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支持痴呆症患者的非正式照护者心理健康的心理社会干预措施 - 系统文献回顾。

Psychosocial interventions to support the mental health of informal caregivers of persons living with dementia - a systematic literature review.

机构信息

Institute for Public Health and Nursing Research, Health Sciences Bremen, University of Bremen, Grazer Straße 4, 28359, Bremen, Germany.

Department of Social Services, Centre for Participation Research, Catholic University of Applied Sciences of North Rhine-Westphalia, Robert-Schuman-Straße 25, 52066, Aachen, Germany.

出版信息

BMC Geriatr. 2021 Feb 1;21(1):94. doi: 10.1186/s12877-021-02020-4.

Abstract

BACKGROUND

Informal caregivers of persons living with dementia have an increased risk of adverse mental health effects. It is therefore important to systematically summarize published literature in order to find out which mental health interventions generate effective support for informal caregivers of persons living with dementia. The objective of this study is to conduct a systematic review of intervention content, effectiveness and subgroup differentiation of mental health interventions for informal caregivers of persons with dementia living at home.

METHOD

We searched four electronic databases (PubMed, PsychINFO, Scopus and CINAHL) and included only methodically high-quality randomized controlled trials (RCTs), published in English or German language between 2009 and 2018. The intervention programmes focused on mental health of family caregivers. A narrative synthesis of the included studies is given.

RESULTS

Forty-eight publications relating to 46 intervention programmes met the inclusion criteria. Burden, depression and quality of life (QoL) are the predominant parameters that were investigated. Twenty-five of forty-six interventions (54.3%) show positive effects on at least one of the outcomes examined. Most often, positive effects are reported for the outcome subjective burden (46.2%). Only six studies explicitly target on a certain subgroup of informal dementia caregivers (13%), whereas all other interventions (87%) target the group as a whole without differentiation.

CONCLUSION

The most beneficial results were found for cognitive behavioural approaches, especially concerning the reduction of depressive symptoms. Besides this, leisure and physical activity interventions show some good results in reducing subjective caregiver burden. In order to improve effectiveness, research and practice may focus on developing more targeted interventions for special dementia informal caregiver subgroups.

摘要

背景

与痴呆症患者共同生活的非专业照护者存在心理健康恶化的风险。因此,系统地总结已发表的文献以确定哪些心理健康干预措施能为痴呆症患者的非专业照护者提供有效支持是非常重要的。本研究旨在对针对居家痴呆症患者非专业照护者的心理健康干预措施的干预内容、效果和亚组分化进行系统评价。

方法

我们检索了四个电子数据库(PubMed、PsychINFO、Scopus 和 CINAHL),仅纳入方法学质量高的、发表于 2009 年至 2018 年的英文或德文随机对照试验(RCT)。干预方案侧重于家庭照护者的心理健康。对纳入研究进行叙述性综合分析。

结果

有 48 篇涉及 46 个干预方案的出版物符合纳入标准。负担、抑郁和生活质量(QoL)是主要的研究参数。46 个干预方案中的 25 个(54.3%)在至少一个所研究的结果上显示出积极效果。最常报告的积极效果是主观负担这一结果(46.2%)。仅有 6 项研究(13%)明确针对特定的非专业痴呆症照护者亚组,而其他所有干预措施(87%)都没有区分地针对整个群体。

结论

认知行为方法的效果最好,特别是在减少抑郁症状方面。除此之外,休闲和体育活动干预在减轻主观照护者负担方面也有一些较好的效果。为了提高效果,研究和实践可以重点为特定的痴呆症非专业照护者亚组开发更有针对性的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99cd/7852361/df1cad6f9716/12877_2021_2020_Fig1_HTML.jpg

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