School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong.
Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong.
Age Ageing. 2023 Sep 1;52(9). doi: 10.1093/ageing/afad160.
Dementia caregiving is associated with notable impacts on the health of family carers. Although sense of coherence (SOC), as a core dimension of inner strength, has been found to have health-protecting effects in stressful encounters, few studies have designed a strength-based intervention to optimise SOC and thereby the health of carers.
To identify the effects of a strength-based intervention on SOC, coping, health-related quality of life (HRQoL), perceived burden and depression among Chinese family carers of people with dementia and to examine whether the health effects, if any, are mediated through an enhanced SOC and effective coping.
A double-blind randomised controlled trial comparing a strengths-based intervention with a general education control.
A 14-session strengths-based intervention which combined the use of narrative and empowerment strategies to support the carers of people with dementia to optimise the use of their generalised resistance resources in coping with the caregiving situation.
Older people community centres in Hong Kong.
A total of 350 family carers participated in the study (mean age: 65.0 (SD = 12.3); female: 84.6%). Participants who received the strength-based intervention reported significantly greater improvements in their SOC, mental health, perceived burden and depression, than those in the education group, over a 22-week evaluation period. Path analysis models revealed that an SOC wholly mediated the relationship between the strength-based intervention and mental HRQoL (covering energy/vitality and psychosocial functioning) and partially mediated the relationship between the strength-based intervention and depression. We did not identify any harm from the intervention.
A strength-based intervention is effective in improving the perceived burden and mental health of family caregivers of persons with dementia, and an SOC plays an important role in accounting for the mental health benefits.
The trial was registered in the World Health Organization International Clinical Trials Registry Platform (Main ID: ChiCTR-IIC-17011097).
痴呆症护理对家庭护理员的健康有显著影响。虽然应对一致性（SOC）作为内在力量的核心维度，已被发现对压力环境具有保护健康的作用，但很少有研究设计基于优势的干预措施来优化 SOC 并改善护理人员的健康。
确定基于优势的干预措施对中国痴呆症患者家庭护理者的 SOC、应对方式、健康相关生活质量（HRQoL）、感知负担和抑郁的影响，并检验这些健康影响是否通过增强 SOC 和有效的应对方式来介导。
一项比较基于优势的干预与一般教育对照的双盲随机对照试验。
一项为期 14 节的基于优势的干预措施，结合使用叙事和赋权策略，支持痴呆症患者的护理者优化他们在应对护理情况时利用一般化抵抗资源的能力。
中国香港的老年人社区中心。
共有 350 名家庭护理者参加了研究（平均年龄：65.0（SD=12.3）；女性：84.6%）。在 22 周的评估期间，接受基于优势的干预措施的参与者在 SOC、心理健康、感知负担和抑郁方面的改善明显优于接受教育组的参与者。路径分析模型显示，SOC 完全介导了基于优势的干预措施与心理健康 HRQoL（包括精力/活力和心理社会功能）之间的关系，部分介导了基于优势的干预措施与抑郁之间的关系。我们没有发现干预措施带来的任何伤害。
基于优势的干预措施可有效改善痴呆症患者家庭护理者的感知负担和心理健康，SOC 在解释心理健康获益方面起着重要作用。
该试验在世界卫生组织国际临床试验注册平台（主要 ID：ChiCTR-IIC-17011097）注册。
