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一项基于社区的痴呆症支持计划与养老院日间护理的比较:对照顾者需求、情感负担和生活质量的影响。

A comparison of a community-based dementia support programme and nursing home-based day care: Effects on carer needs, emotional burden and quality of life.

作者信息

van Haeften-van Dijk A Marijke, Meiland Franka J, Hattink Bart Jj, Bakker Ton Jem, Dröes Rose-Marie

机构信息

ActiVite, the Netherlands.

Department of Psychiatry and Department of General Practice and Elderly Care Medicine, Amsterdam UMC, the Netherlands.

出版信息

Dementia (London). 2020 Nov;19(8):2836-2856. doi: 10.1177/1471301219861767. Epub 2019 Jul 17.

Abstract

OBJECTIVES

Within an implementation study, we investigated the effectiveness of a combined community-based day care programme for persons with dementia and their carers versus traditional psychogeriatric nursing home-based day care. The effects on needs, sense of competence, burden and quality of life of the family carers were studied.

METHODS

A pretest-posttest control group design among family carers of people with dementia who joined community-based day care centres ( = 67) or nursing home-based day care centres ( = 64).

RESULTS

After six months, family carers using community-based day care more often expressed an unmet need for support regarding psychological distress than carers utilising nursing home-based day care. No effect of community-based day care on sense of competence was found. However, carers with a low sense of competence at baseline using community-based compared to nursing home-based day care became less emotionally burdened by behaviour and mood problems of their relative. Overall, no added value of community-based day care on needs, sense of competence, burden and quality of life was found. Increased unmet needs on psychological distress may have been caused by the increased awareness of carers participating in the carer programme of community-based day care regarding their own unmet support needs. For carers with a low sense of competence, community-based day care proves to decrease the impact of behaviour and mood problems of their relative. A larger controlled follow-up study is recommended to understand the long-term effects of community-based day care over nursing home-based day care.

摘要

目的

在一项实施研究中,我们调查了一项针对痴呆症患者及其照料者的社区日间护理综合项目相对于传统的基于老年精神科护理院的日间护理的有效性。研究了对家庭照料者的需求、能力感、负担和生活质量的影响。

方法

对加入社区日间护理中心(n = 67)或护理院日间护理中心(n = 64)的痴呆症患者的家庭照料者采用前后测对照组设计。

结果

六个月后,与使用护理院日间护理的照料者相比,使用社区日间护理的家庭照料者更常表示在心理困扰方面未得到满足的支持需求。未发现社区日间护理对能力感有影响。然而,与使用护理院日间护理相比,基线时能力感较低且使用社区日间护理的照料者因亲属的行为和情绪问题而产生的情感负担减轻。总体而言,未发现社区日间护理在需求、能力感、负担和生活质量方面有附加价值。心理困扰方面未满足需求的增加可能是由于参与社区日间护理照料者项目的照料者对自身未得到满足的支持需求的认识提高所致。对于能力感较低的照料者,社区日间护理被证明可减少其亲属行为和情绪问题的影响。建议进行一项更大规模的对照随访研究,以了解社区日间护理相对于护理院日间护理的长期效果。

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