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: 8220741
• 负责人: STEVEN H ZARIT
• 金额: $ 44.75万
• 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/8220741
• 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; Emotional; 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; 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; 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）：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。但是，这项研究的大部分是相关的，数据以一个或两个时间的收集收集，这可能会模糊事件的顺序，从而使压力源可能影响健康的基本机制。使用密集的重复测量个人的新设计方法为澄清事件的序列从压力源到健康标记和福祉，并更准确地确定具体的日常体验的短期健康效应。拟议的研究将在每日压力，情绪和健康症状和健康中的每日互动中，在9天的日期中收集每日日记的数据，以表现出三个可能的链接，以表现出三个重要的生物，并与三个重要的生物相互依据。与先前的日记研究相比，在压力源中暴露范围有限，我们将通过比较使用成人日服务（ADS）的压力反应（ADS）的相对时代，利用自然出现的实验。我们小组的先前工作发现，与非ADS天相比，照顾者在使用广告的天数降低了与护理相关的压力源的66％。与经典的A-B-A研究设计相当，这种方法将使我们能够检查高压力和低压力条件下的压力源的立即和延迟影响。样本将是当前正在使用广告的PWD的180名家庭护理人员。参与者将连续9天进行评估，包括当他们的相对使用AD（低压力天）以及相对没有（高压力天）时进行评估。每日措施包括与护理相关的和非护理压力，主观困扰和健康症状。生物标志物将从每天计划时间提供的唾液样品中获得。将获得具有对健康影响的3种关键生物标志物的测定：皮质醇，α-氨基酶和脱氢双足剂 - 硫酸盐（DHEA-S）。该研究的结果将阐明日常压力源，健康状况和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。减少压力源时压力反应较低的发现还将产生有关护理人员服务如何降低健康风险的实用信息。公共卫生相关性：广泛认识到，与照顾痴呆症患者（PWD）相关的压力与健康和福祉的各种负面结果有关。拟议的研究将检查日常压力源，健康状况和生物标志物之间的联系，并在高压力暴露和低压力暴露日期内进行联系。这种方法将有助于我们确定护理压力可能影响健康的途径，并可能产生有关减少压力暴露及其相关健康风险的护理人员服务的实用信息。