Luchsinger José, Mittelman Mary, Mejia Miriam, Silver Stephanie, Lucero Robert J, Ramirez Mildred, Kong Jian, Teresi Jeanne A
Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, New York, USA.
BMJ Open. 2012 Sep 14;2(5). doi: 10.1136/bmjopen-2012-001941. Print 2012.
Dementia prevalence and its burden on families are increasing. Caregivers of persons with dementia have more depression and stress than the general population. Several interventions have proven efficacy in decreasing depression and stress in selected populations of caregivers. Hispanics in New York City tend to have a higher burden of dementia caregiving compared to non-Hispanic whites (NHW) because Hispanics have a higher prevalence of dementia, tend to have high family involvement, and tend to have higher psychosocial and economic stressors. Thus, we chose to test the effectiveness of a dementia caregiving intervention, the New York University Caregiver Intervention (NYUCI), with demonstrated efficacy in spouse caregivers in Hispanic relative caregivers of persons with dementia. Including the community health worker (CHW) intervention in both arms alleviates general psychosocial stressors and allows the assessment of the effectiveness of the intervention. Compared to two original efficacy studies of the NYUCI, which included only spouse caregivers, our study includes all relative caregivers, including common law spouses, children, siblings, a nephew and nieces. This study will be the first randomised trial to test the effectiveness of the NYUCI in Hispanic caregivers including non-spouses.
The design of the study is a randomised controlled trial (RCT). Participants are randomised to two arms: case management by a CHW and an intervention arm including the NYUCI in addition to case management by the CHW. The duration of intervention is 6 months. The main outcomes in the trial are changes in the Geriatric Depression Scale (GDS) and the Zarit Caregiver Burden Scale (ZCBS) from baseline to 6 months.
This trial is approved by the Columbia University Medical Center Institutional Review Board (AAAI0022), and funded by the National Institute on Minority Health and Health Disparities. The funding agency has no role in dissemination.
www.ClinicalTrials.gov NCT01306695.
痴呆症的患病率及其对家庭的负担正在增加。痴呆症患者的照料者比普通人群有更多的抑郁和压力。多项干预措施已被证明在特定照料者群体中可有效减轻抑郁和压力。与非西班牙裔白人(NHW)相比,纽约市的西班牙裔照料痴呆症患者的负担往往更高,因为西班牙裔痴呆症患病率更高,家庭参与度高,且心理社会和经济压力源也更多。因此,我们选择测试一种痴呆症照料干预措施——纽约大学照料者干预(NYUCI)的有效性,该干预措施在痴呆症患者的西班牙裔亲属照料者中已被证明对配偶照料者有效。在两组中纳入社区卫生工作者(CHW)干预可减轻一般心理社会压力源,并有助于评估干预措施的有效性。与两项仅纳入配偶照料者的NYUCI原始疗效研究相比,我们的研究纳入了所有亲属照料者,包括事实婚姻配偶、子女、兄弟姐妹、侄子和侄女。本研究将是第一项测试NYUCI对包括非配偶在内的西班牙裔照料者有效性的随机试验。
本研究设计为随机对照试验(RCT)。参与者被随机分为两组:由社区卫生工作者进行病例管理的组,以及除社区卫生工作者进行病例管理外还包括NYUCI的干预组。干预持续时间为6个月。试验的主要结局是从基线到6个月时老年抑郁量表(GDS)和扎里特照料者负担量表(ZCBS)的变化。
本试验已获得哥伦比亚大学医学中心机构审查委员会(AAAI0022)的批准,并由美国国立少数民族健康与健康差异研究所资助。资助机构不参与传播工作。
www.ClinicalTrials.gov NCT01306695。