Walter Erik, Pinquart Martin
Department of Psychology, Philipps University, Marburg, Germany.
Gerontologist. 2020 Nov 23;60(8):609-619. doi: 10.1093/geront/gnz118.
Caring for a person with dementia places a significant burden upon informal caregivers and leads to decreased psychological and physical health, which is why dementia caregiver interventions have been developed. However, empirical evidence for the efficacy of those interventions is inconclusive and the last comprehensive meta-analysis (Pinquart & Sörensen. Helping caregivers of persons with dementia: Which interventions work and how large are their effects? International Psychogeriatrics. 2006;18(4), 577-595.) was published more than 10 years ago.
This meta-analysis aims to update the meta-analysis conducted by Pinquart and Sörensen. Based on a systematic search in electronic data bases, effects of 282 controlled studies were integrated. The effectiveness of different intervention types and influences of study characteristics were evaluated.
Interventions had, on average, a significant, small-to-moderate effect on the improvement of ability/knowledge, subjective well-being, burden, depression, and the caregiver's anxiety as well as symptoms of the care recipient. No mean effect was found in regard to reducing the risk of institutionalization. Most intervention types had an effect on the reduction of burden as well as on other outcomes. Psychoeducation and multicomponent interventions affected most outcomes, whereas the efficacy of other intervention types was domain-specific.
There is evidence for the efficacy of dementia caregiver interventions, though due to having predominantly small effect sizes, there is still room for improvement. Interventions should be tailored to the desired outcome. More research on long-term effects, effects on anxiety and institutionalization, efficacy of respite and support interventions, care recipient training, and the intervention process is needed.
照顾痴呆患者给非正式照料者带来了沉重负担，并导致其心理和身体健康状况下降，这就是痴呆照料者干预措施得以发展的原因。然而，这些干预措施有效性的实证证据尚无定论，上一次全面的荟萃分析（平夸特和索伦森。帮助痴呆患者的照料者：哪些干预措施有效，其效果有多大？《国际老年精神病学杂志》。2006年；18(4)，577 - 595。）是在十多年前发表的。
本荟萃分析旨在更新平夸特和索伦森所进行的荟萃分析。基于对电子数据库的系统检索，整合了282项对照研究的效果。评估了不同干预类型的有效性以及研究特征的影响。
干预措施平均而言对能力/知识的提升、主观幸福感、负担、抑郁、照料者的焦虑以及受照料者的症状有显著的小到中等程度的效果。在降低机构化风险方面未发现平均效果。大多数干预类型对减轻负担以及其他结果有影响。心理教育和多成分干预影响了大多数结果，而其他干预类型的效果则具有领域特异性。
有证据表明痴呆照料者干预措施是有效的，不过由于效果大小大多较小，仍有改进空间。干预措施应根据期望的结果进行调整。需要对长期效果、对焦虑和机构化的影响、喘息和支持干预的效果、受照料者培训以及干预过程进行更多研究。
