Sato Shunsuke, Kazui Hiroaki, Shimizu Yoshiro, Yoshida Tetsuhiko, Yoshiyama Kenji, Kanemoto Hideki, Suzuki Yukiko, Morikami Toshimi, Fujisue Hiroshi, Tanaka Toshihisa, Ikeda Manabu
Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan.
Kawanishi City Central Integrated Community Care Support Center, Kawanishi, Japan.
Psychogeriatrics. 2018 May;18(3):166-174. doi: 10.1111/psyg.12304. Epub 2018 Feb 6.
It is unclear whether carer-held records (CHR) are useful for patients with dementia. In this study, we evaluated the usefulness of the CHR for patients with dementia at the municipal level.
Candidates for CHR use in this study were informal caregivers of patients with dementia who lived at home in Kawanishi, Japan. CHR users were those who are involved in the patient's care and treatment, such as informal caregivers, family physicians, dementia specialists, care professionals, and care service coordinators, known as ‛care managers' in Japan. Collaborative meetings were held every month mainly to help users, especially care managers, learn how to effectively use CHR. We surveyed informal caregivers before and 1.5 years after the start of CHR use to evaluate whether CHR improved collaboration and information provision. The Zarit Caregiver Burden Interview and Dementia Behaviour Disturbance Scale were also administered. We divided the informal caregivers who continued CHR use for 1.5 years into two subgroups based on whether their care manager attended the collaborative meetings at least twice. In addition, we divided informal caregivers into three subgroups depending on their relationship to the patient: spouse, child, or daughter-in-law.
The study initially consisted of 201 informal caregivers. Among them, 74 informal caregivers continued CHR use for 1.5 years. The information provision score significantly improved after CHR use for all informal caregivers. The collaboration score significantly improved after CHR use only for informal caregivers whose care managers attended at least two collaborative meetings. The Zarit Caregiver Burden Interview score significantly improved after CHR use for daughter-in-law caregivers. The Dementia Behaviour Disturbance Scale scores did not significantly improve after CHR use.
CHR were useful for informal caregivers of patients with dementia. However, care managers need to teach informal caregivers how to properly use CHR.
目前尚不清楚照护者持有记录(CHR)对痴呆症患者是否有用。在本研究中,我们在市级层面评估了CHR对痴呆症患者的有用性。
本研究中CHR的使用者候选人为居住在日本川西、居家的痴呆症患者的非正式照护者。CHR使用者包括那些参与患者护理和治疗的人员,如非正式照护者、家庭医生、痴呆症专家、护理专业人员以及护理服务协调员(在日本被称为“护理经理”)。每月都会召开协作会议,主要是帮助使用者,尤其是护理经理,学习如何有效使用CHR。我们在CHR使用开始前和使用1.5年后对非正式照护者进行了调查,以评估CHR是否改善了协作和信息提供情况。还进行了扎里特照护者负担访谈和痴呆行为障碍量表评估。我们根据护理经理是否至少参加两次协作会议,将持续使用CHR 1.5年的非正式照护者分为两个亚组。此外,我们根据非正式照护者与患者的关系将其分为三个亚组:配偶、子女或儿媳。
该研究最初有201名非正式照护者。其中,74名非正式照护者持续使用CHR达1.5年。所有非正式照护者在使用CHR后信息提供得分显著提高。仅对于护理经理至少参加两次协作会议的非正式照护者,在使用CHR后协作得分显著提高。儿媳照护者在使用CHR后扎里特照护者负担访谈得分显著提高。使用CHR后痴呆行为障碍量表得分没有显著改善。
CHR对痴呆症患者的非正式照护者有用。然而,护理经理需要教导非正式照护者如何正确使用CHR。