This is an intervention study of stress and mental health which focuses on family caregivers of elderly persons attending day care centers. The overall goal of this research is to anticipate and reduce the psychobiological stress in family caregivers. Although it has been widely recognized that the family caring for the elderly in the home encounters numerous stresses and potential conflicts, little data are available as to the most effective ways to deal with those stresses, thereby enhancing the family member's mental health and preventing deterioration in his/her own overall health status. Bases on a variety of preliminary studies and pilot data analysis, this study will aim to: (1) compare the effectiveness of an educative/didactic group for caregivers with a psychotherapeutic/support group in terms of caregiver coping, psychobiological symptom experience and stress reduction, and (2) identify the long-term effects of these selected intervention strategies on caregivers of the elderly, specifically the most effective time intervals for reinforcement of learning. In the course of the study, the relationship between caregiver psychobiological symptoms and the elder's cognitive and functional abilities will be identified. Caregiver psychobiological symptom experience and coping will be profiled over time by the description and identifying of the types of stress-related symptoms most frequently experienced. A controlled field experiment of two different intervention approaches will be tested with randomly-assigned groups of a total of 60 primary caregivers who are daughters of elders in day care centers. Following pretesting using a variety of family functioning, coping, stress and health status instruments, random assignment of caregivers will be made to 1 of 3 groups: educative/didactic, psychotherapeutic/support, or control. Each group will meet for 8 weekly 2-hour sessions following a designated structure and format and will then be post-tested at the end of treatment groups, and again at 1, 3, 6 month and 1 year intervals after the end of treatment post-test. Elders will be pre and post-tested intermittently on cognitive, functional, and health status instruments and their health status will be monitored by record review in day care centers. Caregivers learning will be reinforced periodically and further self-report data will be collected on their psychobiological symptom experience. Data analysis will consist of descriptive and correlational procedures, in addition to the basic data analysis scheme which will utilize a repeated measures multivariate analysis of variance design to examine the effects of intervention over time.
