Effects of the home Environmental Skill-Building Program on the caregiver-care recipient dyad: 6-month outcomes from the Philadelphia REACH initiative
Effects of the home Environmental Skill-Building Program on the caregiver-care recipient dyad: 6-month outcomes from the Philadelphia REACH initiative
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DOI：
10.1093/geront/43.4.532
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发表时间：
2003-08-01
期刊：
影响因子：
5.7
通讯作者：
Hauck, WW
中科院分区：
文献类型：
--
作者：
Gitlin, LN;Winter, L;Hauck, WW
目的：我们研究了6个月的环境技能建设计划对照顾者的福祉和照顾对象的功能，以及是否影响照顾者的性别，种族（白色或非白色）和关系（配偶或非配偶）。设计和方法：我们招募了255名社区老年痴呆症或相关疾病患者的家庭照顾者，其中190人参加了随访。护理人员被随机分配到常规护理对照组或干预组，接受职业治疗师的五个家庭联系和一个电话联系，职业治疗师提供教育，解决问题的培训和自适应设备。基线和6个月的随访包括自我报告的措施，照顾者的客观和主观负担，照顾者的幸福感，和照顾对象的问题行为和身体功能。结果如下：与对照组（n = 101）相比，干预照顾者（n = 89）报告与记忆相关的行为，更少的需要别人的帮助，更好的影响。干预配偶报告说，他们对破坏性行为的不满程度较低;男性报告说，他们在日常监督上花费的时间较少;与对照组相比，女性报告说，他们对他人帮助的需求较少，影响力更好，管理能力、整体幸福感和掌握能力也有所增强。在帮助工具性日常生活活动的小时数、提供工具性日常生活活动和日常生活活动帮助的不安、躯体症状的感知变化、白色与非白色护理者或护理接受者结局方面，未发现统计学显著性治疗差异。含义：环境技能建设方案减轻了某些领域的负担，提高了照料者的福祉，并为妇女和配偶带来了额外的好处。
Purpose: We examine 6-month effects of the Environmental Skill-Building Program on caregiver wellbeing and care recipient functioning and whether effects vary by caregiver gender, race (White or non-White), and relationship (spouse or nonspouse). Design and Methods: We enrolled 255 family caregivers of community-residing persons with Alzheimer's disease or related disorders, of whom 190 participated in a follow-up interview. Caregivers were randomized to a usual care control group or intervention group that received five home contacts and one telephone contact by occupational therapists, who provided education, problem-solving training, and adaptive equipment. Baseline and 6-month follow-up included self-report measures of caregiver objective and subjective burden, caregiver well-being, and care recipient problem behaviors and physical function. Results: Compared with controls (n = 101), intervention caregivers (n = 89) reported less upset with memory-related behaviors, less need for assistance from others, and better affect. Intervention spouses reported less upset with disruptive behaviors; men reported spending less time in daily oversight; and women reported less need for help from others, better affect, and enhanced management ability, overall well-being, and mastery relative to control group counterparts. Statistically significant treatment differences were not found for hours helping with instrumental activities of daily living, upset with providing assistance with instrumental activities of daily living and activities of daily living, perceived change in somatic symptoms, White versus non-White caregivers, or care recipient outcomes. Implications: The Environmental Skill-Building Program reduces burden and enhances caregiver wellbeing in select domains and has added benefit for women and spouses.