Douglas Sara L, Plow Matthew, Packer Tanya, Lipson Amy R, Lehman Michelle J
From the Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH (SLD, MP, ARL).
School of Occupational Therapy (TP) and School of Health Administration (MJL), Dalhousie University, Halifax, Nova Scotia, Canada.
Int J MS Care. 2023 Nov-Dec;25(6):252-258. doi: 10.7224/1537-2073.2022-111. Epub 2023 Nov 8.
Caregivers of people with multiple sclerosis (MS) report poor emotional outcomes yet few interventions have been tested. The goal of this study was to compare the effectiveness of a remotely delivered intervention with 2 arms (ie, website and telecoaching vs website only) aimed at reducing depression, anxiety, stress, and distress in informal caregivers of individuals with MS.
From March 2021 through August 2021, 151 care-givers were enrolled in the study. The intervention occurred over a 4-month period. The website plus telecoaching arm received (a) a monthly coaching session focused on information, skill building, and support that was delivered by a licensed social worker via videoconference or telephone, and (b) had access to a study-designed website for caregivers of individuals with MS. The website-only arm did not receive coaching sessions and had the same website access. Data were obtained at baseline, immediately after the intervention period, and 6 weeks after the intervention.
A linear mixed-effects model using an autoregressive covariance structure was used. It showed that the group by time interaction was statistically significant for the overall composite emotion score (depression, anxiety, stress) ( = .037) and the stress subscale score ( = .047), and it indicated that the website plus telecoaching arm demonstrated greater effectiveness at reducing the overall composite emotion and stress subscale scores.
Use of a remotely delivered psychoeducational intervention that included individual coaching sessions as well as website access demonstrated preliminary efficacy in improving emotional outcomes in caregivers of individuals with MS. Further testing of the intervention with a larger sample is recommended.
多发性硬化症（MS）患者的照料者报告称其情绪状况不佳，但针对此的干预措施鲜有经过测试的。本研究的目的是比较一种远程干预措施的两种形式（即网站加电话辅导与仅网站）在减轻MS患者非正式照料者的抑郁、焦虑、压力和痛苦方面的效果。
从2021年3月至2021年8月，151名照料者参与了本研究。干预为期4个月。网站加电话辅导组接受了以下两项：（a）每月一次由持照社会工作者通过视频会议或电话进行的辅导课程，重点是提供信息、培养技能和给予支持；（b）可访问一个为MS患者照料者设计的研究网站。仅网站组未接受辅导课程，但可访问相同的网站。在基线、干预期结束后立即以及干预后6周获取数据。
使用了具有自回归协方差结构的线性混合效应模型。结果显示，时间交互作用组在总体综合情绪评分（抑郁、焦虑、压力）（P = 0.037）和压力子量表评分（P = 0.047）方面具有统计学意义，这表明网站加电话辅导组在降低总体综合情绪和压力子量表评分方面效果更佳。
使用一种包括个人辅导课程以及网站访问的远程心理教育干预措施，在改善MS患者照料者的情绪状况方面显示出初步疗效。建议使用更大样本对该干预措施进行进一步测试。
