Gaugler Joseph E, Jutkowitz Eric, Shippee Tetyana P, Brasure Michelle
Center on Aging,School of Nursing,University of Minnesota,Minneapolis,Minnesota,USA.
Division of Health Policy and Management,School of Public Health,University of Minnesota,Minneapolis,Minnesota,USA.
Int Psychogeriatr. 2017 Jan;29(1):19-30. doi: 10.1017/S1041610216001514. Epub 2016 Sep 27.
There are many systematic reviews and meta-analyses (SRs) of interventions for family caregivers of persons with Alzheimer's disease or a related dementia. A challenge when synthesizing the efficacy of dementia caregiver interventions is the potential discrepancy in how they are categorized. The objective of this study was to systematically examine inconsistencies in how dementia caregiver interventions are classified.
We searched Ovid Medline®, Ovid PsycINFO®, Ovid Embase®, and the Cochrane Library to identify previous SRs published and indexed in bibliographic databases through January 2015. Following a graphical network analysis, open-coding of classification definitions was conducted. A descriptive analysis was then completed to examine classification consistency of individual interventions across SR grouping labels.
Twenty-three SRs were identified. A graphical network analysis revealed a significant amount of overlap in individual studies included across SRs, but stark differences in how reviews labeled or categorized them. The qualitative content analysis identified seven themes; one of these, content of the intervention, was used to compare classification consistency. When subjecting the classification of interventions to descriptive empirical analysis, extensive inconsistency was apparent.
The substantial inconsistency in how dementia caregiver interventions are classified across SRs has hindered the science and practice of dementia caregiver interventions. Specifically, accurate reporting of intervention components and SRs would allow for more precise assessments of efficacy as well as a fuller determination of how caregiver interventions can best yield benefits for caregivers and persons with dementia.
针对阿尔茨海默病或相关痴呆症患者家庭照护者的干预措施,已有许多系统评价和荟萃分析(SRs)。在综合痴呆症照护者干预措施的疗效时,一个挑战在于它们的分类方式可能存在差异。本研究的目的是系统地检查痴呆症照护者干预措施分类中的不一致性。
我们检索了Ovid Medline®、Ovid PsycINFO®、Ovid Embase®和Cochrane图书馆,以识别截至2015年1月在书目数据库中发表并编入索引的先前SRs。在进行图形网络分析之后,对分类定义进行了开放编码。然后完成描述性分析,以检查各个干预措施在SR分组标签之间的分类一致性。
共识别出23项SRs。图形网络分析显示,各SRs纳入的个体研究存在大量重叠,但在综述对其的标注或分类方式上存在明显差异。定性内容分析确定了七个主题;其中一个主题,即干预措施的内容,被用于比较分类一致性。对干预措施的分类进行描述性实证分析时,明显存在广泛的不一致性。
各SRs对痴呆症照护者干预措施的分类存在大量不一致性,这阻碍了痴呆症照护者干预措施的科学研究和实践。具体而言,准确报告干预措施的组成部分和SRs,将有助于更精确地评估疗效,并更全面地确定照护者干预措施如何能最好地为照护者和痴呆症患者带来益处。