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自我实施的穴位按压对老年家庭成员照顾者的影响:一项随机对照试验。

Self-Administered Acupressure for Caregivers of Older Family Members: A Randomized Controlled Trial.

机构信息

School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.

School of Nursing, Hong Kong Sanatorium and Hospital, Hong Kong, China.

出版信息

J Am Geriatr Soc. 2020 Jun;68(6):1193-1201. doi: 10.1111/jgs.16357. Epub 2020 Feb 25.

Abstract

OBJECTIVE

To test whether self-administered acupressure reduces stress and stress-related symptoms in caregivers of older family members.

DESIGN

In this randomized, assessor-blind, controlled trial, 207 participants were randomized (1:1) to an acupressure intervention or a wait-list control group.

SETTING

Community centers in Hong Kong, China.

PARTICIPANTS

Primary caregivers of an older family member who screened positive for caregiver stress with symptoms of fatigue, insomnia, or depression.

INTERVENTION

The 8-week intervention comprised four training sessions on self-administered acupressure, two follow-up sessions for learning reinforcement, and daily self-practice of self-administered acupressure.

MEASUREMENTS

The primary outcome was caregiver stress (Caregiver Burden Inventory). Secondary outcomes included fatigue (Piper Fatigue Scale), insomnia (Pittsburgh Sleep Quality Index), depression (Patient Health Questionnaire), and health-related quality of life (QoL) (12-item Short-Form Health Survey version 2). An intention-to-treat analysis was adopted.

RESULTS

Of 207 participants, 201 completed the study. Caregiver stress in the intervention group was significantly lower than that in the control group after 8 weeks (difference = -8.12; 95% confidence interval [CI] = -13.20 to -3.04; P = .002) and at 12-week follow-up (difference = -8.52; 95% CI = -13.91 to -3.12; P = .002). The intervention group, relative to the control group, also had significantly improved secondary outcomes of fatigue (difference = -0.84; 95% CI = -1.59 to -0.08; P = .031), insomnia (difference = -1.34; 95% CI = -2.40 to -0.27; P = .014), depression (difference = -1.76; 95% CI = -3.30 to -0.23; P = .025), and physical health-related QoL (difference = 3.08; 95% CI = 0.28-5.88; P = .032) after 8 weeks.

CONCLUSION

Self-administered acupressure intervention significantly relieves self-reported caregiver stress and co-occurring symptoms in those caring for older family members. Further studies are needed to measure the symptoms objectively and to examine the clinical importance of the observed improvement in caregiver stress. J Am Geriatr Soc 68:1193-1201, 2020.

摘要

目的

测试自我实施的穴位按压是否可以减轻老年家庭成员照顾者的压力和与压力相关的症状。

设计

在这项随机、评估者盲法、对照试验中,将 207 名参与者随机(1:1)分为穴位按压干预组或候补对照组。

地点

中国香港的社区中心。

参与者

经筛查,被照顾的老年家庭成员出现压力症状(疲劳、失眠或抑郁)的初级照顾者。

干预

为期 8 周的干预包括四次关于自我实施穴位按压的培训课程、两次学习强化的随访课程和每日自我实施穴位按压的自我实践。

测量

主要结局是照顾者压力(照顾者负担量表)。次要结局包括疲劳(派珀疲劳量表)、失眠(匹兹堡睡眠质量指数)、抑郁(患者健康问卷)和与健康相关的生活质量(QoL)(12 项简短健康调查量表第 2 版)。采用意向治疗分析。

结果

在 207 名参与者中,有 201 名完成了研究。干预组的照顾者压力在 8 周后(差值=-8.12;95%置信区间[CI]=-13.20 至-3.04;P=.002)和 12 周随访时(差值=-8.52;95%CI=-13.91 至-3.12;P=.002)显著低于对照组。与对照组相比,干预组的次要结局也得到了显著改善,包括疲劳(差值=-0.84;95%CI=-1.59 至-0.08;P=.031)、失眠(差值=-1.34;95%CI=-2.40 至-0.27;P=.014)、抑郁(差值=-1.76;95%CI=-3.30 至-0.23;P=.025)和与身体健康相关的 QoL(差值=3.08;95%CI=0.28-5.88;P=.032)。

结论

自我实施的穴位按压干预显著缓解了照顾老年家庭成员的自我报告的照顾者压力和伴随症状。需要进一步的研究来客观测量症状,并检查观察到的照顾者压力改善的临床重要性。美国老年医学会 68:1193-1201,2020。

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