问题解决治疗降低了轻度认知障碍或早期痴呆症患者家庭成员照顾者的主观负担水平：一项随机临床试验的二次分析。
Problem-solving therapy reduces subjective burden levels in caregivers of family members with mild cognitive impairment or early-stage dementia: Secondary analysis of a randomized clinical trial.
机构信息
Duquesne University School of Nursing, Pittsburgh, Pennsylvania, United States.
Chatham University, Pittsburgh, Pennsylvania, United States.
出版信息
Int J Geriatr Psychiatry. 2019 Jul;34(7):957-965. doi: 10.1002/gps.5095. Epub 2019 Apr 17.
Abstract
OBJECTIVES
Interventions addressing burden have limited impact among long-term family caregivers. We examined whether problem-solving therapy (PST) would reduce burden levels of caregivers of individuals diagnosed with mild cognitive impairment (MCI) or early-stage dementia (AD).
METHODS
Caregivers (N = 73) randomly received PST or nutritional training (NT). Burden measures were assessed over 1-year post-intervention.
RESULTS
Relative to NT, caregivers receiving PST endorsed improved perceived burden levels over time, regardless of the type of caregiver. Distress over the care recipient's dementia-related behaviors remained low over time among MCI caregivers receiving PST, while these burden levels among MCI caregivers receiving NT rose over time. AD caregivers receiving PST endorsed reductions in these burden levels over time, while AD caregivers in the NT group endorsed higher burden levels over time.
CONCLUSION
PST, taught early in the caregiving trajectory, improves subjective burden levels among caregivers of family members with relatively mild cognitive deficits.
摘要
目的
针对负担问题的干预措施对长期家庭照顾者的影响有限。我们研究了问题解决疗法（PST）是否会降低被诊断为轻度认知障碍（MCI）或早期痴呆（AD）患者的照顾者的负担水平。
方法
照顾者（N=73）随机接受 PST 或营养培训（NT）。在干预后 1 年内评估负担测量结果。
结果
与 NT 相比，无论照顾者类型如何，接受 PST 的照顾者的感知负担水平随着时间的推移而逐渐改善。在接受 PST 的 MCI 照顾者中，与认知障碍相关的行为引起的照顾者的痛苦感随着时间的推移保持较低水平，而接受 NT 的 MCI 照顾者的这些负担水平随着时间的推移而升高。接受 PST 的 AD 照顾者的这些负担水平随着时间的推移而降低，而接受 NT 的 AD 照顾者的负担水平随着时间的推移而升高。
结论
在照顾者的早期轨迹中教授 PST 可以改善有相对轻度认知缺陷的家庭成员的照顾者的主观负担水平。
相似文献
1
Problem-solving therapy reduces subjective burden levels in caregivers of family members with mild cognitive impairment or early-stage dementia: Secondary analysis of a randomized clinical trial.问题解决治疗降低了轻度认知障碍或早期痴呆症患者家庭成员照顾者的主观负担水平：一项随机临床试验的二次分析。
Int J Geriatr Psychiatry. 2019 Jul;34(7):957-965. doi: 10.1002/gps.5095. Epub 2019 Apr 17.
2
Effects of problem solving therapy on mental health outcomes in family caregivers of persons with a new diagnosis of mild cognitive impairment or early dementia: a randomized controlled trial.问题解决治疗对轻度认知障碍或早期痴呆新诊断患者家属心理健康结局的影响：一项随机对照试验。
Am J Geriatr Psychiatry. 2014 Aug;22(8):771-81. doi: 10.1016/j.jagp.2013.07.007. Epub 2013 Oct 8.
3
Bilingual problem-solving training for caregivers of adults with dementia: A randomized, factorial-design protocol for the CaDeS trial.痴呆症成人照料者的双语问题解决训练：CaDeS 试验的随机、析因设计方案。
Contemp Clin Trials. 2021 Sep;108:106506. doi: 10.1016/j.cct.2021.106506. Epub 2021 Jul 15.
4
Efficacy of problem-solving therapy for spouses of men with prostate cancer: A randomized controlled trial.问题解决疗法对前列腺癌男性配偶的疗效：一项随机对照试验。
Psychooncology. 2019 Mar;28(3):497-504. doi: 10.1002/pon.4964. Epub 2018 Dec 28.
