School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland.
Haute Ecole de Santé Fribourg, Route Des Arsenaux 16a, 1700, Fribourg, Switzerland.
BMC Geriatr. 2024 Feb 27;24(1):197. doi: 10.1186/s12877-024-04815-7.
As the number of people living with dementia rapidly increases worldwide, the support provided by their informal caregivers remains key to the sustainability of most healthcare systems, this voluntary contribution representing 40% of the costs of dementia worldwide. Informal caregiving in dementia, however, is linked to long periods of chronic stress with frequent and serious negative consequences on the health and quality of life of the caregiver. A psycho-educational group intervention focusing on coping with the daily stress of dementia caregiving ("Learning to feel better… to help better"), developed in French-speaking Canada and showing broad effects on quality of life, was selected with the aim of 1) adapting it to a new cultural context (French-speaking Switzerland) based on identified facilitators and barriers, using a participative approach; and 2) conducting a feasibility study to evaluate whether the adapted programme showed similar or improved feasibility and effects compared to the original Canadian programme.
A mixed-methods concurrent nested design was used to evaluate the feasibility and the effects on five quantitative core outcomes. Additional qualitative data helped document in depth the acceptability and impact of the intervention.
We shortened the programme from 30 to 21 h in total, which resulted in increased accessibility, in terms of facilitated recruitment of participants and inclusion of a broader range of informal caregivers. There were significant reductions in subjective burden (effect size: d = -0.32) and psychological distress (d = -0.48), as well as decreases in the stress reactions of informal caregivers related to the behaviour problems of the persons with dementia (d = -0.57). The qualitative results emphasized the usefulness of providing informal caregivers with structured procedures for efficiently tackling everyday challenges, and of enabling learning through a variety of channels and activities.
Substantial improvements are associated with this 21-h group intervention, organised in 7 sessions of 3 h each, focused on learning more efficient strategies to cope with the daily stress of dementia caregiving. This intervention empowered informal caregivers to master their daily challenges with more confidence, satisfaction and calm.
ISRCTN13512408 (registration date 17.05.2021, retrospectively registered).
随着全球范围内痴呆症患者人数的迅速增加，他们的非正式照顾者所提供的支持仍然是大多数医疗保健系统可持续性的关键，这种自愿贡献占全球痴呆症成本的 40%。然而，痴呆症的非正式护理与长期慢性压力有关，经常对护理人员的健康和生活质量产生严重的负面影响。一种以应对痴呆症护理日常压力为重点的心理教育小组干预措施（“学会感觉更好……更好地帮助”），在法语国家加拿大开发，并显示出对生活质量的广泛影响，被选中的目的是 1）根据确定的促进因素和障碍，采用参与式方法将其适应新的文化背景（法语瑞士）；2）进行可行性研究，以评估适应后的方案是否与原始的加拿大方案具有相似或改善的可行性和效果。
采用混合方法的嵌套设计，评估五项核心定量结果的可行性和效果。额外的定性数据有助于深入记录干预措施的可接受性和影响。
我们将方案从 30 小时缩短到 21 小时，从而提高了方案的可及性，便于招募参与者，并纳入了更广泛的非正式照顾者群体。主观负担（效应量：d=-0.32）和心理困扰（d=-0.48）显著降低，与痴呆症患者行为问题相关的非正式照顾者的应激反应也降低（d=-0.57）。定性结果强调了为非正式照顾者提供有效应对日常挑战的结构化程序，以及通过多种渠道和活动进行学习的有用性。
与这种 21 小时的小组干预相比，组织 7 次 3 小时的会议，重点学习更有效的应对痴呆症护理日常压力的策略，可显著改善。这种干预措施使非正式照顾者更有信心、更满意、更平静地应对日常挑战。
ISRCTN8753174（注册日期 2021 年 5 月 17 日，回溯性注册）。
