Gitlin Laura N, Reever Karen, Dennis Marie P, Mathieu Esther, Hauck Walter W
Center for Applied Research on Aging and Health, Thomas Jefferson University, 130 South 9th Street, Suite 513, Philadelphia, PA 19130, USA.
Gerontologist. 2006 Oct;46(5):630-9. doi: 10.1093/geront/46.5.630.
This study examined the short- and long-term effects of Adult Day Services Plus (ADS Plus), a low-cost care management intervention designed to enhance family caregiver well-being, increase service utilization, and decrease nursing home placement of impaired older adults enrolled in adult day care.
We used a quasi-experimental design, to recruit 129 caregivers from three adult day centers. Two centers offered adult day services and ADS Plus (n = 67); the third center (n = 62) offered only routine adult day services. ADS Plus involved a staff social worker who provided care management and support to family caregivers through face-to-face and telephone contact. Education, counseling, and referral services were offered for 12 months.
At 3-month follow-up, ADS Plus participants (n = 106) reported less depression (p =.016), improved confidence managing behaviors (p =.013) and enhanced well-being (p = .001) compared with controls. Long-term effects analyses (n = 69) showed that, compared with controls, ADS Plus participants continued to report less depression (p = .005) and enhanced confidence managing behaviors (p = .007). Also, intervention participants used adult day services on average 37 days more than controls (p = .003) and had fewer nursing home placements (n = 8) than controls (n = 17).
ADS Plus is cost efficient and is easy to implement within adult day centers. It affords important clinical and public health benefits, including enhanced caregiver well-being, greater adult day service use, and fewer nursing home placements.
本研究考察了成人日间服务增强计划（ADS Plus）的短期和长期效果。这是一种低成本的护理管理干预措施，旨在提升家庭照顾者的幸福感，增加服务利用率，并减少参加成人日间护理的受损老年人的养老院安置率。
我们采用了准实验设计，从三个成人日间护理中心招募了129名照顾者。两个中心提供成人日间服务和ADS Plus（n = 67）；第三个中心（n = 62）仅提供常规成人日间服务。ADS Plus包括一名工作人员社会工作者，通过面对面和电话联系为家庭照顾者提供护理管理和支持。提供为期12个月的教育、咨询和转介服务。
在3个月的随访中，与对照组相比，ADS Plus参与者（n = 106）报告的抑郁情绪减轻（p = 0.016），管理行为的信心增强（p = 0.013），幸福感提升（p = 0.001）。长期效果分析（n = 69）表明，与对照组相比，ADS Plus参与者继续报告抑郁情绪减轻（p = 0.005），管理行为信心增强（p = 0.007）。此外，干预组参与者使用成人日间服务的平均天数比对照组多37天（p = 0.003），养老院安置人数比对照组少（干预组n = 8，对照组n = 17）。
ADS Plus具有成本效益，且易于在成人日间护理中心实施。它带来了重要的临床和公共卫生益处，包括增强照顾者幸福感、增加成人日间服务使用以及减少养老院安置。
