College of Public Health, Department of Health Promotion, University of Nebraska Medical Center, Omaha, Nebraska, USA.
QualityMetric Incorporated, LLC, Johnston, Rhode Island, USA.
Aging Ment Health. 2021 Aug;25(8):1483-1492. doi: 10.1080/13607863.2020.1850638. Epub 2020 Dec 1.
The current study translated the Resources for Enhancing Alzheimer's Caregiver Health: Offering Useful Treatments (REACH OUT), a skills-building stress and burden intervention, for the primary care setting and pilot the resulting intervention.
The 16-week intervention consisted of a combination of clinic-based group and one-on-one sessions offered within a medical home, geriatrics clinic. A quasi-experimental pre- and post-test study design without a control group tested the resulting intervention. Semi-structured qualitative exit interviews evaluated program satisfaction.
Twenty-five caregivers participated in one of four intervention groups; 21 caregivers completed the intervention (attended at least five of six group sessions). Caregiver burden on standardized assessments was significantly reduced between pre- and post-intervention, specifically for physical/emotional strain and caregiving uncertainty. Significant reductions were found in the frequency of reported disruptive behaviors; increased caregiver confidence in handling behavior problem frequency, depressive symptoms, disruptive behaviors, and memory-related problems; and decreased bother with respect to behavioral problem frequency and care recipient depression. Program satisfaction was high.
This work suggests that the REACH OUT program can be successfully modified for use within a primary-care medical home setting.
本研究将一项技能培养压力和负担干预措施——增强阿尔茨海默病照护者健康资源:提供有用的治疗方法(REACH OUT),译为适用于初级保健环境的版本,并对由此产生的干预措施进行试点。
该 16 周的干预措施包括在医疗之家、老年病诊所中提供的基于诊所的小组和一对一的组合。一项无对照组的准实验前后测试设计测试了由此产生的干预措施。半结构化的定性退出访谈评估了项目满意度。
25 名照护者参加了四个干预组中的一个;21 名照护者完成了干预(参加了至少六次小组会议中的五次)。在干预前后,标准化评估中的照护者负担明显减轻,特别是在身体/情绪紧张和照顾不确定性方面。报告的破坏性行为的频率显著降低;照护者处理行为问题频率、抑郁症状、破坏性行为和与记忆相关问题的信心增加;以及对行为问题频率和照顾者抑郁的困扰减少。项目满意度很高。
这项工作表明,REACH OUT 计划可以成功地修改为适用于初级保健医疗之家环境。