HES-SO University of Applied Sciences and Arts Western Switzerland - Fribourg, School of Health Sciences, Fribourg, Switzerland.
Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, Lausanne University Hospital, Lausanne, Switzerland.
BMC Prim Care. 2024 Sep 28;25(1):353. doi: 10.1186/s12875-024-02602-2.
'Learning to feel better… and help better' is a psychoeducational intervention that aims to empower family caregivers of people with dementia by helping them cope better with the daily stress of dementia caregiving. The intervention has been adapted to a Swiss context and evaluated with a mixed-method design, yielding promising results in caregivers, such as a reduced subjective burden and improved self-efficacy. Qualitative findings have provided insight into potentially relevant intermediate changes that must be further explored to better understand how the intervention precipitates the achieved changes. We aim to qualitatively explore such changes, related mechanisms and key intervention components in the context of this intervention.
A constructivist grounded theory approach was used to achieve this aim. Changes, related mechanisms and key intervention components were identified by exploring the following: 1) longitudinal qualitative data, collected from 13 family caregivers via interviews performed before, during and after the intervention (39 interviews total) and 2) cross-sectional post-intervention interview data collected from 22 family caregivers (22 interviews).
Experiencing calmness was the most important change for caregivers in the context of this intervention. The calmness model, developed based on the qualitative analysis, illustrates the intermediate changes that contributed to calmness, such as being able to cope with daily life and experiencing positive interactions with the family member with dementia. Related key intervention components were the coping strategy 'reframing', employed in diverse ways by the caregivers to reduce daily stress, and the didactic method 'active skills' training', which involved active participation by the caregivers and the guidance of a professional group leader. One important factor hampering changes in caregivers was having difficulties accepting the caregiver role or accepting the losses due to dementia.
The calmness model offers valuable insight into how this intervention can benefit family caregivers and aid in developing interventions targeting similar mechanisms and changes.
ISRCTN13512408 (registration date 17.05.2021, retrospectively registered).
“学会感觉更好……并更好地帮助”是一种心理教育干预措施，旨在通过帮助痴呆症患者的家庭照顾者更好地应对日常的痴呆症护理压力，使他们更有能力。该干预措施已被改编为瑞士语境，并采用混合方法设计进行了评估，在照顾者中取得了有希望的结果，例如主观负担减轻和自我效能提高。定性研究结果提供了对潜在相关中间变化的深入了解，这些变化必须进一步探索，以更好地了解干预措施是如何引发所取得的变化的。我们旨在在这种干预的背景下，从定性角度探讨这些变化、相关机制和关键干预因素。
采用建构主义扎根理论方法来实现这一目标。通过探索以下内容来确定变化、相关机制和关键干预因素：1）通过对 13 名家庭照顾者进行访谈，在干预前、干预期间和干预后收集的纵向定性数据（共 39 次访谈）；2）对 22 名家庭照顾者进行的干预后横断面访谈收集的横截面数据（共 22 次访谈）。
在这种干预的背景下，照顾者最重要的变化是体验到平静。基于定性分析开发的平静模型说明了促成平静的中间变化，例如能够应对日常生活并与痴呆症患者家庭成员进行积极互动。相关的关键干预因素是应对策略“重新定义”，照顾者以不同的方式采用这种策略来减轻日常压力，以及教学方法“积极技能”培训，这种方法涉及照顾者的积极参与和专业小组组长的指导。一个阻碍照顾者变化的重要因素是难以接受照顾者的角色或接受痴呆症造成的损失。
平静模型提供了有价值的见解，了解这种干预如何使家庭照顾者受益，并有助于开发针对类似机制和变化的干预措施。
ISRCTN85230063（注册日期 2021 年 5 月 17 日，回顾性注册）。
