The broad long-term objective of this proposal is to gain in-depth experience in biobehavioral research focusing on improving outcomes in persons on prolonged mechanical ventilation (PMV) and their family caregivers to strengthen the applicant's ability to launch a competitive and independent research career. Persons on PMV often suffer from long-term physical and psychological sequelae after surviving in the intensive care unit (ICU) and therefore require significant assistance from family caregivers. Research has shown that negative psychological and behavioral responses in caregivers of persons with chronic disease (e.g., dementia) are associated with negative caregiver health outcomes. Despite reports of psychological distress and burden in caregivers of persons on PMV, there is limited understanding of the extent of this stress responses, including psychological, behavioral and biological responses over the continuum of illness (ICU admission to post discharge). The purposes of this pilot feasibility study using a multidisciplinary, integrative biobehavioral model, the Pittsburgh Mind-Body Center Model are: 1) to evaluate the feasibility of conducting a longitudinal biobehavioral study in caregivers of persons on PMV and 2) to explore the interactions among caregivers'psychological (e.g., burden), behavioral (e.g., sleep) and biological (e.g., IL1) responses of acute and chronic stress over time and how those interactions are related to characteristics of care recipients. A longitudinal prospective descriptive repeated measure design will be used. A total of 40 dyads of caregivers and persons on PMV (care recipient) who spent >=4 days on mechanical ventilation will be enrolled in the study. Data collection will occur three times (baseline [ICU admission], ICU discharge, and 2 months after ICU discharge). Feasibility will be evaluated using descriptive statistics including recruitment and retention rates, and caregivers'acceptability of behavioral and biological data collection. To explore the potential longitudinal changes in caregivers'responses and relationships among responses, trends of changes in descriptive statistics and correlation coefficients will be used. This study is consistent with NINR's mission to integrate the biological and behavioral sciences, employ new technologies to research questions, improve research methods, and develop scientists of the future. The proposed research also meets one of NINR's areas of research emphasis on family caregiving. The relevance of this research to public health is to identify specific time-points to prevent and intervene to improve caregivers'emotional and physical health over the care recipient's illness trajectory. Improving caregivers'emotional and physical health may also improve the delivery of care as well as quality of life for the care recipient.
