Pfeiffer Klaus, Hautzinger Martin, Patak Margarete, Grünwald Julia, Becker Clemens, Albrecht Diana
Department of Clinical Gerontology and Rehabilitation, Robert-Bosch-Hospital, Auerbachstr. 110, 70376, Stuttgart, Germany.
Department of Psychology, Clinical Psychology and Psychotherapy, Eberhard Karls University, Schleichstr. 4, 72076, Tuebingen, Germany.
BMC Geriatr. 2017 Mar 6;17(1):64. doi: 10.1186/s12877-017-0456-x.
Despite the positive evaluation of various caregiver interventions over the past 3 decades, only very few intervention protocols have been translated to delivery in service contexts. The purpose of this study is to train care counsellors of statutory long term care insurances in problem-solving and to evaluate this approach as an additional component in the statutory care counselling in Germany.
A pragmatic cluster randomized controlled trial in which 38 sites with 58 care counsellors are randomly assigned to provide either routine counselling plus additional problem-solving for caregivers or routine counselling alone. The counsellor training comprises an initial 2-day training, a follow-up day after 4 months, and biweekly supervision contacts with a psychotherapist for 6 months over the phone. The agreed minimum counselling intensity is one initial face-to-face contact including a caregiver assessment and at least one telephone follow-up contact. Caregivers who are positively screened for significant strain in their role are followed up at 3 and 6 months after baseline assessment. Main outcome are caregivers' depressive symptoms.
While it is unclear if the expected very low amount of additional counselling time is sufficient to yield any additional effects on caregiver depression, it is also unclear if the additional problem-solving component yields to synergies with routine counselling that is based on information and case management. There are different potential individual and organisational barriers to a consistent intervention delivery like gratification for participation, time for extra work or internal motivation to participate.
( ISRCTN23635523 ).
尽管在过去30年里对各种照护者干预措施的评价都是积极的，但只有极少数干预方案被转化为可在服务环境中实施的方案。本研究的目的是培训法定长期护理保险的照护顾问解决问题的能力，并将这种方法作为德国法定照护咨询的一个附加组成部分进行评估。
一项实用的整群随机对照试验，将38个地点的58名照护顾问随机分配，为照护者提供常规咨询加额外的问题解决服务或仅提供常规咨询。顾问培训包括为期2天的初始培训、4个月后的跟进日，以及在6个月内每两周与一名心理治疗师通过电话进行一次督导联系。商定的最低咨询强度是一次初始面对面接触，包括对照护者进行评估，以及至少一次电话跟进接触。在基线评估后3个月和6个月对被积极筛查出角色压力较大的照护者进行随访。主要结局是照护者的抑郁症状。
虽然尚不清楚预期的极少量额外咨询时间是否足以对照护者的抑郁产生任何额外影响，但也不清楚额外的问题解决部分是否能与基于信息和个案管理的常规咨询产生协同作用。在持续实施干预方面存在不同的潜在个人和组织障碍，如参与的满足感、额外工作的时间或参与的内在动力。
（ISRCTN23635523）
