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提高非专业痴呆照护者的照护能力、应对压力的能力和心理健康水平。

Improving caregiving competence, stress coping, and mental well-being in informal dementia carers.

机构信息

Mary Chiu, Virginia Wesson, Joel Sadavoy, Department of Psychiatry, The Cyril and Dorothy, Joel and Jill Reitman Centre for Alzheimer's Support and Training, Mount Sinai Hospital, Toronto, Ontario, M5G 1X5, Canada.

出版信息

World J Psychiatry. 2013 Sep 22;3(3):65-73. doi: 10.5498/wjp.v3.i3.65.

Abstract

AIM

To study the effectiveness of Reitman Centre "Coaching, Advocacy, Respite, Education, Relationship, and Simulation" (CARERS) program, which uses problem-solving techniques and simulation to train informal dementia carers.

METHODS

Seventy-three carers for family members with dementia were included in the pilot study. Pre- and post-intervention data were collected from carers using validated measures of depression, mastery, role captivity and overload, caregiving competence and burden, and coping styles. To assess program effectiveness, mean differences for these measures were calculated. One-way ANOVA was used to determine if change in scores is dependent on the respective baseline scores. Clinical effects for measures were expressed as Cohen's D values.

RESULTS

Data from 73 carers were analyzed. The majority of these participants were female (79.5%). A total of 69.9% were spouses and 30.1% were children of the care recipient. Participants had an overall mean age of 68.34 ± 12.01 years. About 31.5% of participating carers had a past history of psychiatric illness (e.g., depression), and 34.2% sustained strained relationships with their respective care recipients. Results from carers demonstrated improvement in carers' self-perception of competence (1.26 ± 1.92, P < 0.0001), and significant reduction in emotion-focused coping (measured by the Coping Inventory of Stressful Situations, -2.37 ± 6.73, P < 0.01), Geriatric Depression scale (-0.67 ± 2.63, P < 0.05) and Pearlin's overload scale (-0.55 ± 2.07, P < 0.05), upon completion of the Program. Secondly, it was found that carers with more compromised baseline scores benefited most from the intervention, as they experienced statistically significant improvement in the following constructs: competence, stress-coping style (less emotion-oriented), sense of mastery, burden, overload.

CONCLUSION

Study results supported the effectiveness of the CARERS Program in improving caregiving competence, stress coping ability and mental well-being in carers caring for family members with dementia.

摘要

目的

研究 Reitman 中心“辅导、倡导、喘息、教育、关系和模拟”(CARERS)计划的有效性,该计划使用解决问题的技巧和模拟来培训非专业痴呆症护理人员。

方法

纳入了 73 名照顾痴呆症家庭成员的护理人员进行试点研究。使用经过验证的抑郁、掌握、角色禁锢和负担过重、照顾能力和负担以及应对方式的措施,在干预前后从护理人员那里收集数据。为了评估方案的有效性,计算了这些措施的平均值差异。采用单因素方差分析来确定分数的变化是否依赖于各自的基线分数。用 Cohen's D 值表示措施的临床效果。

结果

分析了 73 名护理人员的数据。这些参与者大多数是女性(79.5%)。总共 69.9%是照顾对象的配偶,30.1%是其子女。参与者的平均年龄为 68.34 ± 12.01 岁。大约 31.5%的参与护理人员有精神病史(如抑郁症),34.2%与各自的护理对象关系紧张。护理人员的结果表明,护理人员对自己能力的自我认知有所提高(1.26 ± 1.92,P < 0.0001),情绪聚焦应对(通过应激状况应对量表测量)显著减少(-2.37 ± 6.73,P < 0.01),老年抑郁量表(-0.67 ± 2.63,P < 0.05)和 Pearlin 的负担量表(-0.55 ± 2.07,P < 0.05)。其次,研究发现,基线评分受损更严重的护理人员从干预中获益最大,因为他们在以下方面有显著的改善:能力、应对压力的方式(较少情绪化)、掌握感、负担、负担过重。

结论

研究结果支持了 CARERS 计划在提高照顾痴呆症家庭成员的护理人员的照顾能力、应对压力的能力和心理健康方面的有效性。

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