Group multi‐component programme based on cognitive behavioural therapy and positive psychology for family caregivers of people with dementia: a randomised controlled study ( 3C study)
Group multi‐component programme based on cognitive behavioural therapy and positive psychology for family caregivers of people with dementia: a randomised controlled study ( 3C study)
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基于认知行为疗法和积极心理学的针对痴呆症患者家庭照顾者的团体多成分计划：一项随机对照研究（3C研究）
DOI：
10.1111/psyg.12919
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发表时间：
2022
期刊：
影响因子：
2
通讯作者：
Fujisawa Daisuke
中科院分区：
文献类型：
--
作者：
Tamura Noriko Takasaki;Shikimoto Ryo;Nagashima Kengo;Sato Yasunori;Nakagawa Atsuo;Irie Sachiko;Iwashita Satoru;Mimura Masaru;Fujisawa Daisuke
背景痴呆症患者的照顾者经常经历更高水平的心理痛苦和负担。本研究旨在检验以认知行为疗法和积极心理学为基础的团体形式多组分方案的有效性。方法将痴呆症家庭照顾者按1：1分配到干预组和等待名单对照组，按年龄(<；65 岁，≥65 岁)和照顾状况(在家或在机构)分层。干预组接受了为期6个疗程、为期10周的小组形式的方案。主要结果是医院焦虑抑郁量表(HADS)。次要结果是Zarit负担访谈的简短版本(个人压力和角色压力)、神经精神病学问卷、痴呆症照顾者积极情感量表和自我同情反应问卷。在基线、10 周(干预后)和14 周(随访)进行评估。结果对登记的参与者进行了分析。在整个样本中，未观察到对HADS的显著影响。对角色应变的影响中等(P=0.04，偏η2=0.08)。积极的照顾感觉在干预后有所增加，但在随访中没有保持。在65岁以下照顾者的分组分析中，观察到个人压力的影响具有统计学意义(P=0.03，偏η2= 0.16)。护理积极感受总分(P<； 0.0 5，Partialη2= 0.0 2)和护理意义(P=0.0 2，部分η2= 0.10)之间存在交互作用。结论该项目对痴呆症患者照顾者的抑郁和焦虑情绪没有明显改善，但减轻了他们的角色冲突负担(角色紧张)，对参与者的积极情感和护理意义有较好的短期效果。此外，该方案有效地减轻了65 岁以下照顾者的个人压力。
BackgroundCaregivers of people with dementia frequently experience an elevated level of psychological distress and burden. This study aimed to examine the effectiveness of a group‐format multi‐component programme which is based on cognitive behavioural therapy and positive psychology.MethodsFamily caregivers of dementia were allocated (1:1) to the intervention group and the wait‐list control group, stratified by age (<65 years, ≥65 years) and care status (at home or in an institution). The intervention group received a six‐session, 10‐week, group‐format programme. The primary outcome was the Hospital Anxiety Depression Scale (HADS). Secondary outcomes were the short‐version of the Zarit Burden Interview (personal strain and role strain), Neuropsychiatric Inventory Questionnaire, Dementia Caregiver Positive Feeling Scale, and Self‐Compassionate Reactions Inventory. The evaluations were conducted at baseline, 10 weeks (post‐intervention), and 14 weeks (follow‐up).ResultsThe analyses were performed with 64 registered participants. In the whole sample, no significant effect was observed on HADS. There was medium effect on role strain (P= 0.04, partial η2= 0.08). Positive feelings of caregiving increased after the intervention but were not maintained at follow‐up. In the subgroup analysis of caregivers under 65 years of age, a statistically significant effect was observed for personal strain (P= 0.03, partial η2= 0.16). An interaction effect was also found for the total score of positive feelings of caregiving (P< 0.05, partial η2= 0.02) and the meaning of caregiving (P= 0.02, partial η2= 0.10).ConclusionsThis programme did not show significant improvement in depression and anxiety of caregivers of dementia; however, it reduced the burden of their role conflict (role strain) and yielded favourable short‐term effects on the positive feelings and the meaning of caregiving among the participants. Also, the programme effectively reduced the personal strain of caregivers under 65 years.