Department of General Practice and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
PLoS One. 2012;7(1):e30936. doi: 10.1371/journal.pone.0030936. Epub 2012 Jan 27.
Family caregivers of dementia patients are at increased risk of developing depression or anxiety. A multi-component program designed to mobilize support of family networks demonstrated effectiveness in decreasing depressive symptoms in caregivers. However, the impact of an intervention consisting solely of family meetings on depression and anxiety has not yet been evaluated. This study examines the preventive effects of family meetings for primary caregivers of community-dwelling dementia patients.
A randomized multicenter trial was conducted among 192 primary caregivers of community dwelling dementia patients. Caregivers did not meet the diagnostic criteria for depressive or anxiety disorder at baseline. Participants were randomized to the family meetings intervention (n = 96) or usual care (n = 96) condition. The intervention consisted of two individual sessions and four family meetings which occurred once every 2 to 3 months for a year. Outcome measures after 12 months were the incidence of a clinical depressive or anxiety disorder and change in depressive and anxiety symptoms (primary outcomes), caregiver burden and quality of life (secondary outcomes). Intention-to-treat as well as per protocol analyses were performed.
A substantial number of caregivers (72/192) developed a depressive or anxiety disorder within 12 months. The intervention was not superior to usual care either in reducing the risk of disorder onset (adjusted IRR 0.98; 95% CI 0.69 to 1.38) or in reducing depressive (randomization-by-time interaction coefficient = -1.40; 95% CI -3.91 to 1.10) or anxiety symptoms (randomization-by-time interaction coefficient = -0.55; 95% CI -1.59 to 0.49). The intervention did not reduce caregiver burden or their health related quality of life.
This study did not demonstrate preventive effects of family meetings on the mental health of family caregivers. Further research should determine whether this intervention might be more beneficial if provided in a more concentrated dose, when applied for therapeutic purposes or targeted towards subgroups of caregivers.
Controlled-Trials.com ISRCTN90163486.
痴呆症患者的家庭照顾者患抑郁或焦虑症的风险增加。一项旨在调动家庭网络支持的多组分计划已证明可有效降低照顾者的抑郁症状。然而，单独由家庭会议组成的干预措施对抑郁和焦虑的影响尚未得到评估。本研究旨在检验针对社区居住的痴呆症患者的主要照顾者的家庭会议的预防效果。
在 192 名社区居住的痴呆症患者的主要照顾者中进行了一项随机多中心试验。基线时，照顾者未符合抑郁或焦虑障碍的诊断标准。参与者被随机分配至家庭会议干预组（n=96）或常规护理组（n=96）。干预措施包括两次个体会议和四次家庭会议，每年每 2-3 个月进行一次，持续一年。12 个月后的结局指标为临床抑郁或焦虑障碍的发生率以及抑郁和焦虑症状的变化（主要结局）、照顾者负担和生活质量（次要结局）。进行了意向治疗和方案分析。
在 12 个月内，大量照顾者（72/192）出现了抑郁或焦虑障碍。该干预措施在降低疾病发生风险方面并不优于常规护理（调整后的 IRR 0.98；95%CI 0.69 至 1.38），也不能降低抑郁（随机分组-时间交互系数=-1.40；95%CI-3.91 至 1.10）或焦虑症状（随机分组-时间交互系数=-0.55；95%CI-1.59 至 0.49）。该干预措施并未减轻照顾者的负担或其健康相关生活质量。
本研究未显示家庭会议对家庭照顾者心理健康的预防作用。进一步的研究应确定，如果以更集中的剂量提供这种干预、将其用于治疗目的或针对照顾者的亚组，该干预是否会更有益。
Controlled-Trials.com ISRCTN90163486。
