Tong Allison, Sainsbury Peter, Craig Jonathan C
NHMRC Centre for Clinical Research Excellence in Renal Medicine, Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW 2145, Australia.
Nephrol Dial Transplant. 2008 Dec;23(12):3960-5. doi: 10.1093/ndt/gfn415. Epub 2008 Jul 25.
A growing number of patients with chronic kidney disease (CKD) rely on non-professional healthcare providers, such as family and friends, to manage their long-term condition throughout the trajectory of CKD. These informal caregivers can experience stress, depression, lack of confidence and poor quality of life. Yet, the needs of caregivers are often neglected and under-prioritized. The objective of this review is to evaluate the effectiveness of interventions aimed at providing support to caregivers of people with CKD.
We conducted a systematic review of studies that evaluated any intervention for informal caregivers of CKD patients. We searched five electronic databases (up to January Week 5, 2008) including Medline, EMBASE, PsychINFO, CINAHL, Cochrane Central Register and reference lists of relevant articles.
Three studies were identified that evaluated an intervention for caregivers of CKD patients. All three only assessed the effect of educational material on caregivers' knowledge. Two evaluated information provided to caregivers of dialysis patients using a pre- and post-test study design. The other study used participatory action research methods to develop and evaluate an information handbook for transplant patients and their caregivers. Studies consistently found that the provision of information improved caregivers' knowledge. No other outcomes were reported.
Despite the growing recognition of the burden and adverse effects of CKD on caregivers, no high-quality evidence is available about the effect of information or support interventions on the physical or psychosocial well-being of informal caregivers and the patients. More attention towards the development and evaluation of services that respond to the support and informational needs of caregivers is needed, and this may also lead to improved outcomes for patients.
越来越多的慢性肾脏病（CKD）患者依靠非专业医疗服务提供者，如家人和朋友，在CKD病程中管理其长期病情。这些非正式护理人员可能会经历压力、抑郁、信心不足和生活质量低下的情况。然而，护理人员的需求往往被忽视且未得到优先重视。本综述的目的是评估旨在为CKD患者护理人员提供支持的干预措施的有效性。
我们对评估针对CKD患者非正式护理人员的任何干预措施的研究进行了系统综述。我们检索了五个电子数据库（截至2008年第5周），包括医学索引数据库（Medline）、荷兰医学文摘数据库（EMBASE）、心理学文摘数据库（PsychINFO）、护理学与健康领域数据库（CINAHL）、考克兰系统评价数据库（Cochrane Central Register）以及相关文章的参考文献列表。
共确定了三项评估针对CKD患者护理人员干预措施的研究。所有三项研究均仅评估了教育材料对护理人员知识的影响。两项研究采用前后测试研究设计，评估了向透析患者护理人员提供的信息。另一项研究使用参与式行动研究方法，为移植患者及其护理人员开发并评估了一本信息手册。研究一致发现，提供信息可提高护理人员的知识水平。未报告其他结果。
尽管人们越来越认识到CKD对护理人员的负担和不良影响，但关于信息或支持干预措施对非正式护理人员和患者的身体或心理社会福祉的影响，尚无高质量证据。需要更多关注开发和评估能够满足护理人员支持和信息需求的服务，这也可能改善患者的结局。
