A multidimensional approach to studying the impact of caregiving on health among dementia caregivers

研究护理对痴呆症护理人员健康影响的多维方法

基本信息

批准号：
10210566
负责人：
Jinmyoung Cho
金额：
$ 44.53万
依托单位：
BAYLOR RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-05-01 至 2023-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10210566
关键词：
Address Algorithms Alzheimer&apos s disease related dementia Alzheimer&apos s disease risk Behavior Cardiovascular Diseases Caregivers Caring Chronic Chronic Disease Chronic stress Clinical Clinical Data Clinical Trials Data Dementia caregivers Depressive disorder Development Diabetes Mellitus Disease Distress Electronic Health Record Family Caregiver Family member Funding Mechanisms Goals Health Health Promotion Health Status Health behavior Healthcare Systems Heterogeneity Incidence Individual Integrated Health Care Systems Intervention Measurement Mental Depression Methods Monitor Outcome Patient Care Patient Self-Report Patients Pattern Personal Satisfaction Persons Physical Function Positioning Attribute Quality of life Research Risk Risk Factors Role Societies Spouse Caregiver Spouses Subgroup Supervision Survey Methodology United States Variant base caregiving dementia care dementia caregiving design experience family caregiving frailty health assessment health care service health care service utilization improved innovation insight multiple data sources novel strategies patient population physical conditioning prevent preventive intervention protective factors psychosocial recruit response social engagement tailored health care

项目摘要

Family caregiving is both essential and highly respected in contemporary societies. In the U.S., very few affordable alternatives to family caregiving are available for the care of individuals living with Alzheimer’s disease and related dementia (ADRD). Protecting and promoting the health and well-being of family caregivers is crucial. The daily care and supervision of a family member living with ADRD have been associated with threats to the health and well-being of family caregivers, who often experience an overall decrease in quality of life indicators. Although more is known about the relationship of caregiving and psychosocial distress, such as depression, far less is known of the relationship between ADRD caregiving and physical health indicators and the relationship between changes in these indicators and health outcomes. Furthermore, not all caregivers have poor health effects, but we have little understanding of the profile of various health responses to caregiving. In particular, spouses of persons with ADRD are challenged by a chronic diseases and, for some, poor health outcomes; yet the health effects of caregiving vary across caregivers with some having few physical health issues and others having multiple physical health issues. A multidimensional approach inclusive of health indicators and outcomes from multiple data sources is required to fill this gap in the study of the physical health of family caregivers. The purpose of the proposed project is to characterize the health risks of ADRD spousal caregivers using self-reports of physical health and functioning, clinical health indicators, and health care utilization data represented in electronic health records (EHR). The research team will recruit spousal caregivers of individuals with ADRD, extract various health indicators from EHRs, including health care utilization, and use survey methods with a cross-sectional design to collect self-reported health and functioning as well as health behaviors. More specifically, using latent class analysis, this proposal addresses three specific aims: 1) characterize health risk profiles through a combination of objective and subjective assessments of health status among spousal caregivers; 2) Identify the degree of intensity of caregiving experience and patterns of health care utilization among spousal caregivers for the distinct health risk profiles determined in Aim 1; and 3) assess health promotion behaviors that serve as protective factors in the relationship between stressful caregiving experiences and health care utilization among subgroups of caregivers. Consistent with the purpose of the R21 funding mechanism, the expected outcomes of the project will provide a method for monitoring spousal caregiver health indicators. The study will inform the development of tailored interventions to address health risks among spousal ADRD caregivers. Findings from the study will provide the need for, and design of caregiver health risk identification algorithms that can be integrated into EHRs. The long-term goal of the proposed research is to improve recognition of caregivers’ health risks and to develop tailored interventions that reduce caregivers’ physical health burdens associated with providing continuous care for their spouses with ADRD in health care systems.

在当代社会，家庭照顾既重要又受到高度尊重，但在美国，这种情况很少。为阿尔茨海默病患者提供家庭护理之外的负担得起的替代方案和相关痴呆症 (ADRD) 保护和促进家庭护理人员的健康和福祉至关重要。患有 ADRD 的家庭成员的日常护理和监督与对 ADRD 的威胁有关。家庭照顾者的健康和福祉，他们的生活质量指标往往总体下降。尽管人们对护理与抑郁症等社会心理困扰之间的关系了解更多，但目前还不清楚 ADRD 护理与身体健康指标之间的关系知之甚少。此外，并非所有护理人员的健康状况都不佳。影响，但我们对护理的各种健康反应知之甚少。 ADRD 患者的配偶面临慢性疾病的挑战，其中一些人的健康状况仍然不佳；护理对健康的影响因护理人员而异，有些人几乎没有身体健康问题，而另一些人则没有什么身体健康问题存在多种身体健康问题。包括健康指标和结果的多维方法。需要来自多个数据源的数据来填补家庭护理人员身体健康研究中的这一空白。拟议项目的目的是通过自我报告来描述 ADRD 配偶照顾者的健康风险身体健康和功能、临床健康指标和医疗保健利用数据研究小组将招募 ADRD 患者的配偶照顾者，从电子病历中提取各种健康指标，包括医疗保健利用率，并使用调查方法横断面设计，收集自我报告的健康和功能以及健康行为。具体来说，通过使用潜在类别分析，该提案解决了三个具体目标：1）描述健康风险通过对配偶健康状况进行客观和主观评估相结合的方式进行概况分析 2) 确定护理经验的强度程度和医疗保健利用模式配偶照顾者针对目标 1 中确定的不同健康风险状况进行评估；以及 3) 评估健康促进；在压力护理经历与健康之间的关系中充当保护因素的行为与 R21 资助机制的目的一致，该项目的预期成果将提供一种监测配偶照顾者健康指标的方法。研究将为制定量身定制的干预措施提供信息，以解决配偶 ADRD 中的健康风险研究结果将提供护理人员健康风险识别的需求和设计。可以集成到电子病历中的算法所提出的研究的长期目标是改进。认识到护理人员的健康风险，并制定量身定制的干预措施，以减少护理人员的身体负担在医疗保健系统中为患有 ADRD 的配偶提供持续护理相关的健康负担。