Mittelman Mary
Silberstein Institute, Department of Psychiatry, New York University School of Medicine, New York, New York 10016, USA.
Curr Opin Psychiatry. 2005 Nov;18(6):633-9. doi: 10.1097/01.yco.0000184416.21458.40.
Comprehensive treatment for people with chronic illnesses or disabilities should include interventions for their family caregivers. In order for such interventions to achieve widespread implementation, they must first be proven efficacious in randomized controlled trials. The present review briefly summarizes the recent literature on the results of randomized controlled trials and pilot studies of psychosocial interventions for caregivers.
Many of the recent studies of psychosocial interventions for caregivers have resulted in significant outcomes, regardless of the chronic illness of the relative or friend for whom care is being provided. While didactic interventions can provide knowledge, supportive interventions generally have more impact on caregiver and patient emotional and psychological well-being. Pilot studies suggest that new modes of intervention, such as telephone-based and web-based counseling and support, show promise and appear to be feasible. Psychosocial interventions for caregivers that are individualized and flexible, and provide long-term support appear to be the most efficacious.
The literature on caregiver intervention studies, conducted in research centers, suggests that treating the caregiver may be an important component of a comprehensive treatment for chronic diseases and disabilities. Interventions with demonstrated efficacy should now be tested more widely in community settings in multiple geographic settings, ethnic groups, disease entities and caregiver types, to more fully evaluate their generalizability and effectiveness.
对患有慢性疾病或残疾的人群进行综合治疗时，应将针对其家庭照顾者的干预措施纳入其中。为使此类干预措施得到广泛实施，必须首先在随机对照试验中证明其有效性。本综述简要总结了近期关于照顾者心理社会干预随机对照试验和试点研究结果的文献。
近期许多针对照顾者的心理社会干预研究都取得了显著成果，无论所照顾的亲属或朋友患有何种慢性疾病。虽然说教式干预可以提供知识，但支持性干预通常对照顾者和患者的情绪及心理健康有更大影响。试点研究表明，电话咨询和网络咨询及支持等新的干预模式显示出前景且似乎可行。针对照顾者的个性化、灵活且提供长期支持的心理社会干预似乎最为有效。
在研究中心开展的关于照顾者干预研究的文献表明，治疗照顾者可能是慢性疾病和残疾综合治疗的重要组成部分。现在应在多个地理区域、种族群体、疾病类型和照顾者类型的社区环境中更广泛地测试已证明有效的干预措施，以更全面地评估其普遍性和有效性。
