Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, England, UK; School of Psychology & Clinical Language Sciences, University of Reading, Earley Gate, Reading RG6 6AL, England, UK.
Health Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, England, UK.
Clin Psychol Rev. 2018 Mar;60:109-125. doi: 10.1016/j.cpr.2018.01.008. Epub 2018 Feb 2.
Family carers of people who have long term illness often experience physical and mental health morbidities, and burden. While there is good evidence to suggest that carers benefit from psychosocial interventions, these have primarily been delivered via face-to-face individual or group-formats. eHealth interventions offer a novel, accessible and self-paced approach to care delivery. Whether these are effective for carers' wellbeing has been little explored. This paper reports the first comprehensive systematic review in this area. A total of 78 studies, describing 62 discrete interventions, were identified. Interventions commonly aimed to promote carers' knowledge, self-efficacy, caregiving appraisal, and reduce global health morbidities. Interventions were offered to carers of people with a wide range of long term illness; dementia has been the most researched area, as reported in 40% of studies. Clinical and methodological heterogeneity in interventions precluded meta-analyses, and so data were analysed narratively. The most popular approach has comprised psychoeducational interventions delivered via an enriched online environment with supplementary modes of communication, such as network support with professionals and peers. Overall, carers appreciate the flexibility and self-paced nature of eHealth interventions, with high rates of satisfaction and acceptability. More studies using robust designs are needed to extend the evidence base.
长期患病者的家庭照顾者经常经历身心健康的病态和负担。虽然有很好的证据表明照顾者从心理社会干预中受益,但这些干预主要是通过面对面的个人或小组形式提供的。电子健康干预提供了一种新颖、可及和自我 paced 的护理提供方式。这些方法是否对照顾者的幸福感有效,还很少有人探讨。本文报告了该领域的首次全面系统评价。共确定了 78 项研究,描述了 62 项离散干预措施。干预措施通常旨在提高照顾者的知识、自我效能、照顾评估,并减少整体健康病态。这些干预措施提供给患有各种长期疾病的照顾者;如报道的 40%的研究中,痴呆症是研究最多的领域。干预措施的临床和方法学异质性排除了荟萃分析,因此数据以叙述性方式进行分析。最流行的方法包括通过丰富的在线环境和补充的沟通方式(如与专业人员和同行的网络支持)提供心理教育干预。总的来说,照顾者赞赏电子健康干预的灵活性和自我 paced 性质,满意度和可接受性很高。需要更多使用可靠设计的研究来扩展证据基础。