The Caregiving Trajectory for Community-Dwelling Mexican-American Elders

社区居住的墨西哥裔美国老年人的护理轨迹

• 批准号: 7885010
• 负责人: Bronwynne Cadwalader Evans
• 金额: $ 5.09万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7885010
• 关键词: Accounting; Acculturation; Activities of Daily Living; Address; Admission activity; Adult; Advisory Committees; Age; Americas; Area; Behavior; Caregiver Burden; Caregivers; Caring; Case Study; Censuses; Characteristics; Classification; Cognitive; Communities; Country; Deterioration; Elderly; Emotional; Enrollment; Ensure; Ethnic Origin; Ethnic group; Event; Eye; Family; Family member; Gender; German population; Gerontology; Goals; Health; Healthcare; Hispanics; Home Nursing Care; Home environment; Household; Individual; Institutionalization; Intervention; Interview; Knowledge; Lead; Life; Life Cycle Stages; Life Expectancy; Light; Literature; Measurement; Measures; Methods; Mexican Americans; Minority; Nature; Nursing Homes; Occupations; Participant; Pattern; Perception; Phase; Population; Population Heterogeneity; Populations at Risk; Price; Protocols documentation; Questionnaires; Reporting; Research; Research Design; Risk; Role; Sampling; Science; Sleeplessness; Societies; Socioeconomic Status; Time; TimeLine; United States National Academy of Sciences; Variant; aged; base; care giving burden; caregiving; cognitive function; cohort; cost; demographics; depression; design; disability; ethnic minority population; experience; functional decline; functional status; geriatric depression; health disparity; indexing; instrumental activity of daily living; minority health; neglect; patient home care; patient oriented; prevent; social; therapy design; vigilance

DESCRIPTION (provided by applicant): Caregiving burden among Hispanic caregivers is a little understood and growing problem. As a result, research to address caregiver burden and prevent institutionalization in these populations is critical. It is estimated that there are over 42 million Hispanics in the U.S. and the cohort over age 65 is expected to grow faster than any other racial or ethnic group, tripling in number by 2050. Thirteen percent of Hispanic households currently provide care to an adult aged 50 or older whose life expectancy will increase to 87 years by 2050, surpassing all other ethnic groups. Given this dramatic shift in demographics, a burgeoning number of Hispanic families will be placed in a caregiving role. The purpose of this proposed study is to investigate the burden of caregiving in this at-risk population by describing the level, circumstances, and consequences of caregiver burden/strain, and determining the impact of cultural and contextual variables on caregiving and caregiver gain, along with factors that lead to nursing home admission. This proposed project is a longitudinal mixed methods descriptive study designed to intensively explore the natural course of caregiving, caregiving burden and strain, caregiver gain, and admission to nursing homes among Mexican-American families. One hundred ten caregiver-care recipient cases will be enrolled and followed for 15 months. Interviews and standardized questionnaires will be completed at baseline and every 10 weeks, with an additional measurement point if nursing home admission occurs. We will compare and contrast transitions and turning points in the caregiving trajectory (taking into account acculturation, the nature of the caregiver-care recipient relationship, gender, functional and cognitive status, and depression); identify factors that support caregiving; and determine what factors are most important in delaying institutionalization. The core component will be a case-oriented approach, that is, an intensive, qualitatively-driven, study of cases with an eye toward configurations of similarities and differences. A simultaneous, complementary, quantitatively-driven variable-oriented component will look for broad patterns across cases and enable the drawing of inferences based on these broad patterns. These approaches will be integrated throughout the analytic and interpretive phases of the study. This in-depth, systematic research into the caregiving trajectory should prove useful in designing interventions that are timed to occur simultaneously with known crisis points and help keep elders at home or to help families acknowledge when formal nursing home care should be sought. PROJECT NARRATIVE Using life course perspective, this longitudinal, descriptive, mixed methods study is designed to explore the natural course of caregiving, caregiving burden and strain, caregiver gain, and admission to nursing homes among 110 Mexican-American families. The core component will be a case-oriented approach, that is, an intensive, qualitatively-driven, study of cases with an eye toward configurations of similarities and differences. A simultaneous, complementary, quantitatively-driven variable-oriented component will look for broad patterns across cases and enable the drawing of inferences based on these broad patterns. We will compare and contrast transitions and turning points in the caregiving trajectory (taking into account acculturation, the nature of the caregiver-care recipient relationship, gender, functional and cognitive status, and depression); identify factors that support caregiving; and determine what factors are most important in delaying nursing home admission.

描述（由申请人提供）：西班牙裔护理人员的护理负担是一个鲜为人知且日益严重的问题。因此，解决护理人员负担并防止这些人群被送入收容机构的研究至关重要。据估计，美国有超过 4200 万拉美裔，其中 65 岁以上人群的增长速度预计将比任何其他种族或族裔群体增长得更快，到 2050 年，数量将增加两倍。目前，13% 的拉美裔家庭为 10 岁以上的成年人提供护理服务。到2050年，50岁或以上的人的预期寿命将增至87岁，超过所有其他族裔群体。鉴于人口结构的巨大变化，越来越多的西班牙裔家庭将承担起看护的角色。这项拟议研究的目的是通过描述护理人员负担/压力的水平、情况和后果，并确定文化和背景变量对护理和护理人员收益的影响，来调查这一高危人群的护理负担。以及导致入住疗养院的因素。本拟议项目是一项纵向混合方法描述性研究，旨在深入探索墨西哥裔美国家庭的护理自然过程、护理负担和压力、护理人员的增益以及入住疗养院的情况。将登记 110 名护理接受者案例并进行为期 15 个月的跟踪。访谈和标准化问卷将在基线时和每 10 周完成一次，如果入住疗养院，还会有​​一个额外的测量点。我们将比较和对比护理轨迹中的转变和转折点（考虑文化适应、护理者与护理接受者关系的性质、性别、功能和认知状态以及抑郁）；确定支持护理的因素；并确定哪些因素对延迟收容最重要。核心组成部分将是一种以案例为导向的方法，即对案例进行深入、定性的研究，着眼于相似性和差异性的配置。同步的、互补的、定量驱动的变量导向组件将寻找跨案例的广泛模式，并能够根据这些广泛模式得出推论。这些方法将整合到研究的整个分析和解释阶段。这种对护理轨迹的深入、系统的研究应该有助于设计与已知危机点同时发生的干预措施，并帮助让老年人留在家中或帮助家庭认识到何时应该寻求正式的疗养院护理。项目叙述 这项纵向、描述性、混合方法研究采用生命历程的视角，旨在探索 110 个墨西哥裔美国家庭的护理自然过程、护理负担和压力、护理人员增益以及入住疗养院。核心组成部分将是一种以案例为导向的方法，即对案例进行深入、定性的研究，着眼于相似性和差异性的配置。同步的、互补的、定量驱动的变量导向组件将寻找跨案例的广泛模式，并能够根据这些广泛模式得出推论。我们将比较和对比护理轨迹中的转变和转折点（考虑文化适应、护理者与护理接受者关系的性质、性别、功能和认知状态以及抑郁）；确定支持护理的因素；并确定哪些因素对延迟入住疗养院最重要。