a Six Degrees Social Enterprise , Salford , UK.
b Institute of Dementia , University of Salford , Salford , M6 6PU , UK.
Aging Ment Health. 2018 Jul;22(7):863-880. doi: 10.1080/13607863.2017.1399343. Epub 2017 Nov 10.
OBJECTIVES: To update previous reviews and provide a more detailed overview of the effectiveness, acceptability and conceptual basis of communication training-interventions for carers of people living with dementia. METHOD: We searched CINAHL Plus, MEDLINE and PsycINFO using a specific search and extraction protocol, and PRISMA guidelines. Two authors conducted searches and extracted studies that reported effectiveness, efficacy or acceptability data regarding a communication training-intervention for carers of people living with dementia. Risk of bias was assessed using the Cochrane Collaboration guidelines. Quality of qualitative studies was also systematically assessed. RESULTS: Searches identified 450 studies (after de-duplication). Thirty-eight studies were identified for inclusion in the review. Twenty-two studies focused on professional carers; 16 studies focused mainly on family carers. Training-interventions were found to improve communication and knowledge. Overall training-interventions were not found to significantly improve behaviour that challenges and caregiver burden. Acceptability levels were high overall, but satisfaction ratings were found to be higher for family carers than professional carers. Although many interventions were not supported by a clear conceptual framework, person-centred care was the most common framework described. CONCLUSION: This review indicated that training-interventions were effective in improving carer knowledge and communication skills. Effective interventions involved active participation by carers and were generally skills based (including practicing skills and discussion). However, improvements to quality of life and psychological wellbeing of carers and people living with dementia may require more targeted interventions.
目的:更新以往的综述,更详细地概述针对痴呆症患者照顾者的沟通培训干预措施的有效性、可接受性和概念基础。
方法:我们使用特定的搜索和提取方案以及 PRISMA 指南,在 CINAHL Plus、MEDLINE 和 PsycINFO 中进行了搜索。两位作者进行了搜索,并提取了报告针对痴呆症患者照顾者的沟通培训干预措施的有效性、疗效或可接受性数据的研究。使用 Cochrane 协作组指南评估偏倚风险。还系统评估了定性研究的质量。
结果:搜索共确定了 450 项研究(去重后)。确定了 38 项研究纳入综述。22 项研究主要针对专业照顾者;16 项研究主要针对家庭照顾者。培训干预措施被发现可以改善沟通和知识。总体而言,培训干预措施并未显著改善具有挑战性的行为和照顾者负担。总体而言,可接受程度较高,但家庭照顾者的满意度评分高于专业照顾者。尽管许多干预措施没有明确的概念框架支持,但以人为中心的护理是描述最多的常见框架。
结论:本综述表明,培训干预措施在提高照顾者的知识和沟通技巧方面是有效的。有效的干预措施涉及照顾者的积极参与,并且通常基于技能(包括练习技能和讨论)。然而,要改善照顾者和痴呆症患者的生活质量和心理健康,可能需要更有针对性的干预措施。
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