Department of Psychiatry and Behavioral Sciences/Center on Aging.
Center on Aging, University of Miami Miller School of Medicine, Florida.
Gerontologist. 2018 Mar 19;58(2):e130-e137. doi: 10.1093/geront/gny001.
Family caregivers (CGs) are critical to the provision of long-term services and support for older adults. Numerous intervention programs to alleviate CG distress have been developed and evaluated yet few have been implemented in community settings. This paper describes and presents outcomes from Community REACH, a community implementation of the evidence-based Resources for Enhancing Alzheimer's Caregiver Health (REACH) II program.
Community REACH involved a partnership between REACH II investigators and United HomeCare Services (UHCS), a nonprofit home health organization that provides home health, personal care, companion, and respite services. The intervention program, an adapted version of an evidence-based program, was a 6-month multicomponent psychosocial intervention, which involved six individual face-to-face and six individual telephone sessions, and telephone support groups. One hundred and forty-six CGs who were primarily female (76%) and Latino, and providing care for an individual with Alzheimer's disease (AD) were enrolled. Program effectiveness was assessed by examining changes in perceived social support, burden, and depression, and CG self-efficacy.
At 6 months, CGs reported significant decreases in depression, burden, being and bothered by the care recipient's memory problems. There was also a significant decline in the number of CGs at risk for clinical depression. These improvements were maintained at 12 months and there was an increase in feelings of social support.
The findings indicate that evidence-based CG programs can be successfully implemented in community settings and benefit CGs of AD patients. A continued partnership between the program developers and community partners is key to implementation success.
家庭照顾者(CGs)对于为老年人提供长期服务和支持至关重要。已经开发并评估了许多减轻 CG 压力的干预计划,但很少有在社区环境中实施。本文描述并介绍了基于证据的增强阿尔茨海默病 caregiver 健康资源(REACH)II 计划的社区实施情况(Community REACH)的结果。
Community REACH 涉及 REACH II 调查人员与 United HomeCare Services(UHCS)之间的合作,后者是一家提供家庭健康、个人护理、陪伴和临时护理服务的非营利性家庭健康组织。干预计划是一个经过改编的循证方案,是一项为期 6 个月的多成分心理社会干预措施,包括六次面对面的个人会议和六次个人电话会议,以及电话支持小组。共有 146 名 CG 参加了该计划,他们主要是女性(76%)和拉丁裔,为患有阿尔茨海默病(AD)的个体提供护理。通过检查感知社会支持、负担和抑郁以及 CG 自我效能感的变化来评估计划的有效性。
在 6 个月时,CG 报告抑郁、负担、照顾者记忆问题的困扰和被困扰程度显著下降。有临床抑郁风险的 CG 人数也有所减少。这些改善在 12 个月时得到维持,并且社会支持感增加。
研究结果表明,循证 CG 计划可以成功地在社区环境中实施,并使 AD 患者的 CG 受益。计划开发者和社区合作伙伴之间的持续合作是实施成功的关键。