Wald Claudia, Fahy Martin, Walker Zuzana, Livingston Gill
Central and North West London Mental Health NHS Trust, St Charles Hospital, London, UK.
Int J Geriatr Psychiatry. 2003 Apr;18(4):313-7. doi: 10.1002/gps.828.
To determine and prioritise what information dementia caregivers wish to know at the time of diagnosis and later on in the illness, and in what form this information should be presented.
100 carers were recruited from community mental health teams (CMHT) and a memory clinic (MC). A semi-structured Carer Interview was administered covering possible symptoms and management.
Carers requested as much information as possible. There was no significant difference between CMHTs and the MC. After carers prioritised the information they wished to receive, we proposed a 'rule of threes'. At diagnosis, carers want information about what dementia is, medications available and behavioural and psychiatric symptoms of dementia. In an early follow-up appointment, they want information about services, the course of the illness and what to do in a crisis. In a later follow-up appointment, they want information about support groups, benefits, and financial and legal issues. At a later stage, they want information about psychological therapies, the effects of the illness on carers and complementary treatments. Most carers wish to receive information from a health professional, backed up by written information.
The 'rule of threes' enables health professionals to make informed decisions about primacy of information and strategies to prevent carers becoming overloaded. Information should also be provided in written form and from support groups.
确定痴呆症照料者在诊断时及疾病后期希望了解的信息，并对这些信息进行优先级排序，同时确定应以何种形式呈现这些信息。
从社区心理健康团队（CMHT）和记忆诊所（MC）招募了100名照料者。进行了一次半结构化的照料者访谈，内容涵盖可能出现的症状及管理方法。
照料者希望获取尽可能多的信息。CMHT和MC之间没有显著差异。在照料者对他们希望获得的信息进行优先级排序后，我们提出了“三三法则”。在诊断时，照料者想了解痴呆症是什么、可用药物以及痴呆症的行为和精神症状。在早期随访预约时，他们想了解服务、疾病进程以及危机时该怎么做。在后期随访预约时，他们想了解支持小组、福利以及财务和法律问题。在更后期阶段，他们想了解心理治疗、疾病对照料者的影响以及辅助治疗。大多数照料者希望从健康专业人员那里获取信息，并辅以书面资料。
“三三法则”使健康专业人员能够就信息的优先级和防止照料者负担过重的策略做出明智决策。信息还应以书面形式提供，并由支持小组提供。
