Tak Youngran, Song Junghee, Woo Haeyoung, An Jiyeon
College of Nursing, Hanyang University, Seoul, Republic of Korea.
Department of Nursing, Ansan University, Ansan, Republic of Korea.
Asian Nurs Res (Korean Soc Nurs Sci). 2019 Feb;13(1):11-19. doi: 10.1016/j.anr.2019.01.002. Epub 2019 Jan 9.
Caring for patients with dementia is a challenging issue entailing heavy responsibility. Many interventions for caregivers have been developed, but their effectiveness is not clear. This study aimed to examine how, why, and under what circumstances interventions for dementia caregivers affected their burden of caring.
Authors used a realist review approach to explore the evidence for how different interventions reduce the burden of dementia caregivers. We completed the literature review about the burden of dementia caregivers and extracted the theoretical concepts to explain context-mechanism-outcome configuration why an intervention may be effective in some situations and not others. Six databases were searched for experimental or quasi-experimental studies conducted from 2008 to 2017. Of 1,225 screened studies, 10 studies were eligible for inclusion.
None of the studies included all the derived contexts while explaining in detail the mechanism of the intervention effectiveness. Among contexts, the variable of other family members requiring care was not included in all studies. Among the analyzed studies, no studies have applied repeated intervention. Most studies included only some variables of context and mechanism, and these variables did not directly explain the effectiveness of intervention. The effect of outcome variables was significant for each study, and the effects of research intervention and national services could not be separately described.
Authors conclude that Korean culture's emphasis on relationships with others increases the burden of care. In context, Confucian norms and traditional femininity of Korea were reflected in the core. It is necessary to check the homogeneity of participants and the design of intervention to verify the effectiveness of the outcome variable of psychological burden.
照顾痴呆患者是一项具有挑战性且责任重大的任务。已经开发了许多针对照顾者的干预措施，但其效果尚不清楚。本研究旨在探讨痴呆照顾者干预措施如何、为何以及在何种情况下会影响他们的照顾负担。
作者采用现实主义综述方法，探索不同干预措施减轻痴呆照顾者负担的证据。我们完成了关于痴呆照顾者负担的文献综述，并提取了理论概念，以解释情境 - 机制 - 结果配置，即为何一种干预措施在某些情况下可能有效而在其他情况下无效。检索了六个数据库，查找2008年至2017年进行的实验性或准实验性研究。在筛选的1225项研究中，有10项研究符合纳入标准。
在详细解释干预效果机制时，没有一项研究涵盖所有推导的情境。在情境中，其他需要照顾的家庭成员这一变量并非在所有研究中都有涉及。在分析的研究中，没有研究应用重复干预。大多数研究仅纳入了部分情境和机制变量，且这些变量并未直接解释干预的有效性。每个研究的结果变量效应均显著，研究干预和国家服务的效应无法分别描述。
作者得出结论，韩国文化对人际关系的重视增加了照顾负担。在此背景下，韩国的儒家规范和传统女性特质在核心方面有所体现。有必要检查参与者的同质性和干预设计，以验证心理负担结果变量的有效性。
