Together from the start: A transdiagnostic framework for early dyadic interventions for neurodegenerative diseases.
Together from the start: A transdiagnostic framework for early dyadic interventions for neurodegenerative diseases.
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DOI：
10.1111/jgs.17801
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发表时间：
2022-06
影响因子：
6.3
通讯作者：
Vranceanu, Ana-Maria
中科院分区：
文献类型：
--
作者：
Bannon, Sarah M.;Grunberg, Victoria A.;Manglani, Heena R.;Lester, Ethan G.;Ritchie, Christine;Vranceanu, Ana-Maria
神经退行性疾病(NDDS)越来越普遍，并从根本上改变了个人及其非正式护理伙伴(统称为二人组)的生活。随着症状的发展，夫妻双方都面临着情绪困扰加剧、人际关系功能和生活质量下降的风险。在确诊后早期向二人组提供的心理社会干预措施成功地预防了包括癌症和急性脑损伤在内的几种慢性病的慢性情绪困扰。患有NDD的二联体可以从这种干预中受益，然而，它们是有限的。由于NDD具有不同于其他慢性病的症状特征，它们需要一个独特的框架和干预措施。考虑到有限的二元干预措施和整个NDD的统一症状，跨诊断框架可能有助于提高可扩展性和效率。为了解决这个问题，我们开发了一个跨诊断框架，该框架横跨NDD的身体诊断和情感诊断，为经济有效和可持续的NDD二元干预提供信息。为了建立这一框架，我们进行了：(1)对NDD患者的二元调节和现有的二元干预的叙述性回顾，以及(2)综合研究结果，为诊断后早期的二元干预开发我们的NDD跨诊断框架。结果显示，在诊断后不久，并不存在对NDDS的二元干预。在可用的干预措施中，所有干预措施都是在疾病进展的较晚阶段提供的，从而将重点放在更高级阶段的两难挑战上。此外，尽管研究强调了个体、二元和语境因素对双亲早期适应的影响，但还没有建立概念模型。在理论和当前研究的启发下，我们介绍了一个NDD跨诊断框架，用于夫妇的早期生物心理社会适应。这一框架包括NDD特有的：背景因素、疾病相关因素、个体和二元应激源、适应性应对策略和二元资源。我们的NDD跨诊断框架可用于为贯穿所有NDD的早期二元心理社会干预提供信息。这种方法对实现和可伸缩性具有重要影响。
Neurodegenerative diseases (NDDs) are increasingly prevalent and radically alter the lives of individuals and their informal care-partners (together called a dyad). As symptoms progress, dyads are at risk for elevated emotional distress and declines in relationship functioning and quality of life. Psychosocial interventions delivered to dyads early after diagnosis have successfully prevented chronic emotional distress across several chronic illnesses including cancer and acute brain injury. Dyads with NDD could benefit from such interventions, however, they are limited. Because NDDs have symptom profiles that are distinct from other chronic illnesses, they require a unique framework and interventions. Given the limited dyadic interventions and unified symptoms across NDDs, a transdiagnostic framework may help to enhance scalability and efficiency. To address this problem, we developed a transdiagnostic framework that cuts across NDD physical and emotional diagnoses to inform cost-effective and sustainable NDD dyadic interventions. To develop this framework, we conducted: (1) a narrative review on dyadic adjustment and existent dyadic interventions for those with NDDs, and (2) integrated findings to develop our NDD transdiagnostic framework for dyadic interventions early after diagnosis. Findings revealed no existent dyadic interventions for NDDs delivered shortly after diagnosis. Among available interventions, all were delivered later in disease progression, thereby focusing on dyadic challenges at more advanced stages. In addition, although research emphasized the influence of individual, dyadic, and contextual factors on dyads’ early adjustment to NDDs, no conceptual model has been developed. Informed by theory and current research, we introduce an NDD transdiagnostic framework for couples’ early biopsychosocial adjustment. This framework includes NDD specific: contextual factors, illness-related factors, individual and dyadic stressors, adaptive coping strategies, and dyads’ resources. Our NDD transdiagnostic framework can be used to inform early dyadic psychosocial interventions that cut across all NDDs. This approach has important implications for implementation and scalability.
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DOI：
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