Dröes R M, Breebaart E, Ettema T P, van Tilburg W, Mellenbergh G J
Department of Psychiatry, Faculty of Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
Int Psychogeriatr. 2000 Mar;12(1):99-115. doi: 10.1017/s1041610200006232.
This study tests the hypothesis that integrated family support, in which patients and caregivers are both supported by one professional staff, is more effective in influencing behavior problems and mood of the dementia patient than nonintegrated support, such as psychogeriatric day care only.
A quasi-experimental pretest-posttest control group design with matched groups was applied.
Psychogeriatric day-care centers of four community centers and three nursing homes.
Fifty-six dementia patients living at home and their caregivers.
The patients in the experimental group (n = 33) participated together with their caregivers in an integrated family support program, whereas the patients in the control group (n = 23) received psychogeriatric day care only.
Behavior problems and mood were observed using standardized behavior observation scales.
After 7 months the experimental support program, compared to the regular psychogeriatric day care, showed a large positive effect on the total number of behavior problems (effect size .75), and also specifically on the degree of inactivity (effect size .66) and nonsocial behavior (effect size .61). No effect on mood was found.
In influencing the total amount of behavior problems, as well as the degree of inactivity and nonsocial behavior, the integrated family support program proved to be more effective than psychogeriatric day care. Because behavior problems are an important determinant for admission of persons with dementia into a nursing home, integrated family support may contribute to the delay of institutionalization.
本研究检验以下假设，即由一名专业人员同时支持患者及其照护者的整合式家庭支持，在影响痴呆患者的行为问题和情绪方面，比非整合式支持（如仅提供老年精神日间护理）更有效。
采用准实验性前后测对照组设计，并进行组间匹配。
四个社区中心和三个养老院的老年精神日间护理中心。
56名居家痴呆患者及其照护者。
实验组（n = 33）的患者与其照护者共同参与一项整合式家庭支持项目，而对照组（n = 23）的患者仅接受老年精神日间护理。
使用标准化行为观察量表观察行为问题和情绪。
经过7个月的实验性支持项目，与常规老年精神日间护理相比，该项目对行为问题总数（效应量为0.75），特别是对活动减少程度（效应量为0.66）和非社交行为（效应量为0.61）显示出较大的积极影响。未发现对情绪有影响。
在影响行为问题总量以及活动减少程度和非社交行为方面，整合式家庭支持项目被证明比老年精神日间护理更有效。由于行为问题是痴呆患者入住养老院的一个重要决定因素，整合式家庭支持可能有助于延迟机构化。
