Gaugler Joseph E, Reese Mark, Mittelman Mary S
Division of Health Policy & Management, School of Public Health, Minneapolis.
Families and LTC Projects, School of Nursing, University of Minnesota, Minneapolis.
Innov Aging. 2018 Jun;2(2):igy015. doi: 10.1093/geroni/igy015. Epub 2018 Jun 22.
Many evaluations of nonpharmacologic interventions for family members of persons with Alzheimer's disease or related dementias (ADRDs) exist, but few consider effects on outcomes that are pertinent to caregivers' roles and relationships. The current study evaluated the efficacy of the New York University Caregiver Intervention-Adult Child (NYUCI-AC) on perceptions of family conflict, role conflict (effects of family caregiving and time, family, and social life), and perceived social support for adult child caregivers of relatives with ADRD over a 3-year period.
A single-blinded randomized controlled trial design was used. One-hundred and seven adult child caregivers were enrolled in the NYUCI-AC and randomly assigned to a treatment or contact control group. Assessments were scheduled to be completed every 4 months during the first year of participation and every 6 months thereafter for up to 3 years. Individual growth curve models were utilized to ascertain the effects of the NYUCI-AC on change in family conflict, role conflict, and perceptions of social support.
Among the entire sample, role conflict significantly ( < .05) declined and satisfaction with instrumental assistance increased over the course of the study, whereas family conflict slightly increased over the initial study period and then declined slightly. The findings indicated that the NYUCI-AC did not exert statistically significant effects on changes in family conflict, role conflict, or perceptions of social support over the 3-year study period.
Although the clinical content of some dementia caregiver interventions is tailored to the specific needs of each caregiver and family, the outcomes selected to judge the efficacy of these interventions might not follow similar principles. Incorporating clinical content and evaluation outcomes that are family-centered will help to advance the state of the art of dementia caregiving interventions.
针对阿尔茨海默病或相关痴呆症（ADRD）患者家庭成员的非药物干预措施已有诸多评估，但很少有研究考虑其对与照顾者角色及关系相关结局的影响。本研究评估了纽约大学照顾者干预 - 成年子女版（NYUCI - AC）在3年期间对ADRD亲属的成年子女照顾者的家庭冲突认知、角色冲突（家庭照顾以及时间、家庭和社会生活的影响）以及感知到的社会支持的疗效。
采用单盲随机对照试验设计。107名成年子女照顾者参与了NYUCI - AC，并被随机分配到治疗组或接触对照组。在参与的第一年，评估计划每4个月完成一次，此后每6个月进行一次，为期3年。采用个体生长曲线模型来确定NYUCI - AC对家庭冲突、角色冲突和社会支持认知变化的影响。
在整个样本中，在研究过程中角色冲突显著下降（P <.05），对工具性帮助的满意度增加，而家庭冲突在研究初期略有增加，随后略有下降。研究结果表明，在3年的研究期间，NYUCI - AC对家庭冲突、角色冲突或社会支持认知的变化没有产生统计学上的显著影响。
尽管一些痴呆症照顾者干预措施的临床内容是根据每个照顾者和家庭的特定需求量身定制的，但用于判断这些干预措施疗效的结局可能并未遵循类似原则。纳入以家庭为中心的临床内容和评估结局将有助于推动痴呆症照顾干预技术的发展。
