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照顾者积极参与心理教育干预可以提高照顾技能和能力。

Caregiver active participation in psychoeducational intervention improved caregiving skills and competency.

机构信息

Taiwan Catholic Foundation of Alzheimer's Disease and Related Dementia, Taipei, Taiwan.

Department of Occupational Therapy, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

Geriatr Gerontol Int. 2018 May;18(5):750-757. doi: 10.1111/ggi.13246. Epub 2018 Jan 22.

Abstract

AIM

To determine whether giving dementia caregivers active psychoeducational intervention is more efficacious than passive intervention for improving their caregiving skills and reducing their caregiving burden.

METHODS

This study was a prospective, single-blinded, controlled trial with 43 caregiver/person-with-dementia dyads. The dyads were randomly assigned to the active psychoeducational intervention (AP) group, which used role-play, discussion, and development of problem-solving capacity to build up their caregiving skills and competence, or the passive psychoeducational intervention (PP) group, which gave caregivers educational materials on common caregiving strategies. Primary outcomes were the levels of caregiver competence (Care Skill Inventory [CSI]), burden (Chinese Zarit Burden Inventory [CZBI]), and distress caused by the behavioral and psychological symptoms of dementia (Neuropsychiatric Inventory-Questionnaire [NPI-Q]). Outcomes were assessed pre-test, post-test and after 3 months. Repeated measures one-way analysis of variance was used to compare mean-change scores between time-points, and generalized estimating equations (GEE) were used to compare groups.

RESULTS

Post-test or 3-month (or both) Care Skill Inventory, Chinese Zarit Burden Inventory and Neuropsychiatric Inventory-Questionnaire distress levels were significantly (p < 0.05) better in the AP but not in the PP group. The generalized estimating equation intergroup comparison, adjusted for potential confounders, showed that Care Skill Inventory in the AP group was more significantly improved than in the PP group, and that Chinese Zarit Burden Inventory nearly reached significance.

CONCLUSIONS

Active rather than passive psychoeducation, even in a short (3 months) intervention of six visits, was more efficacious for improving caregiving competence. Future studies will require larger samples. Geriatr Gerontol Int 2018; 18: 750-757.

摘要

目的

确定给予痴呆症照顾者积极的心理教育干预是否比被动干预更能提高他们的照顾技能,减轻他们的照顾负担。

方法

这是一项前瞻性、单盲、对照试验,共纳入 43 对照顾者/痴呆症患者。将这些患者随机分配到积极心理教育干预(AP)组或被动心理教育干预(PP)组。AP 组采用角色扮演、讨论和解决问题能力的培养来提高他们的照顾技能和能力,PP 组则为照顾者提供常见的照顾策略的教育材料。主要结局是照顾者的能力(照顾技能量表[CSI])、负担(中国 Zarit 负担量表[CZBI])和由痴呆症的行为和心理症状引起的困扰(神经精神疾病问卷[NPI-Q])。在测试前、测试后和 3 个月后评估结果。采用重复测量单向方差分析比较各时间点的平均变化分数,并用广义估计方程(GEE)比较组间差异。

结果

AP 组的 CSI、CZBI 和 NPI-Q 评分在测试后或 3 个月(或两者)时显著(p<0.05)改善,而 PP 组则无显著改善。调整了潜在混杂因素的广义估计方程组间比较显示,AP 组的 CSI 评分显著优于 PP 组,而 CZBI 评分则接近显著。

结论

与被动心理教育相比,即使是在为期 3 个月(共 6 次访问)的短期干预中,积极的心理教育也更能有效提高照顾能力。未来的研究需要更大的样本量。

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