Background characteristics and treatment-related factors associated with treatment success or failure in a non-pharmacological intervention for dementia caregivers.
Background characteristics and treatment-related factors associated with treatment success or failure in a non-pharmacological intervention for dementia caregivers.
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DOI：
10.1017/s1041610217000205
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发表时间：
2017-06
影响因子：
7
通讯作者：
Gitlin LN
中科院分区：
文献类型：
--
作者：
Rose KC;Gitlin LN
对痴呆症患者的非药物干预往往依赖于家庭护理人员来实施。然而，照顾者在使用策略的准备程度上有所不同。本研究探讨了在高级护理人员培训（ACT）干预结束时，与治疗成功（高准备使用策略）和失败（低准备使用策略）相关的二元特征和治疗相关机制。在110名护理人员的干预中，对护理人员和痴呆患者的特征和治疗相关变量（治疗参与，引入和制定的策略的数量和类型）进行了检查。干预者在最后一次ACT会议上对护理人员使用策略的准备程度进行了评分（1=预先考虑; 2=考虑; 3=准备; 4=行动）。单变量分析检查了二元特征，多元协方差分析（MANCOVA）和协方差分析（ANCOVA）检查了与治疗完成时准备使用策略相关的治疗相关因素。在治疗完成时，28.2%（N=31）在行动前评分，71.8%（N=79）在行动时评分。行动前准备水平的照顾者比行动中的照顾者更有可能成为配偶，报告更大的经济困难，管理更少的问题行为。虽然这两个群体都引入了同等数量的非药物策略，照顾者在行动前不太可能比那些在行动报告制定策略。某些二元特征和治疗相关因素与治疗失败相关，包括财务紧张和缺乏策略整合。研究结果表明，制定干预措施，以解决财务问题，并增加实践策略的机会，然后在治疗期间使用它们可能是重要的护理人员在治疗失败的风险。
Non-pharmacological interventions for persons with dementia often rely on family caregivers for implementation. However, caregivers differ in their readiness to use strategies. This study examines dyadic characteristics and treatment-related mechanisms associated with treatment success (high readiness to use strategies) and failure (low readiness to use strategies) at the conclusion of the Advancing Caregiver Training (ACT) intervention. Caregiver and person with dementia characteristics and treatment-related variables (treatment participation, number and type of strategies introduced and enacted) were examined in 110 caregivers in intervention. Interventionists rated readiness (1=precontemplation; 2=contemplation; 3=preparation; 4=action) of caregivers to use strategies at the final ACT session. Univariate analyses examined dyadic characteristics, and Multiple Analysis of Covariance (MANCOVA) and Analyses of Covariance (ANCOVA) examined treatment-related factors associated with readiness to use strategies at treatment completion. At treatment completion, 28.2% (N=31) scored in pre-action and 71.8% (N=79) at action. Caregivers at pre-action readiness levels were more likely than those at action to be a spouse, report greater financial difficulties and be managing fewer problem behaviors. Although both groups were introduced an equivalent number of non-pharmacological strategies, caregivers at pre-action were less likely than those at action to report enacting strategies. Certain dyadic characteristics and treatment-related factors were associated with treatment failure including financial strain and lack of strategy integration. Findings suggest that developing intervention components to address financial concerns and increase opportunities for practicing strategies and then using them between treatment sessions may be important for caregivers at risk of treatment failure.