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一项关于引导式自助以改善抑郁症患者照料者照料体验的随机对照试验。

A randomized controlled trial of guided self-help for improving the experience of caring for carers of clients with depression.

作者信息

McCann Terence V, Songprakun Wallapa, Stephenson John

机构信息

Centre for Chronic Disease, College of Health and Biomedicine (Discipline of Mental Health Nursing), Victoria University, Melbourne, Victoria, Australia.

McCormick Faculty of Nursing, Payap University, Chiang Mai, Thailand.

出版信息

J Adv Nurs. 2015 Jul;71(7):1600-10. doi: 10.1111/jan.12624. Epub 2015 Feb 6.

Abstract

AIM

To evaluate the effectiveness of a cognitive behaviour therapy guided self-help manual for enhancing the experience of caregiving of family carers of individuals with depression.

BACKGROUND

The prevalence of depression is increasing markedly in Thailand. While primary carers give most of the support for individuals with depression, they receive little support from mental health services in this critical role.

DESIGN

A randomized controlled trial.

METHOD

Carers were randomized to guided self-help (n = 27), while the control group received standard information and support (n = 27). Both groups also received a short weekly telephone call. Participants were assessed at three time points; the outcome measure was the Experience of Caregiving Inventory. A doubly multivariate analysis of variance (anova) procedure, including between-group and within-group factors, was implemented. Fieldwork was from October 2007-May 2008.

RESULTS

Fifty-four carers completed the study and intent-to-treat analyses were undertaken. The findings showed there was a significant reduction in the total negative experience of caring, from baseline to post-treatment, in the intervention group recipients of the manual compared with the control group and treatment effects were maintained at one-month follow-up. Similarly, a significant improvement in the total positive experience of caring occurred, from baseline to post-treatment, in the intervention group in contrast with the control group and these outcomes were sustained at one-month follow-up.

CONCLUSION

Guided self-help strengthen carers' positive and reduces their negative, experience of caring. The study contributes to the limited evidence base about this approach in a developing country such as Thailand.

摘要

目的

评估认知行为疗法指导的自助手册对提升抑郁症患者家庭照料者照料体验的有效性。

背景

抑郁症在泰国的患病率显著上升。虽然主要照料者为抑郁症患者提供了大部分支持,但他们在这一关键角色中很少得到心理健康服务的支持。

设计

一项随机对照试验。

方法

照料者被随机分为自助指导组(n = 27),而对照组接受标准信息和支持(n = 27)。两组还每周接受一次简短的电话随访。在三个时间点对参与者进行评估;结果测量指标是照料体验量表。采用双因素多变量方差分析程序,包括组间和组内因素。实地调查时间为2007年10月至2008年5月。

结果

54名照料者完成了研究并进行了意向性分析。结果显示,与对照组相比,接受手册的干预组从基线到治疗后的照料总体负面体验显著减少,且治疗效果在1个月随访时得以维持。同样,与对照组相比,干预组从基线到治疗后的照料总体正面体验有显著改善,且这些结果在1个月随访时持续存在。

结论

自助指导增强了照料者照料的积极体验,减少了消极体验。该研究为泰国等发展中国家关于这种方法的有限证据库做出了贡献。

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