Concordance of race or ethnicity of interventionists and caregivers of dementia patients: Relationship to attrition and treatment outcomes in the REACH study
Concordance of race or ethnicity of interventionists and caregivers of dementia patients: Relationship to attrition and treatment outcomes in the REACH study
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DOI：
10.1093/geront/46.4.449
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发表时间：
2006-08-01
期刊：
影响因子：
5.7
通讯作者：
Mercurio, Rocco
中科院分区：
文献类型：
--
作者：
McGinnis, Kathleen A.;Schulz, Richard;Mercurio, Rocco
目的：我们在一项多中心随机临床试验中评估了照顾者和干预者之间种族或民族一致性对照顾者流失、抑郁变化和负担变化的影响。设计和方法：从1996年到2000年，阿尔茨海默病患者的家庭照顾者被随机分为干预组和对照组。干预者提供心理社会干预，旨在减少照顾者的抑郁和负担。这项分析包括694名照顾者，他们接受了来自5个地点的36名干预者的面对面干预。我们通过使用随机效应logistic和线性回归模型，控制护理人员年龄、性别、种族或民族、与护理接受者的关系、干预主义者种族或民族以及护理接受者的日常生活活动，对护理人员在12个月时失访以及种族或民族一致性的抑郁和负担较基线的变化进行建模。失访模型也控制了护理接受者的机构化和死亡。结果：总的来说，在照顾者失访或抑郁或负担的变化方面，种族或民族一致性没有差异。与不同种族或民族的干预者相比，具有相同种族或民族的干预者的非裔美国人照顾者的抑郁症下降幅度更大。然而，这一发现必须谨慎解释，因为只有两个非洲裔美国人干预。含义：虽然这些初步的研究结果并没有提供决定性的证据，是否种族或民族的一致性与阿尔茨海默病患者的照顾者的干预结果，这些结果，沿着缺乏研究评估这个问题，表明种族或民族的一致性的影响，在研究中应系统地检查在未来的研究。
Purpose: We assess the effects of racial or ethnic concordance between caregivers and interventionists on caregiver attrition, change in depression, and change in burden in a multisite randomized clinical trial. Design and Methods: Family caregivers of patients with Alzheimer's disease were randomized to intervention or control groups at six sites from 1996 to 2000. Interventionists provided psychosocial interventions aimed at decreasing caregiver depression and burden. This analysis included 694 caregivers who received face-to-face interventions from 36 interventionists at five sites. We modeled caregiver loss to follow-up at 12 months and changes in depression and burden from baseline by racial or ethnic concordance by using random effects logistic and linear regression models, controlling for caregiver age, gender, race or ethnicity, relation to care recipient, interventionist race or ethnicity, and care recipient activities of daily living. The loss to follow-up model also controlled for care recipient institutionalization and death. Results: Overall, there was no difference in caregiver loss to follow-up or change in depression or burden by racial or ethnic concordance. African-American caregivers with an interventionist of the same race or ethnicity had greater decreases in depression than did African-American caregivers with interventionists of a different race or ethnicity. However, this finding has to be interpreted cautiously because there were only two African-American interventionists. Implications: Although these initial findings do not provide conclusive evidence on whether racial or ethnic concordance is associated with intervention outcomes for caregivers of Alzheimer's disease patients, these results, along with the paucity of research studies evaluating this issue, suggest that the effects of racial or ethnic concordance in research should be systematically examined in future studies.