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基于电话的心理干预对早发性阿尔茨海默病患者照料者的影响:意大利新冠疫情紧急状态期间的一项为期六个月的研究

Effects of Phone-Based Psychological Intervention on Caregivers of Patients with Early-Onset Alzheimer's Disease: A Six-Months Study during the COVID-19 Emergency in Italy.

作者信息

De Stefano Manuela, Esposito Sabrina, Iavarone Alessandro, Carpinelli Mazzi Michele, Siciliano Mattia, Buonanno Daniela, Atripaldi Danilo, Trojsi Francesca, Tedeschi Gioacchino

机构信息

First Division of Neurology, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.

CDCD AORN "Ospedali dei Colli"-CTO, 80131 Naples, Italy.

出版信息

Brain Sci. 2022 Feb 24;12(3):310. doi: 10.3390/brainsci12030310.

Abstract

Caregivers of patients with early-onset Alzheimer's disease (EOAD) experience higher level of burden, stress, and depression, due to premature role changes and social isolation. Moreover, the SARS-CoV-2 pandemic compelled restrictions regarding social interactions and mobility in Italy from March 2020, prompting telemedicine approaches for supporting patients and their families confined at home. We reported our experience regarding the effects of psychological phone-intervention (phone-I) on EOAD caregivers during pandemic. Twenty caregivers of EOAD patients were randomly assigned to treatment (TG) or control (CG) group. TG weekly underwent a phone-I for one month. All participants were assessed for caregiver burden and needs, anxiety and depression levels, and subjective impact of traumatic events at baseline (T0), at the fifth week (T1) and after 6 months (T2) from phone-I. We observed higher vulnerability to post-traumatic stress in TG compared to CG in all timepoints ( ≤ 0.05). Decreased stress effects and caregiver burden were revealed in TG at T1 compared to T0 ( ≤ 0.05), although showing an increase of these measures at T2 in the treated caregivers. Our findings suggest that although TG showed a peculiar vulnerability to post-traumatic stress, they showed increased wellbeing immediately after phone-I. However, this benefit disappeared six months later, along with the second infection wave, probably due to "exhaustion stage" achievement in "General Adaptation Syndrome". This trend may suggest a beneficial but not solving role of a prompt phone-I on burden of caregivers of EOAD patients during the SARS-CoV-2 emergency.

摘要

早发性阿尔茨海默病(EOAD)患者的照料者由于角色过早转变和社会隔离,承受着更高程度的负担、压力和抑郁。此外,2020年3月起,意大利因新冠疫情对社交互动和出行实施了限制,促使采用远程医疗方法来支持居家的患者及其家人。我们报告了在疫情期间心理电话干预(电话干预)对EOAD照料者影响的经验。20名EOAD患者的照料者被随机分配到治疗组(TG)或对照组(CG)。TG组每周接受一次电话干预,为期一个月。在电话干预前的基线(T0)、第五周(T1)和电话干预后6个月(T2),对所有参与者进行照料者负担和需求、焦虑和抑郁水平以及创伤性事件主观影响的评估。我们观察到,在所有时间点,TG组相比CG组创伤后应激的易感性更高(≤0.05)。与T0相比,TG组在T1时应激效应和照料者负担有所降低(≤0.05),不过在接受治疗的照料者中,这些指标在T2时有所增加。我们的研究结果表明,尽管TG组表现出对创伤后应激的特殊易感性,但在电话干预后其幸福感立即有所提升。然而,这种益处6个月后消失了,随着第二波感染的到来,这可能是由于“一般适应综合征”进入了“衰竭阶段”。这种趋势可能表明,在新冠疫情紧急情况下,及时的电话干预对EOAD患者照料者的负担具有有益但非解决性的作用。

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