Department of Psychology, Cleveland State University, 2121Euclid Avenue, CB 109, Cleveland, OH 44115, USA.
Gerontologist. 2013 Apr;53(2):280-92. doi: 10.1093/geront/gns076. Epub 2012 Aug 16.
This study examined the efficacy of a newly developed intervention, Acquiring New Skills While Enhancing Remaining Strengths (ANSWERS), for family caregivers of individuals with dementia. ANSWERS was designed for dyads comprised of an individual with dementia and his/her family caregiver. Using a strength-based approach, ANSWERS combined educational skills (traditionally used with caregivers) and cognitive rehabilitation skills training (traditionally used with individuals with dementia) into a single protocol for addressing the dyad's care issues and needs. Key domains addressed by the intervention included: education about dementia and memory loss; effective communication; managing memory; staying active; and recognizing emotions and behaviors. This analysis focused on outcomes for caregivers.
DESIGN & METHODS: The Stress Process Model guided the study's hypotheses and design. Caregiving dyads were randomly assigned to the control or intervention conditions. Intervention dyads received 6-curriculum guided sessions with an intervention specialist. Data came from in-person baseline interviews with caregivers conducted prior to randomization and follow-up interviews conducted approximately 14.56 weekspost-baseline.
Intervention caregivers, compared to controls, had decreased care-related strain as indicated by lower emotional health strain, dyadic relationship strain, role captivity, and higher caregiving mastery. Additionally, intervention caregivers had improved well-being as indicated by fewer symptoms of depression and anxiety.
ANSWERS was efficacious in improving key strain and psychosocial outcomes for caregivers. Features essential to the success of ANSWERS included a strength-based approach for selecting, developing, and implementing care goals, as well as teaching caregivers educational and cognitive rehabilitation skills for addressing care needs.
本研究考察了一种新开发的干预措施——在增强剩余力量的同时获得新技能（ANSWERS）对痴呆症患者家庭照顾者的疗效。ANSWERS 专为由痴呆症患者及其家庭照顾者组成的二人组设计。ANSWERS 采用基于优势的方法，将教育技能（传统上用于照顾者）和认知康复技能训练（传统上用于痴呆症患者）结合到一个单一的协议中，以解决二人组的护理问题和需求。干预措施重点解决的关键领域包括：关于痴呆症和记忆丧失的教育；有效沟通；管理记忆；保持活跃；以及识别情绪和行为。本分析侧重于照顾者的结果。
应激过程模型指导了研究的假设和设计。照顾者二人组被随机分配到对照组或干预组。干预组接受了 6 次由干预专家指导的课程。数据来自于随机分组前对照顾者进行的面对面基线访谈和大约 14.56 周的基线后随访访谈。
与对照组相比，干预组的照顾相关压力降低，表现为情绪健康压力、二元关系压力、角色束缚降低，以及照顾能力提高。此外，干预组的幸福感也有所提高，表现为抑郁和焦虑症状减少。
ANSWERS 有效地改善了照顾者的关键压力和心理社会结果。ANSWERS 成功的关键特征包括：采用基于优势的方法来选择、制定和实施护理目标，以及教授照顾者教育和认知康复技能来满足护理需求。
