Decreased mental health care utilization following a psychosocial intervention in caregivers of hematopoietic stem cell transplant patients.
Decreased mental health care utilization following a psychosocial intervention in caregivers of hematopoietic stem cell transplant patients.
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DOI：
10.4081/mi.2014.5120
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发表时间：
2014-03-04
期刊：
影响因子：
6.3
通讯作者：
Laudenslager ML
中科院分区：
文献类型：
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作者：
Ouseph R;Croy C;Natvig C;Simoneau T;Laudenslager ML
与非护理人员相比，护理人员的发病率增加。针对照顾者痛苦的干预是否会影响他们的医疗服务利用？148名异基因造血干细胞移植患者的护理者被随机分为常规治疗组（TAU）和心理教育、起搏呼吸和放松（PEPRR）干预组。在基线和移植后1个月、3个月和6个月收集护理人员服务利用的评估。在患者移植后的前30天内，护理人员的医疗和心理健康专业服务使用率下降，而支持小组的出勤率达到峰值。混合模型回归显示，PEPRR组的心理健康服务使用率显著下降（P=0.001）。在6个月时，TAU中的照顾者预测心理健康服务利用的边际概率是PEPRR中照顾者的10倍以上（18.1%对1.5%）。两组在医疗服务（P=0.861）或支持组（P=0.067）使用方面没有差异。我们可以得出结论，参与PEPRR相比，TAU与减少心理健康服务的利用。照顾者心理社会支持服务是改善照顾者结果的关键。
Caregivers are known to experience increased morbidity when compared to noncaregivers. Does an intervention targeting caregiver distress affect their health care utilization? One hundred forty-eight caregivers of allogeneic hematopoietic stem cell transplant patients were randomized to treatment as usual (TAU) or a psychoeducation, paced respiration, and relaxation (PEPRR) intervention. Assessments of caregivers’ service utilization were collected at baseline and 1, 3, and 6 months post-transplant. During the first 30 days after patient transplant, caregiver medical and mental health professional service use decreased while support group attendance peaked. Mixed model regressions showed a significant decrease in mental health service use by the PEPRR group (P=0.001). At six months caregivers in TAU had predicted marginal probabilities of mental health services utilization over 10 times as high as caregivers in PEPRR (18.1% vs 1.5%). Groups failed to differ in medical service (P=0.861) or support group (P=0.067) use. We can conclude that participation in PEPRR compared to TAU was associated with reduced mental health service utilization. Caregiver psychosocial support services are critical to improve caregiver outcomes.