MBSR Intervention to reduce stress in AD caregivers

MBSR 干预可减轻 AD 护理人员的压力

• 批准号: 7360321
• 负责人: Lisa Fredman
• 金额: $ 27.87万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-03-01 至 2010-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7360321
• 关键词: Address; Affect; Alzheimer' s Disease; Area; Biological; Biological Markers; Boston; Caregivers; Caring; Chronic stress; Clinical; Clinical Research; Clinical Trials; Clinical Trials Design; Cognitive; Control Groups; Data; Data Collection; Development; Disease; Distress; Educational Curriculum; Educational Intervention; Educational process of instructing; Effectiveness; Effectiveness of Interventions; Elderly; Eligibility Determination; Equipment and supply inventories; Evaluation; Feasibility Studies; Future; Generic Drugs; Goals; Health; Heart Diseases; Immune system; Inflammatory; Inorganic Sulfates; Interleukin-6; Intervention; Investigation; Measurement; Measures; Meditation; Methods; Mind-Body Intervention; Modeling; Outcome; Pathway interactions; Patient Self-Report; Persons; Phase; Physiological; Pilot Projects; Protocols documentation; Psychoneuroimmunology; Purpose; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Rate; Recruitment Activity; Research; Research Design; Research Personnel; Respondent; Specimen; Stress; System; Techniques; Testing; Training; Universities; Unspecified or Sulfate Ion Sulfates; Week; Yoga; cancer pain; caregiving; clinically relevant; depressive symptoms; design; emotional distress; experience; immune function; improved; insight; mindfulness-based stress reduction; mortality; programs; psychologic; response; social; stress management; theories; trial comparing; willingness

DESCRIPTION (provided by applicant): Mindfulness-Based Stress Reduction (MBSR) is a mind-body technique that incorporates mindfulness meditation, yoga, and cognitive reappraisal with the goal of self-managing the psychological and physical distress resulting from stress, as well as pain, cancer and other illnesses. Although MBSR has been in existence for 20 years and has been incorporated into numerous clinical settings, few randomized clinical trials (RCTs) have evaluated its effects on stress reduction, or the physiological mechanism by which MBSR reduces stress. Caregivers to persons with Alzheimer's Disease (AD) experience high levels of stress, depressive symptoms, and adverse physical health outcomes, likely as a result of chronic stress. However, psycho-educational interventions for AD caregivers have shown only modest benefits on self-reported stress, probably because they teach techniques to deal with current caregiving problems which become less useful as the care recipient's disease progresses. In contrast, MBSR presents a conceptually effective stress reduction method for AD caregivers because of its generic approach to stress management and adaptability to various stressful situations. This revised proposed R21 study is guided by psychoneuoimmunology (PNI) theory. It aims to design and pilot-test an RCT of an 8-week MBSR intervention for older adult AD caregivers to reduce perceived stress, depressive symptoms, and improve two biological markers of PNI mechanisms: dihydroepiandrosterone-sulfate (DHEA-S) and interleukin-6 (IL-6). This study has two phases. The first phase is a development phase in which a team of MBSR experts will design the curriculum and training materials for an 8-week MBSR program adapted for elderly caregivers, and an 8-week social contact program to be used for comparison purposes. The second phase will be a pilot test of an RCT comparing this MBSR program to a social contact control group on short-term (pre-post intervention) and 6-month change in perceived stress, depressive symptoms, and biological markers among 72 elderly AD caregivers, recruited from the Boston University (BU) Alzheimer's Disease Center. Data collection will take place at the BU General Clinical Research Center. The results will provide information on rates of eligibility, participation, compliance and attrition; respondents' willingness to provide biological specimens; and the overall protocol for the future RCT. Mixed effects models will be used to test hypotheses comparing the MBSR group to the control group on changes in perceived stress, depressive symptoms, and DHEA-S and IL-6. The results will guide the design of a larger RCT of the effects of MBSR on reducing stress, and will provide insight into the physiological mechanisms of MBSR.

描述（由申请人提供）：基于正念的压力减轻（MBSR）是一种思维身心技术，它结合了正念冥想，瑜伽和认知重新评估，目的是自我管理由压力以及疼痛，疼痛，癌症和其他疾病引起的心理和身体困扰。尽管MBSR已经存在了20年，并且已纳入了许多临床环境中，但是很少有随机临床试验（RCT）评估了其对减轻压力的影响或MBSR减轻压力的生理机制。患有阿尔茨海默氏病（AD）患者的护理人员会因慢性压力而导致高水平的压力，抑郁症状和不良身体健康结果。但是，对广告护理人员的心理教育干预措施仅在自我报告的压力上显示出适度的益处，这可能是因为他们教授技术来应对当前的护理问题，随着护理人员疾病的发展，这些问题变得不太有用。相比之下，MBSR为AD护理人员提供了一种概念上有效的压力减少方法，因为它具有通用的压力管理方法和对各种压力状况的适应性。 这项经过修订的R21研究由心理免疫学（PNI）理论指导。它旨在设计和试点测试为期8周的MBSR干预的RCT，以减少成人AD护理人员，以减轻感知的压力，抑郁症状，并改善PNI机制的两个生物学标记：二羟基耐甲二硫酸盐（DHEA-S）（DHEA-S）和Iltleukin-6（IL-6）（IL-6）。这项研究有两个阶段。第一阶段是一个开发阶段，其中一组MBSR专家将为为期8周的MBSR计划设计课程和培训材料，适用于老年护理人员，以及为了比较目的的为期8周的社交联系计划。第二阶段将是对RCT的试点测试，该试验将该MBSR计划与社会接触对照组进行了短期（前干预措施）和6个月的感知压力，抑郁症状和生物学标记的6个月变化，从波士顿大学（BU）阿尔茨海默氏病中心招募。数据收集将在BU通用临床研究中心进行。结果将提供有关资格，参与，合规性和流失率的信息；受访者愿意提供生物标本；以及未来RCT的总体协议。混合效应模型将用于测试将MBSR组与对照组进行比较的假设，以了解感知到的压力，抑郁症状以及DHEA-S和IL-6的变化。结果将指导MBSR对减少应力的影响的较大RCT的设计，并将洞悉MBSR的生理机制。