Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, Massachusetts.
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
Semin Neurol. 2024 Oct;44(5):559-566. doi: 10.1055/s-0044-1791568. Epub 2024 Oct 3.
This paper reviews dyadic psychosocial intervention approaches that flexibly incorporate both dyad members despite challenges to equitable involvement due to cognitive limitations or limited availability. We provide an overview, analysis, and examples for the following dyadic intervention approaches: (1) shared interventions that involve each dyad member equitably (i.e., higher care recipient cognition, higher care-partner availability); (2) patient-focused interventions that primarily engage care recipients with early stages of neurocognitive disorders, yet include care-partners in select sessions and target dyadic and relationship needs (i.e., higher care recipient cognition, lower care-partner availability); and (3) care-partner focused interventions that primarily engage care-partners, yet still address care recipient and relationship needs (i.e., lower care recipient cognition, higher care-partner availability). In our review, we propose a flexible definition of dyadic psychosocial intervention that considers the continuum of individuals' involvement, measurement, content, and conceptual background. We conclude with a discussion of implications for neuropalliative care.
本文回顾了双体心理社会干预方法,这些方法灵活地将双体成员纳入其中,尽管由于认知限制或可用性有限,公平参与存在挑战。我们提供了以下双体干预方法的概述、分析和示例:(1)共同干预措施,公平地涉及每个双体成员(即,较高的护理接受者认知,较高的护理伙伴可用性);(2)以患者为中心的干预措施,主要涉及认知障碍早期阶段的护理接受者,但在某些环节中包括护理伙伴,并针对双体和关系需求(即,较高的护理接受者认知,较低的护理伙伴可用性);(3)以护理伙伴为重点的干预措施,主要涉及护理伙伴,但仍解决护理接受者和关系需求(即,较低的护理接受者认知,较高的护理伙伴可用性)。在我们的综述中,我们提出了一个灵活的双体心理社会干预定义,该定义考虑了个体参与、测量、内容和概念背景的连续体。最后我们讨论了神经姑息治疗的意义。