Daily Stress, Health and Well-Being of Family Caregivers

家庭护理人员的日常压力、健康和福祉

• 批准号: 7769488
• 负责人: STEVEN H ZARIT
• 金额: $ 50.35万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-03-01 至 2014-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7769488
• 关键词: Address; Adrenal Glands; Adult; Affect; Age; Anger; Anxiety; Behavior; Behavioral; Biological Assay; Biological Markers; Cardiovascular system; Caregivers; Caring; Characteristics; Communities; Data; Day Care; Dehydroepiandrosterone Sulfate; Dementia; Depressed mood; Distal; Distress; Evaluation; Event; Exposure to; Family Caregiver; Feeling; Health; Health Benefit; Home environment; Hour; Hydrocortisone; Immune; Individual; Interview; Laboratory Study; Lead; Link; Measurement; Measures; Mediator of activation protein; Metabolic; Modeling; Moods; Outcome; Participant; Pathway interactions; Pattern; Personal Satisfaction; Persons; Physiological; Population; Problem behavior; Process; Recovery; Relative (related person); Reporting; Research; Research Design; Risk; Saliva; Salivary; Sampling; Schedule; Services; Severities; Stress; Stressful Event; Symptoms; System; Testing; Time; Variant; Well in self; Withdrawal; Work; allostatic load; alpha-amylase; base; biological adaptation to stress; caregiving; depressive symptoms; design; diaries; experience; falls; follow-up; hypothalamic-pituitary-adrenal axis; improved; mortality; pressure; programs; psychologic; public health relevance; research study; response; simulation; stressor; theories

DESCRIPTION (provided by applicant): Caring for a person with dementia (PWD) has been found to be associated with a variety of negative changes in health and well-being. Much of this research, however, has been correlational, with data gathered at one or two points in time, which can blur the sequence of events and thus the underlying mechanism by which stressors may affect health. New design approaches that use intensive repeated measurement of individuals offer the potential for clarifying the sequence of events from stressors to health markers and well-being and to establish more precisely the short-term health effects of concrete daily experiences The proposed study will collect daily diary data over a 9-day period on daily stressors, daily mood and health symptoms and daily measures of three critical biomarkers to demonstrate the links between stress and health, as well as possible mediators of that relationship. In contrast to prior daily diary studies, where the range of exposure to stressors is limited, we will take advantage of a naturally-occurring experiment by comparing the stress responses of caregivers using Adult Day Services (ADS) for their relative on days they use ADS and days they do not. Prior work by our group found that caregivers experienced a 66 percent reduction in exposure to care-related stressors on days they used ADS compared to non-ADS days. Comparable to the classic A-B-A research design, this approach will enable us to examine immediate as well as delayed effects of stressors under high and low stress conditions. The sample will be 180 family caregivers of a PWD who is currently using ADS. Participants will be assessed over a period of 9 consecutive days, including when their relative uses ADS (low stress days) and when their relative does not (high stress days). Daily measures include care-related and non-care stressors, subjective distress and health symptoms. Biomarkers will be obtained from saliva samples provided at scheduled times during each day. Assays will be obtained for 3 key biomarkers with implications for health: cortisol, alphaamylase and dehydroepiandrosterone- sulfate (DHEA-S). The results of the study will clarify the relation among daily stressors, well- being and biomarkers of health, and suggest the pathways by which caregiving stressors might affect health. The finding that stress responses are lower when exposure to stressors is reduced would also yield practical information on how caregiver services could reduce health risks. PUBLIC HEALTH RELEVANCE: It is widely recognized that the stress associated with caring for a person with dementia (PWD) is associated with a variety of negative outcomes for health and well-being. The proposed study will examine the links among daily stressors, well-being and biomarkers of health on high stress exposure and low stress exposure days. This approach will help us identify the pathways by which caregiving stress might affect health and may also yield practical information on the design of caregiver services that reduce stress exposure and their associated health risks.

描述（由申请人提供）：已发现照顾痴呆症患者 (PWD) 与健康和福祉的各种负面变化有关。然而，这项研究大部分都是相关的，数据在一两个时间点收集，这可能会模糊事件的顺序，从而模糊压力源影响健康的潜在机制。使用对个人进行密集重复测量的新设计方法有可能澄清从压力源到健康标记和幸福感的事件顺序，并更准确地确定具体日常经历的短期健康影响拟议的研究将收集每日日记为期 9 天的每日压力源、每日情绪和健康症状以及三种关键生物标志物的每日测量数据，以证明压力与健康之间的联系以及这种关系的可能调节因素。与之前的每日日记研究相比，压力源暴露的范围是有限的，我们将利用自然发生的实验，比较使用成人日间服务 (ADS) 的护理人员在使用 ADS 的日子里为其亲属的压力反应还有几天他们没有。我们小组之前的研究发现，与未使用 ADS 的日子相比，使用 ADS 的日子里，护理人员接触到的护理相关压力源减少了 66%。与经典的 A-B-A 研究设计相比，这种方法将使我们能够检查高压力和低压力条件下压力源的即时和延迟影响。样本将是目前正在使用 ADS 的残疾人的 180 名家庭护理人员。参与者将在连续 9 天的时间内接受评估，包括其亲属使用 ADS 的时间（低压力日）和其亲属不使用 ADS 的时间（高压力日）。日常测量包括护理相关和非护理压力源、主观痛苦和健康症状。生物标记物将从每天预定时间提供的唾液样本中获得。将获得对健康有影响的 3 种关键生物标志物的检测结果：皮质醇、α淀粉酶和硫酸脱氢表雄酮 (DHEA-S)。研究结果将阐明日常压力源、幸福感和健康生物标志物之间的关系，并提出护理压力源可能影响健康的途径。研究发现，当接触压力源减少时，压力反应就会降低，这一发现也将提供有关护理服务如何降低健康风险的实用信息。公众健康相关性：人们普遍认为，照顾痴呆症患者 (PWD) 所带来的压力与健康和福祉的各种负面后果有关。拟议的研究将研究高压力暴露日和低压力暴露日的日常压力源、幸福感和健康生物标志物之间的联系。这种方法将帮助我们确定护理压力可能影响健康的途径，还可以提供有关设计护理服务的实用信息，以减少压力暴露及其相关的健康风险。