Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
Faculty of Medicine and Pharmacy, Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium.
Int J Geriatr Psychiatry. 2019 Oct;34(10):1534-1544. doi: 10.1002/gps.5164. Epub 2019 Jul 11.
Dementia is a major public health problem with important physical, psychosocial, emotional, and financial consequences for patients, their caregivers, and society. Since patients prefer to be managed at home, extensive research has been conducted into effectiveness of psychosocial interventions to support informal caregivers. The aim of this study was to assess the effectiveness of an in-home respite care program.
In a prospective quasi-experimental study, 99 dyads who received an in-home respite care program were compared at 6 months post-baseline, with 99 matched dyads receiving standard dementia care. Additionally, the short-term effect of the program was evaluated 14 to 15 days post-intervention. The primary outcome was caregiver burden. The secondary outcomes were: desire to institutionalize the patient, caregiver quality of life, and frequency and impact of behavioral problems. Mixed model analyses were performed to evaluate the impact of the intervention.
After 6 months, no significant difference on caregiver burden was observed, but intervention group caregivers had a significant lower desire to institutionalize the patient compared with control group caregivers (adj.diff = -0.51; p = .02). Shortly after the program, intervention group caregivers also had a significant lower role strain (adj.diff = 0.75; p = .05), and a lower burden on social and family life (adj.diff = 0.55; p = .05) compared with baseline.
This study was the first comparative study to investigate effectiveness of an in-home respite care program to support informal caregivers of persons with dementia. The results partly confirm earlier positive findings from explorative studies.
痴呆是一个主要的公共卫生问题，给患者、其照顾者和社会带来了重要的身体、心理社会、情感和经济后果。由于患者更愿意在家中接受治疗，因此广泛开展了研究，以评估心理社会干预措施支持非专业照顾者的有效性。本研究旨在评估家庭暂息护理计划的有效性。
在一项前瞻性准实验研究中，将 99 对接受家庭暂息护理计划的患者及其照顾者与接受标准痴呆护理的 99 对匹配患者及其照顾者进行比较。此外，还在干预后 14-15 天评估了该计划的短期效果。主要结果是照顾者负担。次要结果是：患者住院意愿、照顾者生活质量以及行为问题的频率和影响。采用混合模型分析评估干预的影响。
6 个月后，未观察到照顾者负担的显著差异，但干预组照顾者将患者送进疗养院的意愿显著低于对照组照顾者（调整差异=-0.51；p=0.02）。在计划实施后不久，干预组照顾者的角色紧张程度（调整差异=0.75；p=0.05）和社会及家庭生活负担（调整差异=0.55；p=0.05）也显著低于基线。
这是第一项比较家庭暂息护理计划对支持痴呆患者非专业照顾者有效性的研究。结果部分证实了早期探索性研究的积极发现。
