Gerdner Linda A, Buckwalter Kathleen C, Reed David
School of Nursing, University of Minnesota, 6-101 Weaver-Densford Hall, 308 Harvard Street S.E., Minneapolis, MN 55455, USA.
Nurs Res. 2002 Nov-Dec;51(6):363-74. doi: 10.1097/00006199-200211000-00004.
Eighty percent of persons with Alzheimer's disease and related disorders are cared for by family members who often lack adequate support and training for this all-consuming job.
To evaluate the efficacy of a longitudinal, multisite, community-based intervention designed to teach home caregivers to manage behavioral problems in persons with Alzheimer's disease.
Usable data were analyzed from 237 caregiver/care recipient dyads (n = 132 Experimental; n = 105 Comparison). The experimental group received a psychoeducational nursing intervention that was conceptually grounded in the Progressively Lowered Stress Threshold model (Hall & Buckwalter, 1987). The comparison group received routine information and referrals for case management, community-based services, and support groups. Although a variety of psychosocial outcomes were compared between caregivers in the two groups, this article focuses on frequency and response to behavioral problems and functional decline.
The Progressively Lowered Stress Threshold intervention had a statistically significant effect on spousal response to memory/behavioral problems (p <.01) for all caregivers and on response to activities of daily living problems (p <.01) for spousal caregivers. In addition, nonspouses in the experimental group reported a reduction in the frequency of memory/behavioral problems (p <.01). No intervention effect on reports of activities of daily living frequencies was found for either spouses or nonspouses.
This Progressively Lowered Stress Threshold-based intervention had a positive impact on both the frequency of and response to problem behaviors among spousal caregivers.
80%的阿尔茨海默病及相关疾病患者由家庭成员照顾，而这些家庭成员在从事这项耗费精力的工作时往往缺乏足够的支持和培训。
评估一项基于社区的纵向多地点干预措施的效果，该措施旨在教会家庭护理人员管理阿尔茨海默病患者的行为问题。
对237对护理人员/受护理者二元组（n = 132个实验组；n = 105个对照组）的可用数据进行分析。实验组接受了一项心理教育护理干预，该干预在概念上基于逐步降低压力阈值模型（Hall & Buckwalter，1987）。对照组接受常规信息以及关于病例管理、社区服务和支持小组的转介。尽管对两组护理人员的多种心理社会结果进行了比较，但本文重点关注行为问题的频率和应对方式以及功能衰退情况。
逐步降低压力阈值干预对所有护理人员对记忆/行为问题的配偶反应（p <.01）以及配偶护理人员对日常生活问题的反应（p <.01）具有统计学显著影响。此外，实验组中的非配偶报告记忆/行为问题的频率有所降低（p <.01）。未发现该干预对配偶或非配偶关于日常生活频率报告有影响。
这项基于逐步降低压力阈值的干预措施对配偶护理人员的问题行为频率及应对方式均产生了积极影响。
