Holm Maja, Årestedt Kristofer, Carlander Ida, Wengström Yvonne, Öhlen Joakim, Alvariza Anette
Author Affiliations: Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm (Ms Holm and Drs Wengström and Alvariza); Palliative Research Centre, Ersta Sköndal University College, Stockholm (Ms Holm and Drs Carlander, Öhlen, and Alvariza); Department of Medical Health Sciences, Linköping University (Dr Årestedt); Centre for Collaborative Palliative Care, Linnaeus University, Kalmar (Dr Årestedt); Department of Learning, Informatics, Management, and Ethics, Karolinska Institutet, Stockholm (Dr Carlander); School of Health and Medical Sciences, Örebro University (Dr Wengström); Institute of Health and Care Sciences, University of Gothenburg (Dr Öhlen); Department of Health Care Sciences, Ersta Sköndal University College, Stockholm (Dr Alvariza); and Capio Palliative Care Unit, Dalen Hospital, Stockholm, Sweden (Dr Alvariza).
Cancer Nurs. 2017 Jan/Feb;40(1):76-83. doi: 10.1097/NCC.0000000000000351.
Although there has been a steady increase in intervention studies aimed toward supporting family caregivers in palliative cancer care, they often report modest effect sizes and there is a lack of knowledge about possible barriers to intervention effectiveness.
The aim of this study is to explore the characteristics of family caregivers who did not benefit from a successful psychoeducational group intervention compared with the characteristics of those who did.
INTERVENTION/METHODS: A psychoeducational intervention for family caregivers was delivered at 10 palliative settings in Sweden. Questionnaires were used to collect data at baseline and following the intervention. The Preparedness for Caregiving Scale was the main outcome for the study and was used to decide whether or not the family caregiver had benefited from the intervention (Preparedness for Caregiving Scale difference score ≤ 0 vs ≥ 1).
A total of 82 family caregivers completed the intervention and follow-up. Caregivers who did not benefit from the intervention had significantly higher ratings of their preparedness and competence for caregiving and their health at baseline compared with the group who benefited. They also experienced lower levels of environmental burden and a trend toward fewer symptoms of depression.
Family caregivers who did not benefit from the intervention tended to be less vulnerable at baseline. Hence, the potential to improve their ratings was smaller than for the group who did benefit.
Determining family caregivers in cancer and palliative care who are more likely to benefit from an intervention needs to be explored further in research.
尽管旨在支持癌症姑息治疗中家庭照护者的干预研究一直在稳步增加，但这些研究往往报告的效应量较小，并且缺乏关于干预效果可能存在的障碍的知识。
本研究的目的是探讨与从成功的心理教育小组干预中受益的家庭照护者相比，未受益的家庭照护者的特征。
干预措施/方法：在瑞典的10个姑息治疗机构为家庭照护者提供了心理教育干预。在基线和干预后使用问卷收集数据。照护准备量表是该研究的主要结局指标，用于确定家庭照护者是否从干预中受益（照护准备量表差异得分≤0与≥1）。
共有82名家庭照护者完成了干预和随访。与受益组相比，未从干预中受益的照护者在基线时对自己的照护准备、能力和健康状况的评分显著更高。他们还经历了较低水平的环境负担，并且有抑郁症状较少的趋势。
未从干预中受益的家庭照护者在基线时往往较不易受伤害。因此，与受益组相比，改善他们评分的潜力较小。
在癌症和姑息治疗中，确定哪些家庭照护者更有可能从干预中受益需要在研究中进一步探索。
