Hetzel Christian, Schaller Julia, Michel Wolfgang, Froböse Ingo
Institut für Qualitätssicherung in Prävention und Rehabilitation iqpr GmbH an der Deutschen Sporthochschule Köln, Köln, Germany.
Gesundheitsangebote, Sozialversicherung für Landwirtschaft, Forsten und Gartenbau, Kassel, Germany.
Gesundheitswesen. 2025 Feb;87(2):136-144. doi: 10.1055/a-2305-0146. Epub 2024 Apr 11.
The aim of this study was to assess the effect of a one-week inpatient health programme for family carers together with the persons in need of care (care tandem) on the well-being of family carers. Acceptance and subjective benefits were also assessed. The intervention was funded by the Social Insurance for Agriculture, Forestry and Horticulture (SVLFG).
Central to the intervention are (1) the home care counselling before the seminar, (2) the one-week seminar in the setting of a rehabilitation clinic at a health resort, in particular with a care course, exercise and relaxation units and the use of local remedies, (3) the substitute care of the person in need of care in close proximity to the seminar location and (4) the low-threshold telephone aftercare by SVLFG specialists. In a controlled prospective panel study (IG n=35, VG n=67, allocation not randomised), well-being (WHO-5, range 0-100) was measured at several points in time (IG: 0, 1, 9, 17, 28 and 43 weeks after the start of the seminar; VG 0, 17, 28 and 43 weeks). Statistical analyses were performed using fixed-effects panel regression, controlling for time-varying covariates (period effects, external stress).
In the IG (80% women, mean age 66.5 years), 69% of family carers showed evidence of clinically relevant depression at baseline. All care levels were represented among the people in need of care, predominantly 2 and 3, with medically diagnosed dementia in 37% of the cases. The VG was similarly structured. Under the condition of stable external stress, the initial effect was very clear (delta=+19 points). The effect then flattened out, but remained fairly stable at around 10 points above the initial level. Although the last measurement (43 weeks) was no longer statistically significantly higher, it was independent of the development of external stress. Acceptance and subjective benefit were very high.
The strength of the intervention is the dyadic approach. The intervention promotes well-being and is highly accepted. The design allows at least cautious causal conclusions. For the remaining limitations, larger case numbers and a randomised controlled trial would be necessary.
本研究旨在评估一项为期一周的针对家庭照顾者及其需要照顾者（照顾组合）的住院健康计划对家庭照顾者幸福感的影响。同时还评估了该计划的接受度和主观益处。该干预措施由农业、林业和园艺社会保险（SVLFG）资助。
干预措施的核心包括：（1）研讨会前的家庭护理咨询；（2）在健康度假胜地的康复诊所进行为期一周的研讨会，特别是设有护理课程、锻炼和放松单元，并使用当地疗法；（3）在研讨会地点附近为需要照顾者提供替代护理；（4）由SVLFG专家提供低门槛的电话跟进护理。在一项对照前瞻性面板研究中（干预组n = 35，对照组n = 67，分配未随机化），在多个时间点测量幸福感（WHO-5，范围0 - 100）（干预组：研讨会开始后的0、1、9、17、28和43周；对照组：0、17、28和43周）。使用固定效应面板回归进行统计分析，控制随时间变化的协变量（时期效应、外部压力）。
在干预组（80%为女性，平均年龄66.5岁）中，69%的家庭照顾者在基线时表现出具有临床相关性的抑郁症状。所有护理级别在需要照顾者中均有体现，主要为2级和3级，37%的病例有医学诊断的痴呆症。对照组结构类似。在外部压力稳定的情况下初始效果非常明显（差值 = +19分）。然后效果趋于平稳，但仍比初始水平高约10分且相当稳定。尽管最后一次测量（43周）在统计学上不再显著更高，但它与外部压力的变化无关。接受度和主观益处非常高。
干预措施的优势在于二元方法。该干预促进了幸福感且接受度很高。该设计至少允许得出谨慎的因果结论。对于其余局限性，需要更大的样本量和随机对照试验。
