Outcomes From the Resources for Enhancing Alzheimer's Caregiver Health (REACH) Program for Bereaved Caregivers
Outcomes From the Resources for Enhancing Alzheimer's Caregiver Health (REACH) Program for Bereaved Caregivers
复制标题
DOI：
10.1037/a0014303
复制
发表时间：
2009-03-01
影响因子：
3.7
通讯作者：
Gallagher-Thompson, Dolores
中科院分区：
文献类型：
--
作者：
Holland, Jason M.;Currier, Joseph M.;Gallagher-Thompson, Dolores
尽管在过去的研究中，针对失去亲人的人的预防措施并未被证明特别有效，但有人认为，由于短期后续评估等方法问题，干预效果可能被低估。因此，本研究旨在通过对失去亲人的照顾者进行长期随访评估，评估增强阿尔茨海默病照顾者健康资源 (REACH) 干预措施在预防复杂悲伤、正常悲伤和抑郁症状方面的功效（作为整个干预方案和作为组成部分）（N = 224）。平均而言，积极干预措施对正常悲伤症状有统计学显着影响（d = 0.28），对复杂悲伤症状有改善趋势（d = 0.25），对抑郁症状影响不大（d = 0.09）。有趣的是，对干预成分的检查揭示了不同的效果，其中认知和行为策略对于降低复杂悲伤水平最有效，信息和情感支持对于解决正常悲伤最有效，而环境改变对于改善抑郁症状最有效。这些发现表明，根据护理人员独特的临床表现和风险因素的组合，可能需要采取不同的损失前干预措施。
Although preventive efforts for bereaved individuals have not been shown to be particularly effective in past studies, it has been suggested that intervention effects might be underestimated due to methodological issues such as short follow-up assessments. Thus, the present study aimed to assess the efficacy (as whole intervention packages and as component parts) of the Resources for Enhancing Alzheimer's Caregiver Health (REACH) interventions in preventing complicated grief, normal grief, and depressive symptoms at a longer term follow-up assessment among bereaved caregivers (N = 224). On average, active interventions showed a statistically significant effect on normal grief symptoms (d = 0.28), exhibited a trend toward improvement on complicated grief symptoms (d = 0.25), and demonstrated little impact on depressive symptoms (d = 0.09). Interestingly, the examination of intervention components revealed differential effects, whereby cognitive and behavioral strategies were most effective at reducing levels of complicated grief, information and emotional support were most effective for addressing normal grief, and environmental modifications were most effective for ameliorating depressive symptoms. These findings suggest that different preloss interventions might be warranted depending on a caregiver's unique clinical presentation and combination of risk factors.