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心理教育干预措施:一种支持痴呆症患者照料者的宝贵沟通工具。

The Psychoeducational Interventions: a valuable communication tool to support the caregiver of people with dementia.

作者信息

Cintoli Simona, Tommasini Luca L, Del Prete Eleonora, Cerri Matilde, Ceravolo Roberto, Tognoni Gloria

机构信息

Integrated Assistance Departments (D.A.I.) Neuroscience - Neurology Unit, Azienda Ospedaliero Universitaria Pisana (AOUP), Pisa, Italy.

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

出版信息

BMC Geriatr. 2024 Dec 19;24(1):1004. doi: 10.1186/s12877-024-05562-5.

Abstract

BACKGROUND

informal caregivers of people with dementia are at greater risk of developing physical and mental health problems when compared to the general population: they often experience high levels of stress which can lead to a lowered sense of well-being, feelings of being burdened, depression and compromised physical health. The significant beneficial effects of Psychoeducational Interventions on the critical outcomes of caregiver burden and strain were considered sufficient to warrant a recommendation in favour of the intervention. The emergence of the COVID-19 pandemic has significantly increased the use internet-based interventions: this study describes the effectiveness of support program for informal caregivers of people with dementia internet-based and on-site conditions.

METHODS

A Psychoeducational Interventions program, consisting of 5 meetings every 2 weeks, has been structured. It aims to provide information and strategies for managing cognitive and psycho-behavioral symptoms in neurodegenerative diseases, as well as to develop effective communication skills and understanding of the caregiver's experience. Intervention formats include slides, video, group discussions and are always led by a psychologist. We assessed in 73 caregivers (33 internet-based and 40 on-site conditions) level of Behavioural and Psychological Symptoms of Dementia management, dementia awareness, social support, find leisure time, harmony with relative, stress, with Visual-Analogue Scale at the beginning of PI and at the end. During the pandemic period the protocol was adapted to be available online and subsequently proposed to caregivers belonging to the Cognitive Disorders and Dementia Centre.

RESULTS

in both modalities, internet-based and on-site condition, a statistically significant improvement was highlighted in all aspects (p < 0.05, for all p-value). Questionnaire on basic dementia knowledge was successfully completed at 100%. Also, participants reported a medium to high level of satisfaction with very limited dropouts (< 3%).

CONCLUSIONS

The evidence from this pilot study indicated that caregiver support interventions in both conditions significantly improved several and important outcomes: they showed a significant effect in reducing caregiver strain and improving ability and knowledge. Indeed, Psychoeducational Interventions contribute to effective coping strategies to mitigate caregiver burden so they can continue to provide care for loved ones.

摘要

背景

与普通人群相比,痴呆症患者的非正式照料者出现身心健康问题的风险更高:他们经常承受高水平的压力,这可能导致幸福感降低、有负担感、抑郁以及身体健康受损。心理教育干预对照料者负担和压力等关键结果具有显著的有益影响,足以支持推荐采用该干预措施。新型冠状病毒肺炎疫情的出现显著增加了基于互联网的干预措施的使用:本研究描述了针对痴呆症患者非正式照料者的支持项目在基于互联网和现场条件下的有效性。

方法

构建了一个心理教育干预项目,每两周进行5次会面。其目的是提供管理神经退行性疾病中认知和心理行为症状的信息和策略,以及培养有效的沟通技巧并增进对照料者经历的理解。干预形式包括幻灯片、视频、小组讨论,且始终由一名心理学家主持。我们在73名照料者(33名基于互联网干预和40名现场干预)中,于心理教育干预开始时和结束时,使用视觉模拟量表评估痴呆症行为和心理症状管理水平、痴呆症认知、社会支持、找到休闲时间、与亲属的和谐关系、压力情况。在疫情期间,该方案进行了调整以便在线提供,随后推荐给认知障碍与痴呆症中心的照料者。

结果

在基于互联网和现场干预这两种模式下,所有方面均有统计学上的显著改善(所有p值均<0.05)。关于基本痴呆症知识的问卷完成率达100%。此外,参与者报告的满意度为中等到高度,辍学率非常低(<3%)。

结论

这项试点研究的证据表明,两种条件下的照料者支持干预均显著改善了多个重要结果:它们在减轻照料者压力以及提高能力和知识方面显示出显著效果。事实上,心理教育干预有助于形成有效的应对策略以减轻照料者负担,使他们能够继续为亲人提供照料。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c76/11656952/d6d2c4bada05/12877_2024_5562_Fig1_HTML.jpg

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