5
Design and Implementation of an Intervention Development Study: Retaining Cognition While Avoiding Late-Life Depression (ReCALL).一项干预开发研究的设计与实施：在避免晚年抑郁的同时保持认知能力（ReCALL）。
Am J Geriatr Psychiatry. 2016 Jun;24(6):444-54. doi: 10.1016/j.jagp.2015.10.010. Epub 2015 Nov 18.
6
Anosognosia increases caregiver burden in mild cognitive impairment.疾病感缺失会增加轻度认知障碍患者照料者的负担。
Int J Geriatr Psychiatry. 2016 Jul;31(7):799-808. doi: 10.1002/gps.4394. Epub 2015 Dec 7.
7
Anticipatory grief in new family caregivers of persons with mild cognitive impairment and dementia.轻度认知障碍和痴呆患者新家庭照顾者的预期悲伤。
Alzheimer Dis Assoc Disord. 2012 Apr-Jun;26(2):159-65. doi: 10.1097/WAD.0b013e31822f9051.
8
[Family caregiver burden caused by behavioral and psychological symptoms of dementia: measurement with a new original scale].[痴呆症行为和心理症状导致的家庭照顾者负担：用一种新的原创量表进行测量]
Nihon Ronen Igakkai Zasshi. 2007 Nov;44(6):717-25. doi: 10.3143/geriatrics.44.717.
9
The Relationship Between Caregiver Burden and Emotion Recognition Deficits in Persons With MCI and Early AD: The Mediating Role of Caregivers' Subjective Evaluations.认知障碍症患者和早期阿尔茨海默病患者的照顾者负担与情绪识别缺陷之间的关系：照顾者主观评价的中介作用。
Alzheimer Dis Assoc Disord. 2019 Jul-Sep;33(3):266-271. doi: 10.1097/WAD.0000000000000323.
10
Mild Cognitive Impairment in Parkinson's Disease: Impact on Caregiver Outcomes.帕金森病中的轻度认知障碍：对照料者结局的影响
J Parkinsons Dis. 2016 May 7;6(3):589-96. doi: 10.3233/JPD-160823.
引用本文的文献
1
A Cross-Sectional Study of Dementia-Related Communication Barriers in Clinical Practice in South India.印度南部临床实践中痴呆症相关沟通障碍的横断面研究。
Cureus. 2025 Apr 1;17(4):e81560. doi: 10.7759/cureus.81560. eCollection 2025 Apr.
2
Effect of Video Games on Cognitive Performance and Problem-Solving Ability in the Aged with Cognitive Dysfunction: A Randomized Clinical Trial.电子游戏对认知功能障碍老年人认知表现和解决问题能力的影响：一项随机临床试验。
Iran J Med Sci. 2025 Feb 1;50(2):77-86. doi: 10.30476/ijms.2024.101861.3452. eCollection 2025 Feb.
3
Nurse Telephone Support for Caregivers of Older Adults at Hospital Discharge: A Randomized Clinical Trial.护士电话支持对老年患者出院后照顾者的影响：一项随机临床试验。
JAMA Netw Open. 2024 Oct 1;7(10):e2441019. doi: 10.1001/jamanetworkopen.2024.41019.
4
Feasibility and acceptability of a videoconference-based cognitive-behavioral intervention for caregivers of individuals living with mild cognitive impairment or early Alzheimer's disease.基于视频会议的认知行为干预对轻度认知障碍或早期阿尔茨海默病患者照料者的可行性和可接受性。
PEC Innov. 2024 Jul 4;5:100317. doi: 10.1016/j.pecinn.2024.100317. eCollection 2024 Dec 15.
5
What works to support carers of older people and older carers? an international evidence map of interventions and outcomes.支持老年人和老年照护者的措施有哪些？一项国际干预措施和结果证据图谱。
BMC Geriatr. 2024 Mar 29;24(1):301. doi: 10.1186/s12877-024-04897-3.
6
The RESCUE problem solving intervention for stroke caregivers: A mixed-methods pilot study.RESCUE 问题解决干预对卒中照护者的影响：一项混合方法的初步研究。
Rehabil Psychol. 2022 Nov;67(4):484-496. doi: 10.1037/rep0000460. Epub 2022 Aug 4.
7
Applying the RE-AIM framework to evaluate a holistic caregiver-centric hospital-to-home programme: a feasibility study on Carer Matters.运用 RE-AIM 框架评估整体以照顾者为中心的医院到家庭计划：以 Carer Matters 为例的可行性研究。
BMC Health Serv Res. 2022 Jul 19;22(1):933. doi: 10.1186/s12913-022-08317-3.
