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照护生态系统:提升痴呆症家庭照护者的自我效能感。

The Care Ecosystem: Promoting self-efficacy among dementia family caregivers.

机构信息

Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA.

Philip R. Lee Institute for Health Policy Studies; Global Brain Health Institute, University of California, San Francisco, CA, USA.

出版信息

Dementia (London). 2020 Aug;19(6):1955-1973. doi: 10.1177/1471301218814121. Epub 2018 Nov 29.

Abstract

OBJECTIVES

To illustrate specific psychosocial interventions aimed at improving self-efficacy among family caregivers enrolled in the Care Ecosystem, a model of navigated care designed to support persons with dementia and their primary caregivers. Enrolled family caregivers work with unlicensed care team navigators who are trained in dementia care and provide information, linkages to community resources, and emotional support by phone and email.

METHOD

We conducted focus groups and interviews with the care team navigators to identify the approaches they used to target caregiver self-efficacy. We assessed mean self-efficacy scores in a sample of 780 family caregivers and selected three exemplary cases in which the caregivers had low self-efficacy scores at baseline with significantly higher scores after six months of participation in the Care Ecosystem intervention.

RESULTS

Multiple psychosocial strategies were utilized by care team navigators working with patients with dementia and their family caregivers. Using thematic coding we identified three categories of Care Team Navigator intervention: emotional, informational, and instrumental support. These are consistent with a psychosocial approach to building self-efficacy.

DISCUSSION

Self-efficacy represents a family caregiver's knowledge and preparedness in managing the challenges of care. Psychosocial support shows benefit in improving caregiver self-efficacy that in turn, may positively influence caregiver health and well-being. The findings in this manuscript demonstrate how a model of navigated care can positively impact self-efficacy among dementia family caregivers.

摘要

目的

举例说明特定的心理社会干预措施,旨在提高参与护理生态系统的家庭照顾者的自我效能感,该系统是一种导航式护理模式,旨在为痴呆症患者及其主要照顾者提供支持。参与的家庭照顾者与未经许可的护理团队导航员合作,这些导航员接受过痴呆症护理方面的培训,通过电话和电子邮件提供信息、与社区资源建立联系,并提供情感支持。

方法

我们对护理团队导航员进行了焦点小组和访谈,以确定他们用于针对照顾者自我效能感的方法。我们评估了 780 名家庭照顾者样本中的平均自我效能感得分,并选择了三个具有代表性的案例,这些案例中的照顾者在基线时的自我效能感得分较低,但在参与护理生态系统干预六个月后得分显著提高。

结果

护理团队导航员与痴呆症患者及其家庭照顾者合作时,采用了多种心理社会策略。通过主题编码,我们确定了护理团队导航员干预的三个类别:情感、信息和工具支持。这些与建立自我效能感的心理社会方法一致。

讨论

自我效能感代表了家庭照顾者在应对护理挑战方面的知识和准备。心理社会支持表明可以改善照顾者的自我效能感,从而可能对照顾者的健康和幸福产生积极影响。本文档中的研究结果表明,导航式护理模式如何能够积极影响痴呆症家庭照顾者的自我效能感。

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