一项基于家庭的训练计划对减少痴呆患者家庭照顾者抑郁的随机对照试验。
A randomized controlled trial of a home-based training programme to decrease depression in family caregivers of persons with dementia.
机构信息
School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan.
Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
出版信息
J Adv Nurs. 2017 Mar;73(3):585-598. doi: 10.1111/jan.13157. Epub 2016 Oct 17.
AIMS
The aim of this study was to explore distinct trajectories of caregivers' depressive symptoms and the effects of a training programme on these trajectories over 18 months after the programme.
BACKGROUND
Overall effects of caregiver-training programmes on family caregivers' depressive symptoms have been reported, but few studies explored distinct courses of changes in caregivers' depressive symptoms and followed up intervention effects on these distinct courses.
DESIGN
Randomized clinical trial.
METHODS
Family caregivers (n = 116) were randomly assigned into experimental (n = 57) and control (n = 59) groups. The experimental group received the training programme with telephone consultation and the control group received written educational materials and social telephone follow-ups. Caregivers' depressive symptoms were assessed from June 2009 - March 2012 by self-completed questionnaires before, at 2 weeks and 3, 6, 12 and 18 months after the intervention. Groups of individual trajectories were distinguished using group-based trajectory modelling.
RESULTS
Caregivers' depressive symptoms fell into three stable trajectories: non-depressed, mildly blue and depressed. After controlling for covariates, caregivers who received the caregiver-training programme were less likely than those who did not experience persistent depressive symptoms (b = -1·92, odds ratio = 0·15, P < 0·05).
CONCLUSION
Depressive symptoms of family caregivers of persons with dementia were relatively stable and followed three distinct courses: non-depressed, mildly blue and depressed. Therefore, caregivers' depressive symptoms should be assessed as early as possible. Caregivers in the experimental group had a lower probability of persistent depressive symptoms than caregivers in the control group. Therefore, this training programme can be used by healthcare providers for persons with dementia and their caregivers.
TRIAL REGISTRATION NUMBER
NCT02667951.
目的
本研究旨在探讨照料者抑郁症状的不同轨迹，并研究培训项目对项目结束后 18 个月内这些轨迹的影响。
背景
虽然已有研究报道了照料者培训项目对家庭照料者抑郁症状的总体效果，但很少有研究探索照料者抑郁症状的不同变化过程，并对这些不同过程的干预效果进行跟踪。
设计
随机临床试验。
方法
将 116 名家庭照料者随机分为实验组（n=57）和对照组（n=59）。实验组接受培训项目和电话咨询，对照组接受书面教育材料和社会电话随访。在干预前、干预后 2 周及 3、6、12 和 18 个月，通过自我完成的问卷评估照料者的抑郁症状。使用基于群组的轨迹建模来区分个体轨迹的群组。
结果
照料者的抑郁症状分为三种稳定轨迹：非抑郁、轻度抑郁和抑郁。在控制了协变量后，接受照料者培训项目的照料者比未接受的照料者更不可能出现持续的抑郁症状（b=-1.92，优势比=0.15，P<0.05）。
结论
痴呆患者家庭照料者的抑郁症状相对稳定，可分为三种不同轨迹：非抑郁、轻度抑郁和抑郁。因此，应尽早评估照料者的抑郁症状。实验组的照料者出现持续抑郁症状的可能性低于对照组。因此，医护人员可以为痴呆患者及其照料者提供这种培训项目。
试验注册号
NCT02667951。
Zotero 插件