Lee Cheng-Ya, Jeon Yun-Hee, Watson Karen
Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
J Adv Nurs. 2025 Oct;81(10):6281-6297. doi: 10.1111/jan.16815. Epub 2025 Feb 12.
To examine the role and impact of carer involvement in rehabilitation for community-dwelling individuals with dementia, focusing on cognitive stimulation therapy, cognitive rehabilitation, cognitive training, cognitive behavioural therapy, and exercise.
A systematic review and synthesis without meta-analysis.
Five electronic databases, reference lists, and citations were searched (2017-2024), targeting primary research that reported results concerning one or more of those five focused rehabilitation interventions for people with dementia and their carers.
Results were synthesised using narrative approaches. The Cochrane Risk of Bias Tool and the Mixed Methods Appraisal Tool were used to appraise the quality of included studies.
Forty-one studies (12 main trials, 22 pilot studies, and 7 sub-studies) were included. While the patterns between carer involvement level and types of rehabilitation were observed, their relationship to intervention effectiveness was unclear. High carer involvement in cognitive stimulation therapy and exercise was associated with improved cognition and quality of life for people with dementia and better health-related quality of life for carers. Pilot studies showed mixed but generally positive trends, with increased depressive symptoms in carers needing further investigation. Qualitative findings highlighted social interaction and improved caregiving knowledge as key enablers to positive experiences, whereas lack of motivation was the main barrier to rehabilitation engagement.
This review identified several patterns between the level of carer involvement and intervention types. However, the mechanism underlying different involvement levels and rehabilitation success remains unclear. More rigorous research is needed to determine the relationship between carer involvement and the effects of rehabilitation interventions on supporting the independence of people with dementia.
This review enhanced the understanding of carers' roles and impacts in supporting dementia rehabilitation and possible links to optimal health outcomes.
Synthesis Without Meta-analysis (SWiM) reporting guideline.
No patient/public contribution.
探讨照顾者参与对社区居住的痴呆症患者康复的作用和影响，重点关注认知刺激疗法、认知康复、认知训练、认知行为疗法和运动。
无荟萃分析的系统评价与综合分析。
检索了五个电子数据库、参考文献列表和引用文献（2017 - 2024年），目标是关于痴呆症患者及其照顾者的上述五种重点康复干预措施中一种或多种的主要研究报告结果。
采用叙述性方法综合结果。使用Cochrane偏倚风险工具和混合方法评估工具评估纳入研究的质量。
纳入41项研究（12项主要试验、22项试点研究和7项子研究）。虽然观察到了照顾者参与水平与康复类型之间的模式，但它们与干预效果的关系尚不清楚。照顾者高度参与认知刺激疗法和运动与痴呆症患者认知和生活质量的改善以及照顾者与健康相关生活质量的提高有关。试点研究呈现出好坏参半但总体呈积极的趋势，照顾者抑郁症状增加需要进一步研究。定性研究结果强调社会互动和护理知识的改善是积极体验的关键促成因素，而缺乏动力是康复参与的主要障碍。
本综述确定了照顾者参与水平与干预类型之间的几种模式。然而，不同参与水平与康复成功之间的潜在机制仍不清楚。需要更严格的研究来确定照顾者参与与康复干预对支持痴呆症患者独立性的影响之间的关系。
本综述增进了对照顾者在支持痴呆症康复中的作用和影响以及与最佳健康结果可能联系的理解。
无荟萃分析综合报告（SWiM）指南。
无患者/公众贡献。
