Effects of guided care on family caregivers.
Effects of guided care on family caregivers.
复制标题
指导护理对家庭护理人员的影响。
DOI：
10.1093/geront/gnp124
复制
发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Boult,Chad
中科院分区：
文献类型：
--
作者：
Wolff,JenniferL;Giovannetti,ErinR;Boyd,CynthiaM;Reider,Lisa;Palmer,Sara;Scharfstein,Daniel;Marsteller,Jill;Wegener,StephenT;Frey,Katherine;Leff,Bruce;Frick,KevinD;Boult,Chad
目的：引导护理 (GC) 是一种针对多病种老年人的医疗保健模式，由与患者的初级保健医生 (PCP) 合作的注册护士提供。本研究的目的是确定 GC 是否可以改善患者主要护理人员的抑郁症状、压力、工作效率以及对护理接受者慢性病护理质量的看法。 设计和方法：在 14 个 PCP 团队中进行了一项 GC 整群随机对照试验。研究样本包括 196 名主要护理人员，他们完成了基线调查和 18 个月的调查，其护理对象仍然活着并参加了 GC 研究 18 个月。护理人员结果包括以下内容：抑郁症状（流行病学研究中心抑郁量表）、紧张（改良护理人员紧张指数）、护理接受者的慢性病护理质量[慢性病护理患者评估（PACIC）]和个人生产力（工作生产力和活动障碍调查问卷，适用于护理）。结果：在多元回归模型中，抑郁、紧张、工作生产力和常规活动生产力的组间差异在治疗后不具有统计学意义。 18 个月，但 GC 护理人员报告其接受者慢性病护理的整体质量明显更高（调整后的 beta = 0.40，95% 置信区间：0.14–0.67）。 5 个 PACIC 分量表中的 4 个分量表的质量显着较高，反映了目标设定、护理协调、决策支持和患者激活等维度。 意义：GC 提高了多病护理接受者接受的慢性疾病护理的质量，但没有改善护理人员的抑郁症状、情感或工作效率。
Purpose:Guided Care (GC) is a model of health care for multimorbid older adults that is provided by a registered nurse who works with the patients’ primary care physician (PCP). The purpose of this study was to determine whether GC improves patients’ primary caregivers’ depressive symptoms, strain, productivity, and perceptions of the quality of care recipients’ chronic illness care.Design and Methods:A cluster-randomized controlled trial of GC was conducted within 14 PCP teams. The study sample included 196 primary caregivers who completed baseline and 18-month surveys and whose care recipients remained alive and enrolled in the GC study for 18 months. Caregiver outcomes included the following: depressive symptoms (Center for Epidemiological Studies-Depression scale), strain (Modified Caregiver Strain Index), the quality of care recipients’ chronic illness care [Patient Assessment of Chronic Illness Care (PACIC)], and personal productivity (Work Productivity and Activity Impairment questionnaire, adapted for caregiving).Results:In multivariate regression models, between-group differences in depression, strain, work productivity, and regular activity productivity were not statistically significant after 18 months, but GC caregivers reported the overall quality of their recipients’ chronic illness care to be significantly higher (adjusted beta = 0.40, 95% confidence interval : 0.14–0.67). Quality was significantly higher in 4 of 5 PACIC subscales, reflecting the dimensions of goal setting, coordination of care, decision support, and patient activation.Implications:GC improved the quality of chronic illness care received by multimorbid care recipients but did not improve caregivers’ depressive symptoms, affect, or productivity.