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社区卫生工作者为痴呆症患者的不同家庭照顾者提供支持:一项基于家庭的随机研究的初步定性结果。

Community health workers supporting diverse family caregivers of persons with dementia: Preliminary qualitative results from a randomized home-based study.

作者信息

Lee Jung-Ah, Kim Julie, Rousseau Julie, Sabino-Laughlin Eilleen, Ju Eunae, Kim Eunbee Angela, Rahmani Amir, Gibbs Lisa, Nyamathi Adeline

机构信息

Sue & Bill Gross School of Nursing, University of California, Irvine, USA.

Department of Sociology, University of California, Irvine, CA, USA.

出版信息

Dementia (London). 2025 Feb;24(2):249-268. doi: 10.1177/14713012241302367. Epub 2024 Nov 18.

Abstract

BACKGROUND AND OBJECTIVES

Culturally diverse informal caregivers of community-dwelling persons with dementia face challenges in accessing dementia care resources due to language barriers and cultural stigmas surrounding dementia. This study presents the perceived intervention experiences of a home-based approach which considers the cultural and linguistic needs of diverse family caregivers in dementia care. The intervention model includes home visits by trained bilingual, non-licensed community health workers (CHWs) whose cultural histories and understandings reflect that of the caregivers. The purpose of the present study was to understand family caregivers' experience in caregiving and their feedback on the intervention, which includes caregiver support through education and skill development.

METHODS

The present study thematically analyzed qualitative data from exit interviews with caregivers who participated in a CHW-led, 12-week home visit-based intervention program.

RESULTS

Among 57 caregivers (mean age = 63.5, SD = 14.3) who participated in the 3-month home-visit intervention and completed the exit interviews, 33% were Korean Americans, 28% Vietnamese Americans, 21% non-Hispanic Whites, and 17.5% Latino/Hispanic. The majority were females (81%) and spouses (51%). Main themes include, (a) Individual Level: Improvements in Caregiving Self-efficacy and Self-care Awareness, (b) Relational Level: Enhanced Communications and Relationships with Persons with Dementia, and (c) Community Level: Connection and Access to Community Resources and Support.

CONCLUSION

Interview data show that the culturally and linguistically tailored program supported diverse caregivers by increasing self-care awareness, improving knowledge about dementia and dementia care, strengthening communication skills, and facilitating access to community resources. Strong rapport between CHWs and caregivers enhanced the effectiveness of the intervention. Future approaches can focus on supporting caregivers with especially limited resources.

摘要

背景与目的

患有痴呆症的社区居民的文化背景各异的非正式照料者,由于语言障碍和围绕痴呆症的文化污名,在获取痴呆症护理资源方面面临挑战。本研究介绍了一种居家护理方法的干预体验,该方法考虑了痴呆症护理中不同家庭照料者的文化和语言需求。干预模式包括由经过培训的双语、无执照社区卫生工作者(CHW)进行家访,这些社区卫生工作者的文化背景和理解与照料者相似。本研究的目的是了解家庭照料者的护理体验以及他们对干预措施的反馈,其中包括通过教育和技能发展提供照料者支持。

方法

本研究对参与由社区卫生工作者主导的、为期12周的家访干预项目的照料者进行的离职访谈中的定性数据进行了主题分析。

结果

在参与为期3个月的家访干预并完成离职访谈的57名照料者(平均年龄=63.5,标准差=14.3)中,33%是韩裔美国人,28%是越南裔美国人,21%是非西班牙裔白人,17.5%是拉丁裔/西班牙裔。大多数是女性(81%)和配偶(51%)。主要主题包括:(a)个人层面:照料自我效能感和自我护理意识的提高;(b)关系层面:与痴呆症患者沟通和关系的增强;(c)社区层面:与社区资源和支持的联系与获取。

结论

访谈数据表明,这种文化和语言量身定制的项目通过提高自我护理意识、改善痴呆症及痴呆症护理知识、加强沟通技巧以及促进获取社区资源,为不同的照料者提供了支持。社区卫生工作者与照料者之间良好的融洽关系提高了干预效果。未来的方法可以侧重于为资源特别有限的照料者提供支持。

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