Division of Psychiatry and Applied Psychology, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK,
Department of Psychiatry and Mental Health, Santa Maria University Hospital, Lisbon, Portugal.
Clin Interv Aging. 2019 Mar 1;14:515-523. doi: 10.2147/CIA.S190610. eCollection 2019.
Providing care for a family member with dementia can leave little time for carers to look after their own health needs, which makes them more susceptible to mental and physical health problems. This scoping review aimed to explore potential health benefits of interventions aimed at improving health-promoting self-care in family carers of people with dementia.
A scoping review was carried out using Arksey and O'Malley's methodological framework. EMBASE, MEDLINE, PsycINFO and Google Scholar were consulted. Original and peer-reviewed research published in English up to April 2017 were included. Publications were selected by two reviewers independently. Eight experts from several countries provided extra relevant information, which was triangulated with the review results. A narrative approach was used to describe and discuss the review findings.
Seven interventions were identified. These were highly heterogeneous in content, method of delivery, and outcome measures. None was specifically focused on improving and evaluating health-promoting self-care, instead they often focused on health promotion and healthy lifestyle (eg, physical activity). Some of the multi-component interventions included "self-care" as a domain, but none used a specific measure of health-promoting self-care, so we were unable to affirm that the improvements found in the interventions were due to an improvement in this area. Interventions helped reduce carer depression and burden and increased quality of life, positive affect, and physical activity. The expert panel recommended to consider carers' preparedness and capacity to adhere to self-care practices, as well as carers' age and culture. Future interventions should be context specific, flexible, and person-centered.
Psychosocial interventions may improve health-promoting self-care behavior, but more research is needed to establish efficacy. Interventions should be flexible, use a person-centered approach, be implemented with fidelity and use the right dosage.
照顾痴呆症患者的家庭成员可能几乎没有时间照顾自己的健康需求，这使他们更容易出现身心健康问题。本范围综述旨在探讨旨在改善痴呆症患者家庭照顾者促进健康自我保健的干预措施的潜在健康益处。
使用 Arksey 和 O'Malley 的方法学框架进行范围综述。检索了 EMBASE、MEDLINE、PsycINFO 和 Google Scholar。纳入截至 2017 年 4 月以英文发表的原始同行评审研究。两名评审员独立选择出版物。来自多个国家的 8 名专家提供了额外的相关信息，这些信息与综述结果进行了三角分析。采用叙述方法描述和讨论综述结果。
确定了 7 项干预措施。这些措施在内容、交付方式和结果测量方面高度不同。没有一项专门侧重于改善和评估促进健康的自我保健，而是通常侧重于健康促进和健康的生活方式（例如，体育锻炼）。一些多成分干预措施包括“自我保健”作为一个领域，但没有使用特定的促进健康自我保健测量方法，因此我们无法确定干预措施中发现的改善是由于该领域的改善。干预措施有助于减轻照顾者的抑郁和负担，提高生活质量、积极影响和身体活动。专家小组建议考虑照顾者准备和坚持自我保健实践的能力，以及照顾者的年龄和文化。未来的干预措施应该具体情况具体分析、灵活和以个人为中心。
心理社会干预措施可能改善促进健康的自我保健行为，但需要更多的研究来确定疗效。干预措施应该灵活、采用以人为本的方法、忠实地实施并使用正确的剂量。
