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基于电话的痴呆患者家属随访小组 - 一项随机对照试验效果评估的结果。

Telephone-based aftercare groups for family carers of people with dementia - results of the effect evaluation of a randomised controlled trial.

机构信息

Clinic for Cognitive Neurology, Medical Faculty, University of Leipzig, Liebigstr 16, 04103, Leipzig, Germany.

German Centre for Neurodegenerative Diseases (DZNE) - Site Witten, Witten, Germany.

出版信息

BMC Health Serv Res. 2022 Feb 11;22(1):177. doi: 10.1186/s12913-022-07490-9.

Abstract

BACKGROUND

The care of people with dementia is associated with enormous stress and, in a quarter of cases, leads to depression and anxiety disorders in the caring relatives. A specially designed inpatient psychosomatic rehabilitation (rehab) programme for family carers of people with dementia has proven to be effective but not sustainable. Therefore, the present study aims to increase the sustainability of the inpatient rehab programme by using thematically structured telephone aftercare group sessions.

METHODS

The effectiveness of telephone aftercare groups was investigated in a randomized, controlled, prospective, mixed methods, longitudinal study. The aftercare intervention included social participation in monthly telephone group sessions for 6 months. The primary outcome was increased social participation of family carers, which, like the secondary outcomes (such as quality of life and subjective health), was assessed in written surveys at three or four measurement points.

RESULTS

Complete data from 69 participants from the intervention group and from 72 participants from the control group could be evaluated. A small-sized reduction in restrictions on social participation was observed in the intervention group, whereas the reduction in the control group was negligible. The repeated-measures analysis of variance (ANOVA) showed sustained effects on the secondary outcomes, such as depression, perceived social support, and the mental health domain of quality of life of family carers, in favour of the intervention group. The results also showed that telephone-based aftercare groups had a rather minor influence on the use of support services. Except for those from family, friends and neighbours, existing support offers were hardly used.

CONCLUSION

Telephone aftercare group sessions for carers of people with dementia were not able to increase social participation at the expected magnitude. Nevertheless, the clear effects on selected secondary health-related outcomes and the assessment of the telephone-based group sessions by the participants show that the caring relatives were able to benefit greatly from this aftercare measure. Family carers should be informed more extensively about the corresponding resources and encouraged to use them. Overall, this new aftercare concept can be recommended for implementation, and its use also seems to be target-oriented for other indications.

CLINICAL TRIAL REGISTRATION

German Clinical Trials Register: DRKS00013736 , 14/05/2018.

摘要

背景

痴呆症患者的护理与巨大的压力相关,并且在四分之一的情况下,会导致护理亲属出现抑郁和焦虑障碍。专门为痴呆症患者的家庭护理人员设计的住院身心康复(康复)计划已被证明是有效的,但无法持续。因此,本研究旨在通过使用主题结构化的电话随访小组来提高住院康复计划的可持续性。

方法

在一项随机、对照、前瞻性、混合方法、纵向研究中,研究了电话随访小组的效果。随访干预包括在 6 个月内每月参加一次电话小组会议,进行社会参与。主要结果是增加家庭护理人员的社会参与度,次要结果(如生活质量和主观健康)也通过书面调查在 3 或 4 个测量点进行评估。

结果

可对干预组的 69 名参与者和对照组的 72 名参与者的完整数据进行评估。干预组的社会参与限制略有减少,而对照组的减少微不足道。重复测量方差分析(ANOVA)显示,干预组在护理人员的抑郁、感知社会支持和生活质量的心理健康领域等次要结果上持续有效。结果还表明,基于电话的随访小组对支持服务的使用影响较小。除了来自家人、朋友和邻居的支持外,现有的支持服务几乎没有被利用。

结论

针对痴呆症患者护理人员的电话随访小组未能达到预期的社会参与度增加效果。尽管如此,对选定的与健康相关的次要结果的明显影响以及参与者对基于电话的小组会议的评估表明,护理人员能够从这种随访措施中受益匪浅。应更广泛地告知家庭护理人员相关资源,并鼓励他们使用这些资源。总的来说,这种新的随访概念可以推荐实施,并且其使用似乎也针对其他适应症具有针对性。

临床试验注册

德国临床试验注册处:DRKS00013736,2018 年 5 月 14 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8162/8832817/0b8e99643083/12913_2022_7490_Fig1_HTML.jpg

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