Systematic Review of the Evidence for Stroke Family Caregiver and Dyad Interventions.
Systematic Review of the Evidence for Stroke Family Caregiver and Dyad Interventions.
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DOI：
10.1161/strokeaha.121.034090
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发表时间：
2022-06
期刊：
影响因子：
8.3
通讯作者：
Miller, Elaine L.
中科院分区：
文献类型：
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作者：
Bakas, Tamilyn;McCarthy, Michael J.;Miller, Elaine L.
在过去的几年里，中风家庭照顾者和二人组的文学作品已经扩大了。本综述的目的是建立在先前的两个系统评价的基础上，以评价、分析和综合有关家庭照料者和DYAD干预对中风幸存者和家庭照顾者结局的影响的证据。从2016年12月1日到2021年3月31日，搜索了CINAHL、心理信息、PubMed和参考文献列表。使用PRISMA指南，确定了测试中风家庭照顾者或针对家庭照顾者的健康或福祉的二元干预措施的结果的文章。这些文章的数据被抽象成表格进行分析，然后与前两次系统审查提出的建议进行比较。共有18篇文章符合纳入标准(10名护理者干预；8名二联体干预)，样本大小从7到349名护理者或双联体不等。多数为随机对照试验(n=13)；2为整群随机试验；3为单组准实验设计。在18项研究中，8项研究的照顾者或二人组少于50人，5项是小型可行性研究，报告了数据趋势，而不是测试重要性。只有6项研究报告了显著的生存结果。11项研究报告了照顾者的显著结果，其中最常见的是负担。许多幸存者和照顾者的结果并不显著，或者只对某些亚组有显著意义。研究数量有限，样本量小，结果相互矛盾，因此很难就这些干预措施对结果的影响得出明确的结论。根据这18项研究的现有证据，先前两次审查的建议普遍得到支持。仍需要设计良好、功能强大的随机对照临床试验来证实卒中家庭照顾者和双亲干预的有效性。
Stroke family caregiver and dyad literature has expanded over the past few years. The purpose of this review was to build upon two prior systematic reviews to critique, analyze, and synthesize the evidence pertaining to the impact of family caregiver and dyad interventions on stroke survivor and family caregiver outcomes. CINAHL, PsychINFO, PubMed, and reference lists were searched from December 1, 2016 through March 31, 2021. Using PRISMA guidelines, articles were identified that tested outcomes from stroke family caregiver or dyad interventions that targeted the health or well-being of family caregivers. Data from the articles were abstracted into tables for analysis, then compared with recommendations from the two prior systematic reviews. A total of 18 articles met inclusion criteria (10 caregiver interventions; 8 dyad interventions) representing sample sizes ranging from 7 to 349 caregivers or dyads. Most were randomized controlled trials (n=13); 2 were cluster randomized trials; and 3 were single-group quasi-experimental designs. Of the 18 studies, 8 had less than 50 caregivers or dyads, and 5 were small feasibility studies that reported data trends rather than testing for significance. Only 6 studies reported significant survivor outcomes. Eleven studies reported significant caregiver outcomes, the most common being burden. A number of survivor and caregiver outcomes were not significant, or only significant for certain subgroups. The limited number of studies, small sample sizes, and conflicting results, made it difficult to draw firm conclusions regarding the impact of these interventions on outcomes. Based on the available evidence from these 18 studies, recommendations from the two prior reviews were generally supported. Well-designed and well-powered randomized controlled clinical trials are still needed to confirm efficacy of stroke family caregiver and dyad interventions.