McKechnie Vicky, Barker Chris, Stott Josh
Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
Int Psychogeriatr. 2014 Oct;26(10):1619-1637. doi: 10.1017/S1041610214001045. Epub 2014 Jul 3.
Caring for a friend or relative with dementia can be burdensome and stressful, and puts carers at increased risk of physical and psychological problems. A number of psychosocial interventions, some delivered by computer, have been developed to support carers. This review evaluates the outcomes of computer-mediated interventions.
PsychINFO, MEDLINE, and CINAHL Plus were searched for papers published between January 2000 and September 2012. Study quality was evaluated using a modified version of Downs and Black's (1998) checklist.
Fourteen empirical studies, evaluating a range of complex, multifaceted interventions, met inclusion criteria. The most commonly measured variables were carer burden/stress and depression. In general, higher quality studies found that interventions did have an effect on these variables. Two higher quality studies also found that anxiety was reduced following intervention. Most studies found that positive aspects of caring were increased through these interventions, as was carer self-efficacy. There were mixed results in relation to social support, and physical aspects of caring did not seem to be affected. Program impact measures indicated general acceptability of these interventions.
The findings support the provision of computer-mediated interventions for carers of people with dementia. Future studies would benefit from design improvements, such as articulating clearly defined aims, having a control group, having adequate statistical power, and measuring a greater range of factors important to carers themselves.
照顾患有痴呆症的朋友或亲属可能会很繁重且压力巨大,会使照顾者面临更高的身体和心理问题风险。已经开发了一些心理社会干预措施,其中一些是通过计算机实施的,以支持照顾者。本综述评估了计算机介导干预措施的效果。
检索了PsychINFO、MEDLINE和CINAHL Plus数据库中2000年1月至2012年9月发表的论文。使用唐斯和布莱克(1998年)核对清单的修改版对研究质量进行评估。
14项实证研究评估了一系列复杂、多方面的干预措施,符合纳入标准。最常测量的变量是照顾者负担/压力和抑郁。总体而言,质量较高的研究发现干预措施确实对这些变量有影响。两项质量较高的研究还发现干预后焦虑有所减轻。大多数研究发现,通过这些干预措施,照顾的积极方面有所增加,照顾者的自我效能感也有所提高。在社会支持方面结果不一,照顾的身体方面似乎未受影响。项目影响评估表明这些干预措施具有普遍可接受性。
研究结果支持为痴呆症患者的照顾者提供计算机介导的干预措施。未来的研究若能在设计上加以改进,例如明确阐述清晰界定的目标、设立对照组、具备足够的统计效力以及测量对照顾者自身更广泛的重要因素,将会有所助益。