Au Alma, Gallagher-Thompson Dolores, Wong Meng-Kong, Leung Jess, Chan Wai-Chi, Chan Chun Chung, Lu Hui-Jing, Lai Man Kin, Chan Kevin
Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China ; Institute of Active Aging, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China.
Department of Psychiatry and Behavioral Sciences and Geriatric Education Centre, School of Medicine, Stanford University, Stanford, CA, USA.
Clin Interv Aging. 2015 Mar 26;10:611-9. doi: 10.2147/CIA.S72348. eCollection 2015.
Dementia caregiving is often associated with increase in depressive symptoms and strained relationships. This study tested whether telephone-delivered psychoeducation combined with an enhanced behavioral activation (BA) module had a better effect on the well-being of Alzheimer's caregivers than psychoeducation alone. The focus is on enhancing the competent use of coping skills via BA. The program is delivered by telephone to increase accessibility and sustainability for caregivers. Senior citizens are trained as paraprofessionals to deliver the BA module to increase the potential for sustainability of the program.
The study compared two telephone interventions using a 4-month longitudinal randomized controlled trial. For the first 4 weeks, all participants received the same psychoeducation program via telephone. Then for the following 4 months, eight biweekly telephone follow-up calls were carried out. For these eight follow-up calls, participants were randomized into either one of the two following groups with different conditions. For the psychoeducation with BA (PsyED-BA) group, participants received eight biweekly sessions of BA practice focused on pleasant event scheduling and improving communications. For the psychoeducation only (PsyED only) group, participants received eight biweekly sessions of general discussion of psychoeducation and related information. A total of 62 family caregivers of persons living with dementia were recruited and 59 (29 in the PsyED-BA group and 30 in the PsyED only group) completed the whole study.
As compared to the group with psychoeducation and discussion, the group with enhanced BA had decreased levels of depressive symptoms. The study had a low attrition rate.
Results suggested that competence-based training could be effectively administered through the telephone with the help of senior citizens trained and engaged as paraprofessionals. Results contribute to the present literature by offering some framework for developing effective, accessible, sustainable, and less costly interventions.
痴呆症护理往往与抑郁症状增加和关系紧张有关。本研究测试了电话提供的心理教育与强化行为激活（BA）模块相结合，是否比单独的心理教育对阿尔茨海默病护理者的幸福感有更好的效果。重点是通过BA提高应对技能的有效使用。该项目通过电话提供，以增加护理者的可及性和项目的可持续性。由老年人作为辅助专业人员进行培训，以提供BA模块，从而增加项目可持续性的可能性。
本研究采用4个月的纵向随机对照试验比较了两种电话干预措施。在最初的4周里，所有参与者通过电话接受相同的心理教育项目。然后在接下来的4个月里，进行了8次每两周一次的电话随访。对于这8次随访，参与者被随机分为以下两组中的一组，条件不同。对于心理教育与BA（PsyED-BA）组，参与者接受了8次每两周一次的BA练习课程，重点是愉快事件安排和改善沟通。对于仅心理教育（仅PsyED）组，参与者接受了8次每两周一次的心理教育和相关信息的一般性讨论。总共招募了62名痴呆症患者的家庭护理者，59名（PsyED-BA组29名，仅PsyED组30名）完成了整个研究。
与心理教育和讨论组相比，强化BA组的抑郁症状水平有所降低。该研究的损耗率较低。
结果表明，在经过培训并作为辅助专业人员参与的老年人的帮助下，可以通过电话有效地实施基于能力的培训。研究结果通过提供一些框架，有助于当前文献发展有效、可及、可持续且成本较低的干预措施。
