Gallagher-Thompson Dolores, Gray Heather L, Tang Paulette C Y, Pu Chun Yu, Leung Laurie Y L, Wang Peng-Chih, Tse Collins, Hsu Shannon, Kwo Elizabeth, Tong Hui-Qi, Long James, Thompson Larry W
Stanford University School of Medicine, Stanford, CA, USA.
Am J Geriatr Psychiatry. 2007 May;15(5):425-34. doi: 10.1097/JGP.0b013e3180312028.
Recent work has shown that Chinese Americans caring for a family member with dementia experience considerable psychological distress. However, few studies evaluate treatments for them. This study evaluated the efficacy of in-home intervention, based on cognitive behavior therapy principles, to relieve stress and depression in female Chinese American caregivers (CGs).
Fifty-five CGs who met inclusion criteria were randomly assigned to a telephone support condition (TSC) or to an in-home behavioral management program (IHBMP) for 4 months. In the TSC, biweekly calls were made and relevant material was mailed. In the IHBMP, specific psychological skills were taught to deal with caregiving stress. CGs were assessed before and after treatment. Outcome measures evaluated overall perceived stress, caregiving-specific stress, and depressive symptoms.
CGs in IHBMP were less bothered by caregiving-specific stressors and had lower depression levels than CGs in TSC. There was no difference in overall stress. CGs with low baseline level of self-efficacy for obtaining respite benefited from IHBMP, but showed little improvement in the TSC. CGs with higher self-efficacy benefited from both treatments.
This intervention is promising and warrants replication in future studies. Additional research is needed to evaluate longer-term effects and to identify individual differences associated with improvement.
近期研究表明,照顾患有痴呆症家庭成员的华裔美国人经历了相当大的心理困扰。然而,很少有研究评估针对他们的治疗方法。本研究评估了基于认知行为疗法原则的家庭干预对缓解华裔美国女性照顾者(CGs)的压力和抑郁的效果。
55名符合纳入标准的CGs被随机分配到电话支持组(TSC)或家庭行为管理项目组(IHBMP),为期4个月。在TSC组,每两周进行一次电话沟通并邮寄相关材料。在IHBMP组,教授特定的心理技能以应对照顾压力。在治疗前后对CGs进行评估。结果测量评估总体感知压力、照顾特定压力和抑郁症状。
与TSC组的CGs相比,IHBMP组的CGs较少受到照顾特定压力源的困扰,抑郁水平更低。总体压力方面没有差异。获得喘息机会的自我效能基线水平较低的CGs从IHBMP中受益,但在TSC组中改善甚微。自我效能较高的CGs从两种治疗中均受益。
这种干预措施很有前景,值得在未来研究中重复验证。需要进一步研究来评估长期效果,并确定与改善相关的个体差异。