Hempel Susanne, Norman Gill, Golder Su, Aguiar-Ibáñez Raquel, Eastwood Alison
RAND Corporation, Behavioral and Social Sciences Group, Santa Monica, California, USA.
J Adv Nurs. 2008 Nov;64(3):214-28. doi: 10.1111/j.1365-2648.2008.04806.x. Epub 2008 Sep 10.
This paper is a report of a scoping review to systematically identify and collate the evidence on psychosocial interventions for non-professional carers of people with Parkinson's disease.
Carers are critical to people with Parkinson's disease maintaining independent living and quality of life. Parkinson's disease imposes a challenging constellation of symptoms and no summary of effective interventions for carers and their unique support needs exists.
Thirty electronic databases were searched from their inception to July 2006, and bibliographies and specific internet sites were scanned.
Eligible studies were categorized according to design, type of economic evaluation where applicable, number of participants, country of evaluation, intervention, orientation, provider, setting, method of delivery, carer population, patient population, carer outcomes, patient outcomes and authors' conclusions. Data were extracted by one reviewer and checked by another reviewer; discrepancies were resolved through discussion or arbitration by a third reviewer.
Thirty studies met the inclusion criteria. Most investigated relatively unique interventions involving multiple elements; the majority were not aimed primarily at carers but were embedded in patient treatment programmes. Many were pilot studies, employing weak research designs and involving very small numbers of participants and most were not designed to assess the clinical or cost effectiveness of the intervention for the carers.
Several interventions merit further investigation but there is currently little evidence to show which approaches are effective and cost effective in supporting carers. Future studies need to employ appropriate and rigorous research designs with adequate samples and outcome measures, and with more focus on the carer.
本文是一项范围综述报告,旨在系统识别和整理有关帕金森病患者非专业照料者心理社会干预措施的证据。
照料者对于帕金森病患者维持独立生活和生活质量至关重要。帕金森病会引发一系列具有挑战性的症状,目前尚无针对照料者及其独特支持需求的有效干预措施总结。
检索了30个电子数据库自创建至2006年7月的内容,并浏览了参考文献和特定网站。
符合条件的研究根据设计、适用的经济评估类型、参与者数量、评估国家、干预措施、方向、提供者、环境、实施方法、照料者群体、患者群体、照料者结局、患者结局以及作者结论进行分类。数据由一名审阅者提取,另一名审阅者进行核对;如有差异,通过第三名审阅者进行讨论或仲裁来解决。
30项研究符合纳入标准。大多数研究调查的是涉及多个要素的相对独特的干预措施;大多数并非主要针对照料者,而是纳入了患者治疗方案中。许多是试点研究,采用的研究设计薄弱,参与者数量很少,且大多数并非旨在评估干预措施对照料者的临床或成本效益。
有几种干预措施值得进一步研究,但目前几乎没有证据表明哪些方法在支持照料者方面是有效且具有成本效益的。未来的研究需要采用适当且严谨的研究设计,有足够的样本和结局指标,并更多地关注照料者。