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个性化体育活动干预对改善痴呆症患者家庭照顾者心理健康结局的影响:一项随机对照试验。

Impact of an Individualized Physical Activity Intervention on Improving Mental Health Outcomes in Family Caregivers of Persons with Dementia: A Randomized Controlled Trial.

作者信息

Farran Carol J, Paun Olimpia, Cothran Fawn, Etkin Caryn D, Rajan Kumar B, Eisenstein Amy, Navaie Maryam

机构信息

Rush University Medical Center, College of Nursing, Chicago, 1L, USA.

American Joint Replacement Registry, Rosemont, IL, USA.

出版信息

AIMS Med Sci. 2016;3(1):15-31. doi: 10.3934/medsci.2016.1.15. Epub 2015 Dec 17.

Abstract

PURPOSE

This study examined secondary benefits of an individualized physical activity intervention on improving dementia family caregivers' subjective burden, depressive symptoms and positive affect.

DESIGN AND METHODS

A community-based randomized controlled trial (RCT) was implemented with family caregivers of persons with dementia (N = 211) who received the Enhanced Physical Activity Intervention (EPAI: treatment intervention, n = 106) or the Caregiver Skill Building Intervention (CSBI: control intervention, n = 105). Interventions were delivered over 12 months, including a baseline home visit and regularly spaced telephone calls. Data were collected in person at baseline, 6 and 12-months; and telephonically at 3 and 9-months. The EPAI integrated physical activity and caregiving content while the CSBI focused only on caregiving content. Descriptive, bivariate and intention-to-treat analyses using generalized estimating equations (GEE) were performed to examine secondary benefits of the EPAI on family caregiver burden, depressive symptoms and positive affect.

RESULTS

Compared to caregivers in the CSBI group, caregivers in the EPAI significantly increased their overall and total moderate physical activity and showed a positive interaction between the intervention and time for positive affect at both six ( = 0.01) and 12-months ( = 0.03). The EPAI was significantly associated with improving burden at 3 months ( = 0.03) but had no significant effect on depressive symptoms.

IMPLICATIONS

Caregiver involvement in an individualized physical activity intervention was associated with increased overall and total moderate physical activity and improved positive affect from baseline to 12 months. Improved positive affect may help caregivers to feel better about themselves and their situation, and better enable them to continue providing care for their family member for a longer time at lower risk to their own mental health.

摘要

目的

本研究探讨个性化体育活动干预对改善痴呆症家庭照顾者主观负担、抑郁症状和积极情绪的次要益处。

设计与方法

对痴呆症患者的家庭照顾者(N = 211)实施了一项基于社区的随机对照试验(RCT),这些照顾者接受了强化体育活动干预(EPAI:治疗干预,n = 106)或照顾者技能培养干预(CSBI:对照干预,n = 105)。干预为期12个月,包括一次基线家访和定期的电话沟通。在基线、6个月和12个月时进行面对面数据收集;在3个月和9个月时通过电话收集数据。EPAI整合了体育活动和照顾内容,而CSBI仅关注照顾内容。使用广义估计方程(GEE)进行描述性、双变量和意向性分析,以检验EPAI对家庭照顾者负担、抑郁症状和积极情绪的次要益处。

结果

与CSBI组的照顾者相比,EPAI组的照顾者显著增加了总体和总的中等强度体育活动,并且在6个月(P = 0.01)和12个月(P = 0.03)时,干预与积极情绪之间存在时间上的正向交互作用。EPAI在3个月时与减轻负担显著相关(P = 0.03),但对抑郁症状没有显著影响。

启示

照顾者参与个性化体育活动干预与从基线到12个月总体和总的中等强度体育活动增加以及积极情绪改善有关。积极情绪的改善可能有助于照顾者对自己和自身状况感觉更好,并更好地使他们能够继续为家庭成员提供更长时间的照顾,同时对自身心理健康的风险更低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bcf4/5685520/078b607a2b69/nihms882765f1.jpg

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