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支持家庭痴呆症护理者:测试痴呆症护理管理对多方面护理者负担的疗效。

Supporting family dementia caregivers: testing the efficacy of dementia care management on multifaceted caregivers' burden.

机构信息

a German Center for Neurodegenerative Diseases (DZNE) , Site Rostock/Greifswald , Germany.

b Department Epidemiology of Health Care and Community Health, Institute For Community Medicine , University Medicine Greifswald , Greifswald , Germany.

出版信息

Aging Ment Health. 2018 Jul;22(7):889-896. doi: 10.1080/13607863.2017.1399341. Epub 2017 Nov 20.

Abstract

OBJECTIVES

Current research suggests that dementia care management (DCM) can decrease burden and associated health impairments of caregivers. The objective of this secondary analysis is to investigate the impact of DCM on multifaceted caregivers' burden dimensions by differentiating between objective and subjective burden.

METHODS

A sample of n = 317 dyads of caregivers and community-dwelling people with dementia (PwD) participated in a general practitioner-based, cluster-randomized intervention trial (Identifier:NCT01401582) with two arms and comprehensive data assessment at baseline and 12-month follow-up. Data provided by the caregiver included an inventory with 88 items in 20 different dimensions.

RESULTS

Caregivers in the intervention 'DCM' group showed decreased caregiver burden, especially in caregivers' objective burden due to caring (i.e. emotional support), caregivers' subjective burden due to behavior change (i.e. cognition, aggression and resistance, depression, late symptoms) and caregivers' subjective burden due to perceived conflicts between needs and responsibilities to care (i.e. financial losses) compared to caregivers in the control 'care as usual' group, which showed significant increased caregiver burden after 12 months.

CONCLUSION

Our findings support evidence for the effectiveness of DCM to lower family dementia caregivers' burden in multifaceted dimensions.

摘要

目的

目前的研究表明,痴呆症护理管理(DCM)可以减轻护理人员的负担和相关的健康损害。本二次分析的目的是通过区分客观和主观负担来研究 DCM 对多方面护理人员负担维度的影响。

方法

一组 n = 317 名护理人员和居住在社区的痴呆症患者(PwD)的对参与了一项基于全科医生的、集群随机干预试验(标识符:NCT01401582),该试验有两个组,在基线和 12 个月随访时进行全面的数据评估。护理人员提供的数据包括一份包含 20 个不同维度的 88 个项目的清单。

结果

干预组“DCM”的护理人员的护理人员负担减轻,特别是在护理人员因照顾而产生的客观负担(即情感支持)、护理人员因行为改变而产生的主观负担(即认知、攻击和抵抗、抑郁、晚期症状)以及护理人员因照顾需求和责任之间的感知冲突而产生的主观负担(即经济损失)方面,而对照组“常规护理”组的护理人员在 12 个月后负担显著增加。

结论

我们的发现支持了 DCM 降低家庭痴呆症护理人员多方面负担的有效性证据。

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