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虚拟培训的家庭护理员实施生命回顾的可行性和效果。

Feasibility and Efficacy of Life Review Delivered by Virtually-Trained Family Caregivers.

机构信息

University of Houston Graduate College of Social Work, Houston, TX, USA.

Baylor University Diana R. Garland School of Social Work, Waco, TX, USA.

出版信息

J Alzheimers Dis. 2023;95(2):573-583. doi: 10.3233/JAD-230371.

Abstract

BACKGROUND

Due to the high prevalence of depressive symptoms and Alzheimer's disease and related dementias in older Americans (≥65 years), we developed a six-week depression intervention, Caregiver-Provided Life Review (C-PLR) for care recipients (CRs) with early-stage dementia and mild depression.

OBJECTIVE

The objective of the study was to examine the feasibility and efficacy of C-PLR delivered by virtually-trained caregivers (CGs) on CRs who live with dementia and depression in community and long-term care settings (N = 25 CG-CR dyads).

METHODS

We used fidelity scores as a measure of CG's feasibility to provide C-PLR. We collected the pre- and post-measures on CRs' depression (primary outcome), life satisfaction, CGs' burden, positive aspects of caregiving, and CG-CR relationship quality (secondary outcomes) and compared them using paired t-tests. We evaluated if the effect differed by race/ethnicity, residential setting, or living alone.

RESULTS

The average fidelity check-in score was 14.8±0.78 indicating high feasibility. CGs were 52 years old (mean), 88% female, 64% working, 72% college-educated, and 72% in good-excellent health. CRs were 81 years old (mean), 84% female, and 56% in poor-fair health. CRs' depression significantly improved (p < 0.001), and this effect was found in CRs who were Asian (p = 0.017), White (p = 0.040), community-dwelling (p < 0.001), lived alone (p = 0.045), or with others (p = 0.002).

CONCLUSION

This study demonstrated that the C-PLR can be successfully taught to CGs virtually and is effective in reducing CR's depressive symptoms. C-PLR could be implemented more broadly to improve symptoms among CRs in community and residential settings, as well as among a diverse population of CRs.

摘要

背景

由于美国老年人(≥65 岁)中抑郁症状和阿尔茨海默病及相关痴呆的高患病率,我们为患有早期痴呆和轻度抑郁的照护对象开发了一项为期六周的抑郁干预措施,即照护者提供生活回顾(C-PLR)。

目的

本研究旨在检验由经过虚拟培训的照护者(CG)为社区和长期护理环境中患有痴呆和抑郁的照护对象(CR)实施 C-PLR 的可行性和效果(N=25 对 CG-CR)。

方法

我们使用忠实性评分来衡量 CG 提供 C-PLR 的可行性。我们收集了 CRs 抑郁(主要结果)、生活满意度、CGs 负担、照护积极方面以及 CG-CR 关系质量(次要结果)的预测量和后测量,并使用配对 t 检验进行比较。我们评估了效果是否因种族/民族、居住环境或独居而不同。

结果

平均忠实性检查分数为 14.8±0.78,表明具有高度可行性。CG 年龄为 52 岁(平均),88%为女性,64%有工作,72%受过大学教育,72%健康状况良好。CR 年龄为 81 岁(平均),84%为女性,56%健康状况较差。CRs 的抑郁显著改善(p<0.001),这一效果在亚裔(p=0.017)、白人(p=0.040)、社区居住(p<0.001)、独居(p=0.045)或与他人居住(p=0.002)的 CR 中均有体现。

结论

本研究表明,C-PLR 可以成功地通过虚拟方式教授给 CG,并可有效减轻 CR 的抑郁症状。C-PLR 可以更广泛地实施,以改善社区和居住环境中 CR 的症状,以及不同人群的 CR 症状。

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