Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Salamanca, Spain.
Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Department of Statistics, University of Salamanca, Salamanca, Spain.
J Adv Nurs. 2021 Feb;77(2):987-998. doi: 10.1111/jan.14618. Epub 2020 Oct 27.
This study assesses the effect of an intervention to reduce the disruptive behaviours (DB) presented by care recipient users of adult day care centres (ADCC), thereby reducing caregiver overload. While ADCC offer beneficial respite for family caregivers, the DB that many care recipients show promote resistance to attending these centres, which can be a great burden on their family caregivers.
Randomized controlled clinical trial.
The study was carried out with 130 family caregivers of people attending seven ADCC in the municipality of Salamanca (Spain), randomly distributed into intervention and control groups. The intervention was applied across eight sessions, one per week, in groups of 8-10 people where caregivers were trained in the Antecedent-Behavior-Consequence (ABC) model of functional behaviour analysis. The primary outcome was the reduction of DB measured with the Revised Memory and Behavior Problems Checklist (RMBPC).
An average reduction in the RMBPC of 4.34 points was obtained in the intervention group after applying the intervention (p < 0.01 (U de Mann-Whitney); Cohen d = 1.00); furthermore, differences were found in the Center for Epidemiologic Studies Depression Scale (CES-D) (U = -2.67; p = 0.008; Cohen d = 0.50) and in the Short Zarit Burden Interview (Short ZBI) (t = -4.10; p < 0.01; Cohen d = 0.98).
The results obtained suggest that the implementation of this intervention could reduce both the frequency of DB occurrence and the reaction of the caregiver to their appearance. Improvement was also noted in the results regarding overload and emotional state of the family caregiver.
To our knowledge, this is the first randomized clinical trial to show that an intervention based on the ABC model could reduce the frequency and reaction of DB of care recipients in ADCC increasing their quality of life, and improving the mental health and overload of their family caregivers.
本研究评估了一项干预措施对减少成人日间护理中心（ADCC）使用者的破坏性行为（DB）的效果，从而减轻照顾者的负担。虽然 ADCC 为家庭照顾者提供了有益的喘息机会，但许多照顾对象表现出的 DB 行为抵制了他们参加这些中心，这给他们的家庭照顾者带来了很大的负担。
随机对照临床试验。
本研究在西班牙萨拉曼卡市的 7 个 ADCC 中招募了 130 名照顾者，他们的照顾对象参加了研究，将其随机分为干预组和对照组。干预措施每周进行一次，共 8 次，每次 8-10 人一组，对照顾者进行功能行为分析的前因-行为-后果（ABC）模型培训。主要结果是使用修订后的记忆和行为问题检查表（RMBPC）测量 DB 的减少情况。
干预组在应用干预措施后，RMBPC 平均减少了 4.34 分（p < 0.01（U 曼-惠特尼检验）；Cohen d = 1.00）；此外，在流行病学研究中心抑郁量表（CES-D）（U = -2.67；p = 0.008；Cohen d = 0.50）和简短 Zarit 负担量表（Short ZBI）（t = -4.10；p < 0.01；Cohen d = 0.98）方面也存在差异。
研究结果表明，实施这种干预措施可以减少破坏性行为的发生频率和照顾者对其出现的反应。家庭照顾者的负担和情绪状态也有所改善。
据我们所知，这是第一项随机临床试验，表明基于 ABC 模型的干预措施可以减少 ADCC 中照顾对象的 DB 频率和反应，提高他们的生活质量，并改善其家庭照顾者的心理健康和负担。
