Ko Eunjung, Wongvibul Thanchanok, Rose Karen M, Jun Jin
College of Nursing, The Ohio State University, United States.
Int J Nurs Stud Adv. 2023 Jul 13;5:100141. doi: 10.1016/j.ijnsa.2023.100141. eCollection 2023 Dec.
The number of people living with dementia continues to grow, increasing the demands on unpaid caregivers of people living with dementia. Caregiving can be emotionally and mentally distressing. In response, numerous interventions have been developed and tested to improve mental health in caregivers of people living with dementia. However, the effects of self-guided interventions on mental health in this population have remained understudied.
We systematically examined the effects of self-guided interventions on stress, burden, and mental health of unpaid caregivers of people living with dementia.
A systematic review method following PRISMA guideline was used. PubMed, CINAHL, PsycINFO, Scopus, and Embase databases were searched using relevant search terms for the study aims from September to November 2022. The search was limited to peer-reviewed articles written in English. This review included articles that examined 1) unpaid caregivers of people living with dementia; 2) a self-guided, self-directed, or self-facilitated intervention; and 3) intervention to improve psychological or mental health as an outcome of interest. The exclusion criteria were: 1) secondary data analysis research based on an intervention study, 2) systematic reviews or meta-analyses, or 3) articles that evaluated only the acceptability or feasibility of a program. The collected data were synthesized using descriptive analysis with tabular summaries. The quality of each paper included was assessed by using JBI Quality Assessment tools.
A total of 16 articles and 1,182 unpaid caregivers of people living with dementia were included in this review. Stress, burden, depressive symptoms, anxiety, quality of life, self-efficacy, positive aspects of caregiving, social support, and personal relationship were measured in at least three articles. Depressive symptoms and burden were the most frequently measured outcomes. Stress was generally reduced after the interventions. However, the results of burden and mental health from each intervention were mixed and inconsistent. Interestingly, interventions that lasted less than 3 months were more likely to have better efficacy.
Although the results of self-guided interventions are mixed, this is a potentially useful tool in improving emotional well-being for unpaid caregivers of people living with dementia due to low time burden, ease-to-access, and affordability. Future direction in intervention development should include identifying the optimal length and components of self-guided interventions and collaboration with clinicians for wider distribution to unpaid caregivers of people living with dementia.
This review was not registered at the PROSPERO, and a review protocol was not prepared.
痴呆症患者的数量持续增加，这使得对痴呆症患者无薪照护者的需求也不断上升。照护工作可能会给照护者带来情感和心理上的困扰。为此，人们开发并测试了多种干预措施，以改善痴呆症患者照护者的心理健康。然而，自我引导式干预对这一人群心理健康的影响仍未得到充分研究。
我们系统地研究了自我引导式干预对痴呆症患者无薪照护者的压力、负担和心理健康的影响。
采用遵循PRISMA指南的系统评价方法。于2022年9月至11月，在PubMed、CINAHL、PsycINFO、Scopus和Embase数据库中使用与研究目的相关的检索词进行检索。检索仅限于用英文撰写的同行评议文章。本综述纳入了以下文章：1）痴呆症患者的无薪照护者；2）自我引导、自我指导或自我促进的干预措施；3）以改善心理或心理健康为感兴趣结果的干预措施。排除标准为：1）基于干预研究的二次数据分析研究；2）系统评价或荟萃分析；3）仅评估项目可接受性或可行性的文章。收集的数据采用描述性分析和表格汇总进行综合。使用JBI质量评估工具评估所纳入每篇论文的质量。
本综述共纳入16篇文章和1182名痴呆症患者的无薪照护者。至少在三篇文章中测量了压力、负担、抑郁症状、焦虑、生活质量、自我效能感、照护的积极方面、社会支持和人际关系。抑郁症状和负担是最常测量的结果。干预后压力总体上有所降低。然而，每项干预措施在负担和心理健康方面的结果参差不齐且不一致。有趣的是，持续时间少于3个月的干预措施更有可能具有更好的效果。
尽管自我引导式干预的结果参差不齐，但由于时间负担低、易于获取且成本较低，它对于改善痴呆症患者无薪照护者的情绪健康而言是一种潜在有用的工具。干预措施开发的未来方向应包括确定自我引导式干预的最佳时长和组成部分，并与临床医生合作，以便更广泛地分发给痴呆症患者的无薪照护者。
本综述未在PROSPERO注册，也未制定综述方案。
