College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.
Geriatr Nurs. 2009 Nov-Dec;30(6):426-36. doi: 10.1016/j.gerinurse.2009.09.010.
Family caregivers of older adults with significant cognitive and/or physical impairment are at increased risk for both psychiatric and physical morbidity. This article examines the research literature dedicated to the development of effective interventions to reduce distress and enhance well-being for these caregivers. Using a recent empirically based treatment (EBT) review of the literature as a backdrop, 3 overarching types of interventions were described as effective: psychoeducational skill building, psychotherapy (cognitive-behavioral in focus), and multicomponent (using a combination of at least 2 approaches such as education, family meetings, and skill building). Suggestions are made to facilitate future caregiver intervention research and translation of EBTs into the community including the need to expand rigorous research with caregivers of older adults facing problems other than dementia, including older patients with psychiatric problems; develop and test interventions designed for transitions into and out of the caregiving roles, as well as interventions designed to improve physical health outcomes and promote health behaviors; create linkages between interventions at multiple levels of delivery; extend caregiver intervention work with underrepresented ethnic and racial populations; and investigate the cost-effectiveness of caregiver interventions.
老年认知或身体功能严重受损患者的家庭照顾者,其精神和/或身体发病风险增加。本文探讨了旨在减少这些照顾者痛苦和提高幸福感的有效干预措施的研究文献。在最近的基于实证的文献综述中,描述了三种有效的干预措施:心理教育技能培养、心理治疗(以认知行为疗法为重点)和多组分(至少使用两种方法的组合,如教育、家庭会议和技能培养)。提出了一些建议,以促进未来的照顾者干预研究和 EBT 向社区的转化,包括需要扩大对面临痴呆以外问题的老年照顾者的严格研究,包括有精神问题的老年患者;开发和测试专为照顾角色的进入和退出而设计的干预措施,以及旨在改善身体健康结果和促进健康行为的干预措施;在多个交付层面建立干预措施之间的联系;扩大对代表性不足的族裔和种族群体的照顾者干预工作;并研究照顾者干预措施的成本效益。