Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands.
Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands.
Aging Ment Health. 2022 Feb;26(2):294-304. doi: 10.1080/13607863.2020.1857692. Epub 2020 Dec 9.
A psychosocial intervention for spousal carers of people with dementia promoted emotional well-being through self-monitoring and personalized feedback, as demonstrated in a previous randomized controlled trial. The mechanism behind the intervention effects is thought to lie in increased awareness of, and thus, engagement in behaviours that elicit positive emotions (PA). This secondary analysis tests the assumption by investigating momentary data on activities, affect, and stress and explores the relevance of personalized feedback compared to self-monitoring only. The intervention was based on the experience sampling method (ESM), meaning that carers self-monitored own affect and behaviours 10 times/day over 6 weeks. The experimental group received personalized feedback on behaviours that elicit PA, while the pseudo-experimental group performed self-monitoring only. A control group was also included. ESM-data of 72 carers was analysed using multilevel mixed-effects models. The experimental group reported significant increases in passive relaxation activities over the 6 weeks = 0.28, = 0.12, = 2.43, .05). Passive relaxation in this group was negatively associated with negative affect ( = -0.50, .01) and positively associated with activity-related stress ( 0.52, .007) from baseline to post-intervention. Other activities in this or the other groups did not change significantly. Carer's daily behaviours were only affected when self-monitoring was combined with personalized feedback. Changing one's daily behaviour while caring for a person with dementia is challenging and aligned with mixed emotions. Acknowledging simultaneously positive and negative emotions, and feelings of stress is suggested to embrace the complexity of carer's life and provide sustainable support.
一项针对痴呆症患者配偶照顾者的心理社会干预措施通过自我监测和个性化反馈促进了情感健康，这在前一项随机对照试验中得到了证明。干预效果的机制被认为在于提高了对引发积极情绪（PA）的行为的认识，从而促使人们更多地参与这些行为。这项二次分析通过对活动、情绪和压力的即时数据进行测试来检验这一假设，并探讨个性化反馈与仅自我监测相比的相关性。该干预措施基于经验采样法（ESM），即照顾者在 6 周内每天自我监测 10 次自身的情绪和行为。实验组收到了关于引发 PA 的行为的个性化反馈，而伪实验组仅进行自我监测。还包括一个对照组。使用多层混合效应模型对 72 名照顾者的 ESM 数据进行了分析。实验组在 6 周内报告被动放松活动显著增加 = 0.28， = 0.12， = 2.43， .05）。该组的被动放松与消极情绪呈负相关（ = -0.50， .01），与活动相关的压力呈正相关（ 0.52， .007），从基线到干预后。其他组的其他活动没有明显变化。只有当自我监测与个性化反馈相结合时，照顾者的日常行为才会受到影响。在照顾痴呆症患者的同时改变自己的日常行为是具有挑战性的，这与混合情绪一致。同时承认积极和消极情绪以及压力感，被认为是接受照顾者生活的复杂性并提供可持续支持的一种方式。
