Vandepitte Sophie, Van Den Noortgate Nele, Putman Koen, Verhaeghe Sofie, Faes Kristof, Annemans Lieven
Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Belgium.
Faculty of Medicine and Health Sciences, Department of Internal Medicine, Ghent University, Brussels, Belgium.
J Alzheimers Dis. 2016 Apr 8;52(3):929-65. doi: 10.3233/JAD-151011.
Dementia is known as a major public health problem affecting both patients and caregivers, and placing a high financial strain upon society. In community-dwelling patients, it is important to support informal caregivers in order to help them sustain their demanding role. Previous reviews about effectiveness of such supporting strategies often included a small number of studies, focused only on particular supportive types, particular outcomes, or solely on caregivers.
A general systematic review was conducted investigating effectiveness of different supportive strategies on at least the well-being of the caregiver or the care-recipient.
A systematic literature search was conducted in Web of Science and PubMed. An adapted version of the Downs and Black (1998) checklist was used to assess methodological quality. A new classification was developed to group different types of caregiver support.
Fifty-three papers met the inclusion criteria. Although 87% of the interventions were to some extent effective, methods and findings were rather inconsistent. Psychoeducational interventions generally lead to positive outcomes for caregivers, and delay permanent institutionalization of care-recipients. Cognitive behavioral therapy decreases dysfunctional thoughts among caregivers. Occupational therapy decreases behavioral problems among patients and improves self-efficacy of caregivers. In general, those interventions tailored on individual level generate better outcomes. Comparative research on respite care was very rare.
Despite methodological inconsistency, supporting caregivers appears to be an effective strategy often improving well-being of caregiver or care-recipient and resulting in additional benefits for society. However, there is a need for more research on the (cost)-effectiveness of respite care.
痴呆症是一个重大的公共卫生问题，影响着患者和照料者，给社会带来了沉重的经济负担。对于社区居住的患者而言，支持非正式照料者很重要，以便帮助他们维持这一艰巨的角色。以往关于此类支持策略有效性的综述往往纳入的研究数量较少，仅聚焦于特定的支持类型、特定的结果或仅关注照料者。
进行一项全面的系统综述，调查不同支持策略至少对照料者或受照料者幸福感的有效性。
在科学网和PubMed上进行系统的文献检索。使用经改编的唐斯和布莱克（1998年）检查表来评估方法学质量。开发了一种新的分类方法来对不同类型的照料者支持进行分组。
53篇论文符合纳入标准。尽管87%的干预措施在某种程度上是有效的，但方法和结果相当不一致。心理教育干预通常会给照料者带来积极的结果，并延缓受照料者进入永久性机构照料。认知行为疗法减少了照料者的功能失调性思维。职业疗法减少了患者的行为问题，并提高了照料者的自我效能感。总体而言，那些针对个体水平量身定制的干预措施产生的效果更好。关于喘息服务的比较研究非常罕见。
尽管方法存在不一致性，但支持照料者似乎是一种有效的策略，通常能改善照料者或受照料者的幸福感，并为社会带来额外的益处。然而，需要更多关于喘息服务（成本）效益的研究。