8
An examination and proposed definitions of family members' grief prior to the death of individuals with a life-limiting illness: A systematic review.生命末期患者家属哀伤的评估和定义：系统综述。
Palliat Med. 2022 Apr;36(4):581-608. doi: 10.1177/02692163221074540. Epub 2022 Feb 23.
9
Bilingual problem-solving training for caregivers of adults with dementia: A randomized, factorial-design protocol for the CaDeS trial.痴呆症成人照料者的双语问题解决训练：CaDeS 试验的随机、析因设计方案。
Contemp Clin Trials. 2021 Sep;108:106506. doi: 10.1016/j.cct.2021.106506. Epub 2021 Jul 15.
10
Development and evaluation of an intervention on suPpoRting infOrmal cAregivers of older people with early CogniTIVe declinE (PROACTIVE): a study protocol based on the Medical Research Council framework.支持认知早期衰退老年人的非正式照护者的干预措施的制定和评估（PROACTIVE）：基于医疗研究理事会框架的研究方案。
BMJ Open. 2021 Jan 25;11(1):e047529. doi: 10.1136/bmjopen-2020-047529.
本文引用的文献
1
2016 Alzheimer's disease facts and figures.2016 年阿尔茨海默病事实和数据。
Alzheimers Dement. 2016 Apr;12(4):459-509. doi: 10.1016/j.jalz.2016.03.001.
2
A Systematic Review and Meta-Analysis Comparing Carer Focused and Dyadic Multicomponent Interventions for Carers of People With Dementia.一项比较以照顾者为中心和二元多成分干预对痴呆症患者照顾者影响的系统评价和荟萃分析。
J Aging Health. 2017 Dec;29(8):1308-1349. doi: 10.1177/0898264316660414. Epub 2016 Jul 25.
3
A meta-review of stress, coping and interventions in dementia and dementia caregiving.关于痴呆症及痴呆症护理中的压力、应对方式和干预措施的元综述。
BMC Geriatr. 2016 May 18;16:106. doi: 10.1186/s12877-016-0280-8.
4
Caregiver Burden and Quality of Life of Key Caregivers of Patients with Dementia.痴呆症患者主要照料者的照料负担与生活质量
Indian J Psychol Med. 2016 Mar-Apr;38(2):133-6. doi: 10.4103/0253-7176.178779.
5
Meta-analysis of problem solving therapy for the treatment of major depressive disorder in older adults.针对老年人重度抑郁症治疗的问题解决疗法的荟萃分析。
Int J Geriatr Psychiatry. 2016 May;31(5):526-35. doi: 10.1002/gps.4358. Epub 2015 Oct 5.
6
Translating Evidence-Based Dementia Caregiving Interventions into Practice: State-of-the-Science and Next Steps.将基于证据的痴呆症护理干预措施转化为实践：科学现状与后续步骤
Gerontologist. 2015 Apr;55(2):210-26. doi: 10.1093/geront/gnu123. Epub 2015 Feb 17.
7
Multivariate models of subjective caregiver burden in dementia: a systematic review.多变量模型对痴呆患者主观照料者负担的评估：系统综述。
Ageing Res Rev. 2014 May;15:76-93. doi: 10.1016/j.arr.2014.03.003. Epub 2014 Mar 25.
8
Effects of problem solving therapy on mental health outcomes in family caregivers of persons with a new diagnosis of mild cognitive impairment or early dementia: a randomized controlled trial.问题解决治疗对轻度认知障碍或早期痴呆新诊断患者家属心理健康结局的影响：一项随机对照试验。
Am J Geriatr Psychiatry. 2014 Aug;22(8):771-81. doi: 10.1016/j.jagp.2013.07.007. Epub 2013 Oct 8.
9
Caregiving strain and all-cause mortality: evidence from the REGARDS study.照料者压力与全因死亡率：来自 REGARDS 研究的证据。
J Gerontol B Psychol Sci Soc Sci. 2013 Jul;68(4):504-12. doi: 10.1093/geronb/gbs084. Epub 2012 Oct 2.
10
Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia.非药物干预对痴呆患者神经精神症状的荟萃分析。
Am J Psychiatry. 2012 Sep;169(9):946-53. doi: 10.1176/appi.ajp.2012.11101529.
Zotero 插件