Gallagher-Thompson Dolores, Coon David W, Solano Nancy, Ambler Christian, Rabinowitz Yaron, Thompson Larry W
Older Adult and Family Center, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine and VA Palo Alto Health Care System, 795 Willow Road, mail code 182C/MP, Menlo Park, CA 94025, USA.
Gerontologist. 2003 Aug;43(4):580-91. doi: 10.1093/geront/43.4.580.
Few empirical studies have compared the efficacy between psychoeducational (skill-building) approaches for reducing caregivers' psychological distress and interventions modeled after typical community-based support groups. We compare the impact of two distinct interventions on Anglo and Latino caregivers of elderly relatives with dementia.
The change from preassessment to postassessment (baseline to 3 months) for 213 female caregivers (122 Anglo and 91 Latino) is presented. They were seen weekly for 10 weeks in either the Coping With Caregiving psychoeducational program (instruction and practice in small groups to learn specific cognitive and behavioral skills) or in the Enhanced Support Group condition (guided discussion and empathic listening to develop reciprocal support within the group). Both programs were tailored to be sensitive to the cultural concerns of Anglo and Latino caregivers, and they were delivered in either English or Spanish by trained interventionists.
Overall, participants in the Coping With Caregiving condition reported a significant reduction in depressive symptoms, increased use of adaptive coping strategies, and a trend toward decreased use of negative coping strategies when compared with those in the Enhanced Support Group condition. Results were similar for both ethnic groups: there were no main effects for ethnicity, and no significant ethnicity by treatment interaction effects.
This study provides empirical support that female caregivers benefit more from a skill-building approach to managing their distress than from support group membership alone. We find it very encouraging that the Latino caregivers responded well on key outcome variables, suggesting that Latinos will participate in clinical research and will benefit from their involvement when services are provided to meet their specific needs.
很少有实证研究比较过心理教育（技能培养）方法与典型社区支持小组模式干预措施在减轻照料者心理困扰方面的效果。我们比较了两种不同干预措施对患有痴呆症老年亲属的盎格鲁和拉丁裔照料者的影响。
呈现了213名女性照料者（122名盎格鲁人和91名拉丁裔）从预评估到后评估（基线至3个月）的变化情况。她们在“应对照料”心理教育项目（小组指导和实践，学习特定认知和行为技能）或强化支持小组环境（引导讨论和共情倾听，在小组内建立相互支持）中接受为期10周的每周一次的服务。两个项目都根据盎格鲁和拉丁裔照料者的文化关注点进行了调整，由经过培训的干预人员用英语或西班牙语实施。
总体而言，与强化支持小组环境中的参与者相比，“应对照料”环境中的参与者报告抑郁症状显著减轻，适应性应对策略的使用增加，消极应对策略的使用有减少趋势。两个种族的结果相似：种族没有主效应，治疗与种族之间也没有显著的交互效应。
本研究提供了实证支持，表明女性照料者从技能培养方法中比仅从支持小组成员身份中更能受益于管理自身困扰。我们非常鼓舞地发现，拉丁裔照料者在关键结果变量上反应良好，这表明拉丁裔将参与临床研究，并在提供满足其特定需求的服务时从参与中受益。
