针对照顾者的强效工具对照顾者负担及痴呆症照护对象行为和心理症状的有效性：一项随机对照试验。
Effectiveness of Powerful Tools for Caregivers on Caregiver Burden and on Care Recipient Behavioral and Psychological Symptoms of Dementia: A Randomized Controlled Trial.
作者信息
Terracciano Antonio, Artese Ashley, Yeh Jenie, Edgerton LaVon, Granville Lisa, Aschwanden Damaris, Luchetti Martina, Glueckauf Robert L, Stephan Yannick, Sutin Angelina R, Katz Paul
机构信息
College of Medicine, Florida State University, Tallahassee, FL.
Health and Human Performance, Roanoke College, Salem, VA.
出版信息
J Am Med Dir Assoc. 2020 Aug;21(8):1121-1127.e1. doi: 10.1016/j.jamda.2019.11.011. Epub 2019 Dec 19.
OBJECTIVE
The aim of this study was to evaluate the effectiveness of a psychoeducational intervention, Powerful Tools for Caregivers (PTC), for family caregivers of individuals with dementia.
DESIGN
A pragmatic, 2-arm randomized controlled trial compared the PTC intervention, as delivered in practice, to usual care. Participants randomized to usual care functioned as a control group and then received the PTC intervention.
INTERVENTION
PTC is a 6-week manualized program that includes weekly 2-hour classes in a group setting facilitated by 2 trained and certified leaders. The educational program helps caregivers to enhance self-care practices and manage emotional distress.
SETTING AND PARTICIPANTS
Two stakeholder organizations delivered the intervention in community settings. Participants were family caregivers of individuals with dementia recruited from the community in Florida.
METHODS
Primary outcomes were caregiver burden and behavioral and psychological symptoms of dementia of the care recipient. Secondary outcomes included caregiver depressive symptoms, self-efficacy, self-rated health, and life satisfaction. Measures were collected at baseline (n = 60 participants), postintervention (n = 55), and at 6-week follow-up (n = 44).
RESULTS
Intent-to-treat analyses found PTC reduced caregiver burden (d = -0.48) and depressive symptoms (d = -0.53), and increased self-confidence (d = 0.68), but found no significant benefit for behavioral and psychological symptoms of dementia in care recipients. PTC was rated highly by participants and program attrition was low, with 94% of caregivers completing at least 4 of the 6 classes.
CONCLUSIONS AND IMPLICATIONS
Although no significant effects were found for behavioral and psychological symptoms of dementia, this trial supports the effectiveness of PTC to improve caregiver outcomes as delivered in the community.
目的
本研究旨在评估一项心理教育干预措施“照顾者有力工具”（PTC）对痴呆症患者家庭照顾者的有效性。
设计
一项实用的双臂随机对照试验将实际实施的PTC干预措施与常规护理进行了比较。随机分配到常规护理组的参与者作为对照组，随后接受PTC干预。
干预措施
PTC是一个为期6周的手册化项目，包括每周在由2名经过培训和认证的领导者主持的小组环境中进行2小时的课程。该教育项目帮助照顾者加强自我护理实践并应对情绪困扰。
背景与参与者
两个利益相关组织在社区环境中实施了该干预措施。参与者是从佛罗里达州社区招募的痴呆症患者家庭照顾者。
方法
主要结局指标是照顾者负担以及受照顾者的痴呆行为和心理症状。次要结局指标包括照顾者的抑郁症状、自我效能感、自评健康状况和生活满意度。在基线时（n = 60名参与者）、干预后（n = 55名）和6周随访时（n = 44名）收集测量数据。
结果
意向性分析发现，PTC减轻了照顾者负担（d = -0.48）和抑郁症状（d = -0.53），并增强了自信心（d = 0.68），但未发现对受照顾者的痴呆行为和心理症状有显著益处。参与者对PTC评价很高，项目损耗率很低，94%的照顾者完成了6节课中的至少4节。
结论与启示
尽管未发现PTC对痴呆行为和心理症状有显著影响，但该试验支持PTC在社区实施时改善照顾者结局的有效性。
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