Gitlin Laura N, Winter Laraine, Corcoran Mary, Dennis Marie P, Schinfeld Sandy, Hauck Walter W
Community and Homecare Research Division, 130 South 9th Street, Suite 513, Philadelphia, PA 19107, USA.
Gerontologist. 2003 Aug;43(4):532-46. doi: 10.1093/geront/43.4.532.
We examine 6-month effects of the Environmental Skill-Building Program on caregiver well-being and care recipient functioning and whether effects vary by caregiver gender, race (White or non-White), and relationship (spouse or nonspouse).
We enrolled 255 family caregivers of community-residing persons with Alzheimer's disease or related disorders, of whom 190 participated in a follow-up interview. Caregivers were randomized to a usual care control group or intervention group that received five home contacts and one telephone contact by occupational therapists, who provided education, problem-solving training, and adaptive equipment. Baseline and 6-month follow-up included self-report measures of caregiver objective and subjective burden, caregiver well-being, and care recipient problem behaviors and physical function.
Compared with controls (n = 101), intervention caregivers (n = 89) reported less upset with memory-related behaviors, less need for assistance from others, and better affect. Intervention spouses reported less upset with disruptive behaviors; men reported spending less time in daily oversight; and women reported less need for help from others, better affect, and enhanced management ability, overall well-being, and mastery relative to control group counterparts. Statistically significant treatment differences were not found for hours helping with instrumental activities of daily living, upset with providing assistance with instrumental activities of daily living and activities of daily living, perceived change in somatic symptoms, White versus non-White caregivers, or care recipient outcomes.
The Environmental Skill-Building Program reduces burden and enhances caregiver well-being in select domains and has added benefit for women and spouses.
我们研究了环境技能培养项目对照料者幸福感及受照料者功能的6个月影响，以及这些影响是否因照料者的性别、种族（白人或非白人）和关系（配偶或非配偶）而有所不同。
我们招募了255名患有阿尔茨海默病或相关疾病的社区居住者的家庭照料者，其中190人参与了随访访谈。照料者被随机分为常规护理对照组或干预组，干预组接受职业治疗师的五次家访和一次电话联系，职业治疗师提供教育、问题解决培训和适应性设备。基线和6个月随访包括照料者客观和主观负担、照料者幸福感以及受照料者问题行为和身体功能的自我报告测量。
与对照组（n = 101）相比，干预组照料者（n = 89）报告对与记忆相关行为的烦恼更少、对他人帮助的需求更少且情绪更好。干预组的配偶报告对破坏性行为的烦恼更少；男性报告在日常监督中花费的时间更少；女性报告相对于对照组同伴，对他人帮助的需求更少、情绪更好、管理能力增强、总体幸福感增强且掌控感增强。在帮助进行日常生活工具性活动的时长、对提供日常生活工具性活动和日常生活活动帮助的烦恼、躯体症状的感知变化、白人照料者与非白人照料者或受照料者结局方面，未发现具有统计学意义的治疗差异。
环境技能培养项目减轻了特定领域的负担并增强了照料者的幸福感，对女性和配偶有额外益处。
