Department of Psychiatry, Sinai Health, University of Toronto, Toronto, Canada.
Department of Research & Academics, Ontario Shores Centre for Mental Health Sciences, Whitby, Canada.
Int Psychogeriatr. 2022 Sep;34(9):827-838. doi: 10.1017/S1041610220004019. Epub 2021 Jan 18.
While family caregivers (CGs) of persons with dementia are cost-effective for the health system, this form of caregiving leads to disproportionate vulnerability to physical, mental, and social adverse health consequences among CGs. The study goal was to determine the effect of the Reitman Centre CARERS program on key outcomes in family CGs of people with dementia. The Reitman Centre CARERS program is an innovative, group psychotherapeutic skills training intervention based on integrated problem-solving techniques (PST), simulation learning, and group psychotherapy designed to address each CGs' unique situation.
A quasi-experimental, non-randomized, pre-post evaluation, multiple groups, multisite trial.
Multisite group intervention provided in community agencies and hospital-based locations.
Spousal or adult child family CGs ( = 264) living in the community and providing care to community-dwelling family members with dementia.
CGs were assessed for depression (CES-D); stress (PSS); burden (12-item SZBI); role overload, mastery, caregiving competence, and role captivity (Perlin scales), coping (CISS - Coping Inventory for Stressful Situations), CG reactions to CR's memory and behavioral symptoms (RMBPC). Care recipients (CRs) were assessed on basic and complex activities of daily living (Katz and Lawton). Paired -tests and Wilcoxon signed-rank test were used for statistical analysis of both the whole group and a more compromised subgroup of CGs.
For the group as a whole, CGs showed significant positive change on post-intervention outcome measures of stress, depression, burden, competence, role captivity, overload, mastery, coping, and reaction to memory issues. The intervention showed especially robust effect sizes (ES) in more compromised CGs. These positive outcomes emerged despite a significant measured deterioration in CRs' function.
The CARERS program may be an effective multicomponent intervention to improve the well-being, functioning, and coping skills of dementia CGs.
尽管痴呆症患者的家庭照顾者（CGs）对医疗系统具有成本效益，但这种照顾方式会导致 CGs 面临不成比例的身体、心理和社会健康不良后果。本研究的目的是确定 Reitman 中心 CARERS 计划对痴呆症患者家庭 CGs 的关键结果的影响。Reitman 中心 CARERS 计划是一种创新的、基于团体心理治疗技能培训的干预措施，基于综合问题解决技术（PST）、模拟学习和团体心理治疗，旨在解决每个 CG 的独特情况。
准实验、非随机、前后评估、多组、多地点试验。
在社区机构和医院地点提供多地点团体干预。
配偶或成年子女家庭 CGs（=264），居住在社区，为居住在社区的痴呆症家庭成员提供护理。
CGs 评估抑郁（CES-D）；压力（PSS）；负担（12 项 SZBI）；角色过载、掌握、照顾能力和角色监禁（Perlin 量表），应对（CISS-应对压力情况的清单），CG 对 CR 的记忆和行为症状的反应（RMBPC）。照顾对象（CR）评估基本和复杂日常生活活动（Katz 和 Lawton）。配对检验和 Wilcoxon 符号秩检验用于对整个组和 CGs 更脆弱的亚组的统计分析。
对于整个组，CGs 在干预后压力、抑郁、负担、能力、角色监禁、过载、掌握、应对和记忆问题反应的测量结果方面表现出显著的积极变化。干预在更脆弱的 CGs 中显示出特别强大的效果大小（ES）。尽管 CR 功能明显下降，但这些积极结果仍出现。
CARERS 计划可能是一种有效的多成分干预措施，可以改善痴呆症 CGs 的幸福感、功能和应对技能。
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