《改良正念认知疗法对痴呆患者家属的影响：一项随机临床试验》

Effects of a Modified Mindfulness-Based Cognitive Therapy for Family Caregivers of People With Dementia: A Randomized Clinical Trial.

机构信息

The Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong.

The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong.

出版信息

Gerontologist. 2021 Aug 13;61(6):977-990. doi: 10.1093/geront/gnaa125.

DOI:10.1093/geront/gnaa125

PMID:32886746

Abstract

BACKGROUND AND OBJECTIVES

Family caregivers of people with dementia (PWD) experience high levels of stress resulting from caregiving. This study aimed to investigate the effects of a modified of Mindfulness-Based Cognitive Therapy (MBCT) for dementia caregiving.

RESEARCH DESIGN AND METHODS

113 family caregivers of PWD were randomized to either the intervention group, receiving the 7-session modified MBCT for a period of 10 weeks with telephone follow-up or the control group, receiving the brief education on dementia care and usual care. The caregiving stress (primary outcome) and various psychological outcomes of caregivers and the behavioral and psychological symptoms of dementia (BPSD) in the care recipients were assessed and compared at baseline (T0), postintervention (T1), and at the 6-month follow-up (T2).

RESULTS

At both T1 and T2, the intervention group had a statistically greater improvement in stress (p = .02 and .03), depression (p = .001 and .04), anxiety (p = .007 and .03), and BPSD-related caregivers' distress (p = .003 and p = .04). A significant greater improvement was also demonstrated in mental health-related quality of life at T2 (p = .001) and BPSD of the care recipients at T1 (p = .04). The increased caregivers' level of mindfulness was significantly correlated with the improvement of various psychological outcomes at T1 and T2 with a correlation coefficient -0.64 to 0.43.

DISCUSSION AND IMPLICATIONS

The modified MBCT enhanced the level of mindfulness in the caregivers and was effective to reduce the caregivers' stress and promote their psychological well-being during a 6-month follow-up. Future research is recommended to further examine its effects on the varieties of psychological and behavioral outcomes of both caregivers and care recipients and their dyadic relationships, as well as explore its mechanism of action in facilitating dementia caregiving.

CLINICAL TRIALS REGISTRATION NUMBER

NCT03354819.

摘要

背景与目的

痴呆患者（PWD）的家庭照料者承受着较高的照料压力。本研究旨在探究一种改良的正念认知疗法（MBCT）对痴呆照料者的影响。

研究设计与方法

113 名 PWD 的家庭照料者被随机分为干预组和对照组。干预组接受为期 10 周的 7 次改良 MBCT 治疗，并在治疗结束后进行电话随访；对照组接受关于痴呆症护理的简短教育和常规护理。在基线（T0）、干预后（T1）和 6 个月随访（T2）时，评估并比较照料者的照料压力（主要结局）和各种心理结局以及照料对象的行为和心理症状（BPSD）。

结果

在 T1 和 T2 时，干预组的压力（p =.02 和.03）、抑郁（p =.001 和.04）、焦虑（p =.007 和.03）以及与 BPSD 相关的照料者困扰（p =.003 和 p =.04）都有统计学上的显著改善。在 T2 时，照料者的心理健康相关生活质量也有显著改善（p =.001），T1 时，照料对象的 BPSD 也有显著改善（p =.04）。照料者正念水平的提高与 T1 和 T2 时各种心理结局的改善显著相关，相关系数为-0.64 至 0.43。