Mittelman Mary S, Roth David L, Haley William E, Zarit Steven H
Silberstein Aging and Dementia Research Center, New York University Medical School, NY 10016, USA.
J Gerontol B Psychol Sci Soc Sci. 2004 Jan;59(1):P27-34. doi: 10.1093/geronb/59.1.p27.
Behavioral problems are among the most challenging aspects of caring for a person with Alzheimer's disease. A sample of 406 spouses-caregivers of patients with Alzheimer's disease was randomized to an active multicomponent counseling and support intervention condition or to a usual care condition. Caregivers reported on the frequency of troublesome patient behaviors and their reactions to them at baseline and at regular follow-up interviews. Random-effects regression models over the first 4 years after randomization revealed that, although the intervention did not affect the frequency of patient behavioral problems, it did significantly reduce caregivers' reaction ratings. Because caregiver appraisals have been found to mediate the impact of caregiving stress on depression and to predict nursing home placement rates, they deserve greater attention as an important target of intervention services.
行为问题是照顾阿尔茨海默病患者最具挑战性的方面之一。对406名阿尔茨海默病患者的配偶照顾者进行抽样，随机分为积极的多成分咨询与支持干预组或常规护理组。照顾者在基线以及定期随访访谈中报告患者麻烦行为的频率以及他们对此的反应。随机化后前4年的随机效应回归模型显示，尽管干预并未影响患者行为问题的频率，但确实显著降低了照顾者的反应评分。由于已发现照顾者的评估可调节照顾压力对抑郁的影响并预测疗养院安置率，因此作为干预服务的重要目标，它们值得更多关注。
