护理的压力与许多不良健康结果有关，包括精神病发病率，免疫系统失调，对疾病和疾病的易感性增加以及死亡风险增加。睡眠投诉在护理人员中很常见，与压力相关的睡眠中断可能表明脆弱性或在护理人员的不利健康后果中发挥了因果作用。这项修订研究的总体目的是测试旨在减轻压力和改善睡眠的干预措施的功效，并在患有阿尔茨海默氏病（AD）患者的配偶护理人员的样本中。干预将与仅注意力控制条件进行比较。 这项研究的具体目的是：1。表征AD患者配偶护理人员中与压力相关的睡眠中断。 2。测试压力管理+健康睡眠实践（SM+HSP）干预措施的短期疗效，以改善AD护理人员的睡眠和健康结果。 3。测试广告护理人员中SM+HSP的耐用性。该研究将包括60名AD患者的配偶护理人员，他们将随机分配到两个治疗条件之一。 SM+HSP干预措施将包括八个每周的家庭课程，这些课程将集中于信息支持，技能培训，情感自我管理和健康的睡眠实践。单独地，这些组件已被证明可以有效减轻压力或改善广告护理人员的主观睡眠投诉。控制条件将包括八次每周的家庭课程，这些课程将集中在饮食和食物摄入量上。治疗完整性将通过录音带记录来监视。计划项目测量电池（AgeBat）和针对护理的其他措施将在四个时间点进行：在随机进行之前，立即进行干预后以及6个月和12个月的随访访问。项目特定数据将用于评估护理人员压力和睡眠之间的治疗功效和关系。使用项目1-5中收集的计划范围的数据，将对压力，睡眠和健康之间的关系进行更全面的评估。 我们范围内计划的目的是：表征与压力相关的睡眠中断对老年人健康的影响，包括广告 护理人员，最近的寡妇/遗ow，初级保健环境中失眠的患者以及超过75岁以上的健康长老。在个别项目中要测试的主要假设是，护理的压力会对睡眠产生不利影响，而与压力相关的睡眠中断反过来又对健康和福祉产生了负面影响。假设，相对于仅注意力控制条件，主动干预（SM+HSP）将改善睡眠，随后改善健康和福祉。