Benefit-Finding Intervention for Alzheimer Caregivers: Conceptual Framework, Implementation Issues, and Preliminary Efficacy
Benefit-Finding Intervention for Alzheimer Caregivers: Conceptual Framework, Implementation Issues, and Preliminary Efficacy
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DOI：
10.1093/geront/gnu018
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发表时间：
2014-12-01
期刊：
影响因子：
5.7
通讯作者：
Lam, Linda C. W.
中科院分区：
文献类型：
--
作者：
Cheng, Sheung-Tak;Lau, Rosanna W. L.;Lam, Linda C. W.
目的：在一项小型随机试验中，描述一种促进阿尔茨海默病护理人员获益的干预措施，讨论实施中的关键问题和解决方法，并检查干预措施是否减轻了负担和抑郁。设计与方法：25名护理人员随机分为获益组和心理教育组。两组都有8周的疗程。结果测量包括角色过载、Zarit负担访谈和汉密尔顿抑郁量表在基线和治疗后收集。采用协方差分析对结果进行分析。此外，还定性地分析了实施这些干预措施的挑战，其中一些与文化问题有关。结果：在控制前测的情况下，尽管一些照顾者发现寻找益处具有挑战性，但在后测中，积极寻找组的抑郁程度低于心理教育组。两组在负荷和负担上没有差异。然而，组内分析表明，从测试前到测试后，两组的负荷都显著减少。此外，我们还讨论了参与者在掌握益找思维修正技巧方面的困难，并在家中记录了这些练习，并在小组中分享了他们的想法和经验。我们描述了在主要试验中为克服这些问题所采取的措施。结论：关注利益发现的认知方法在中国照顾者中是可行的，初步证据表明对缓解抑郁有效果。
Purpose: To describe an intervention promoting benefit-finding in Alzheimer caregivers, to discuss key issues in implementation and ways to resolve them, and to examine whether the intervention reduced burden and depression in a small randomized trial. Design and Methods: Twenty-five caregivers were randomized into benefit-finding and psychoeducation groups. Both groups had eight weekly sessions. Outcome measures including role overload, Zarit Burden Interview, and Hamilton depression scale were collected at baseline and after treatment. Results were analyzed using analysis of covariance. Additionally, the challenges of implementing such interventions, some of which related to cultural issues, were analyzed qualitatively. Results: Controlling for pretest, the benefit-finding group had lower depression than the psychoeducation group at post-test, despite the fact that some caregivers found benefit-finding challenging. The two groups did not differ on overload and burden. However, within-group analysis suggested that both groups showed significant reductions in overload from pretest to post-test. In addition, we discussed participants' difficulties in grasping the technique of thought modification for benefit-finding, recording such exercises at home, and sharing their thoughts and experiences in groups. We described measures undertaken in the main trial to overcome these issues. Implications: Cognitive approaches focusing on benefit-finding are feasible among Chinese caregivers, with preliminary evidence suggesting an effect on alleviating depression.