Lab3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.
Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal.
Respiration. 2021;100(12):1230-1242. doi: 10.1159/000517032. Epub 2021 Jul 14.
Chronic obstructive pulmonary disease (COPD) imposes tremendous challenges for both patients and informal caregivers. Caregivers are key players in the management of COPD. Recently, COVID-19 further increased reliance on informal caregivers who urgently need specific support. This systematic literature review aimed to systematically describe the content and explore the effects of interventions to support informal caregivers of people with COPD.
A mixed-methods systematic review was conducted. PubMed, Scopus, Web of Science, and EBSCO were searched. Studies implementing interventions supporting informal caregivers of people with COPD were included. Data were extracted and analysed in outcome domains and categories using framework analysis.
Twenty (14 quantitative, 4 mixed-methods, and 2 qualitative) studies were included. Informal caregivers were mainly female (86%). Caregiving context was poorly/never described. Interventions included patient-caregiver dyads and never caregivers only. Informal caregivers were invited to participate if available. Interventions were delivered across all COPD phases (acute/stable/advanced) and settings (inpatient/outpatient/home), with a wide range of total length, frequency, and duration of sessions. All included education about the disease and its management. Discharge/action plans (n = 12); adherence to therapy and healthy lifestyles (n = 9); and family concerns and psychosocial issues (n = 7) were also commonly addressed. Only 9 (45%) studies reported caregiver-related outcomes, and overall positive effects were observed in 7/9 outcome domains, using a high variety of qualitative and qualitative methods. Often categories were addressed but not assessed.
Interventions have a narrow scope (i.e., education) and have not been specifically designed to support informal caregivers. Current evidence showed positive effects, but high methodological heterogeneity exists. Future studies need to explore caregiver-tailored, taking into consideration gender differences; multicomponent; and flexibly administered interventions to effectively support COPD caregivers.
慢性阻塞性肺疾病（COPD）给患者和非专业照护者带来了巨大挑战。非专业照护者是 COPD 管理的关键参与者。最近，COVID-19 进一步增加了对非专业照护者的依赖，他们迫切需要特定的支持。本系统文献综述旨在系统描述支持 COPD 患者非专业照护者的干预措施的内容，并探讨其效果。
采用混合方法系统综述。检索了 PubMed、Scopus、Web of Science 和 EBSCO。纳入了实施支持 COPD 患者非专业照护者干预措施的研究。使用框架分析在结果领域和类别中提取和分析数据。
纳入了 20 项研究（14 项定量研究、4 项混合方法研究和 2 项定性研究）。非专业照护者主要为女性（86%）。照护背景描述不佳/从未描述。干预措施包括患者-照护者二人组和从不包括照护者。如果有非专业照护者，也邀请他们参加。干预措施在 COPD 的所有阶段（急性/稳定/晚期）和环境（住院/门诊/家庭）中实施，总时长、频率和疗程范围广泛。所有研究都包括疾病及其管理方面的教育。12 项研究报告了出院/行动计划；9 项研究报告了治疗和健康生活方式的依从性；7 项研究报告了家庭关注和心理社会问题。只有 9 项（45%）研究报告了与照护者相关的结果，在 9 个结果领域中的 7 个领域观察到了积极的效果，使用了各种定性和定量方法。经常涉及到类别，但未进行评估。
干预措施的范围较窄（即教育），并未专门设计用于支持非专业照护者。现有证据表明具有积极效果，但方法学异质性较高。未来的研究需要探索针对照护者的、考虑到性别差异的、多组分的、灵活管理的干预措施，以有效支持 COPD 照护者。
