Clinic and Policlinic for Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany.
Medical Faculty, Leipzig, Germany.
BMC Geriatr. 2017 Dec 12;17(1):286. doi: 10.1186/s12877-017-0678-y.
Individualized, outreach and structured multicomponent interventions are a promising intervention approach to relieve the burden of informal caregivers of people with dementia. In this study, we adapted and evaluated a multicomponent intervention (Resources for Enhancing Alzheimer's Caregiver Health II, REACH II), which was developed in the USA, to the German health-care system. Therefore the project is called the German adaptation of REACH II (in German: Deutsche Adaptation der REACH II, DE-REACH).
The effectiveness of DE-REACH was examined in a randomized, controlled trial on 92 informal caregivers of people with dementia. The intervention comprised 12 individual two-weekly sessions (9 at home with the informal caregiver and 3 via telephone) and combined five modules. The reduction of the burden of the informal caregivers was chosen as the primary outcome.
The results showed a great stabilizing effect of the intervention on caregiver burden (effect size d = 0.91), that is, comparing pre- and post-measurements the burden decreased very slightly in the intervention group whereas it increased very strongly in the control group. After a three-month follow-up period this effect decreased from a great to a moderate effect. There were also improvements as a result of the intervention in somatization, health-related psychological quality of life and the reaction of the informal caregivers in response to challenging behaviors of the relative with dementia. Moreover, the frequency of challenging behaviors of the affected person itself was reduced in favor of the intervention.
The findings of this study provide further evidence for the impact of multicomponent support interventions for informal caregivers of people with dementia.
NCT01690117 . Registered September 17, 2012.
针对痴呆患者的照护者，个体化、外展和结构化的多组分干预措施是一种有前途的干预方式，可以减轻他们的负担。在这项研究中，我们对一种多组分干预措施（Resources for Enhancing Alzheimer's Caregiver Health II，REACH II）进行了改编和评估，该干预措施最初在美国开发，现已适用于德国的医疗保健系统。因此，该项目被称为德国版 REACH II（德文：Deutsche Adaptation der REACH II，DE-REACH）。
我们在一项针对 92 名痴呆患者照护者的随机对照试验中评估了 DE-REACH 的效果。该干预措施包括 12 次个体为期两周的上门服务（其中 9 次与照护者在家中进行，3 次通过电话进行），并结合了 5 个模块。选择减轻照护者负担作为主要结局。
结果显示，干预对照护者负担具有很大的稳定作用（效应量 d=0.91），即与干预前相比，干预组的负担仅略有下降，而对照组的负担则大幅增加。在 3 个月的随访期后，这种效果从大到中。干预还改善了躯体化、与健康相关的心理生活质量以及照护者对痴呆患者挑战行为的反应。此外，干预也降低了受影响者自身挑战行为的发生频率。
这项研究的结果进一步证明了多组分支持干预对痴呆患者照护者的影响。
NCT01690117。注册于 2012 年 9 月 17 日。
