Internet-Based Supportive Interventions for Family Caregivers of People With Dementia: Systematic Review and Meta-Analysis.
Internet-Based Supportive Interventions for Family Caregivers of People With Dementia: Systematic Review and Meta-Analysis.
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DOI：
10.2196/19468
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发表时间：
2020-09-09
影响因子：
7.4
通讯作者：
Wang Z
中科院分区：
文献类型：
--
作者：
Leng M;Zhao Y;Xiao H;Li C;Wang Z
照顾痴呆症患者被认为是最有压力和最困难的照顾形式之一。家庭照顾者总是经历高度的心理负担和身体紧张，因此有效和实际的支持至关重要。基于互联网的支持性干预措施可以提供方便和有效的支持和教育，以潜在地减少与提供护理相关的身心负担。本综述旨在（1）评估基于互联网的支持性干预措施在改善痴呆症患者家庭照顾者健康结局方面的有效性，（2）评估照顾者获得基于互联网的支持性干预措施对其照顾对象的潜在影响。截至2020年1月，对PubMed、EMBASE、Web of Science、CINAHL、科克伦图书馆和PsycINFO数据库进行了电子文献检索。两名评审员（ML和YZ）独立工作，以确定符合纳入标准的随机对照试验（RCT），并独立提取数据。采用科克伦干预措施系统评价手册推荐的方法评价纳入的RCT的质量。采用标准化均值差（SMD）和95% CI计算合并效应量。共有17项RCT符合合格标准，并被纳入本系统性综述。荟萃分析表明，基于互联网的支持性干预措施显着改善抑郁症状（SMD=-0.21; 95% CI -0.31 to -0.10; P<.001），感知压力（SMD=-0.40; 95%CI-0.55 to -0.24; P<.001）、焦虑（SMD=-0.33; 95%CI-0.51 to -0.16; P<.001）和自我效能（SMD=0.19; 95%CI 0.05-0.33; P=.007）。在照顾者负担、应对能力、照顾者对行为症状的反应或生活质量方面没有发现显著改善。六项研究评估了基于互联网的支持性干预措施对照顾者的意外影响。结果显示，以网际网路为基础的支援性介入对照护对象的生活品质及神经精神症状有潜在的效益。基于互联网的支持性干预措施通常能有效改善痴呆症护理人员的抑郁症状、感知压力、焦虑和自我效能，并对护理对象有潜在的益处。鼓励未来的研究采用个性化的基于互联网的支持性干预措施，以改善家庭照顾者及其照顾对象的健康。PROSPERO CRD 42020162434; https://www.crd.york.ac.uk/prospero/display_record.php?记录ID =162434
Caring for people with dementia is perceived as one of the most stressful and difficult forms of caring. Family caregivers always experience high levels of psychological burden and physical strain, so effective and practical support is essential. Internet-based supportive interventions can provide convenient and efficient support and education to potentially reduce the physical and psychological burden associated with providing care. This review aimed to (1) assess the efficacy of internet-based supportive interventions in ameliorating health outcomes for family caregivers of people with dementia, and (2) evaluate the potential effects of internet-based supportive intervention access by caregivers on their care recipients. An electronic literature search of the PubMed, EMBASE, Web of Science, CINAHL, Cochrane Library, and PsycINFO databases was conducted up to January 2020. Two reviewers (ML and YZ) worked independently to identify randomized controlled trials (RCTs) that met the inclusion criteria and independently extracted data. The quality of the included RCTs was evaluated using the approach recommended by the Cochrane Handbook for Systematic Reviews of Interventions. Standardized mean differences (SMDs) with 95% CIs were applied to calculate the pooled effect sizes. In total, 17 RCTs met the eligibility criteria and were included in this systematic review. The meta-analysis showed that internet-based supportive interventions significantly ameliorated depressive symptoms (SMD=–0.21; 95% CI –0.31 to –0.10; P<.001), perceived stress (SMD=–0.40; 95% CI –0.55 to –0.24; P<.001), anxiety (SMD=–0.33; 95% CI –0.51 to –0.16; P<.001), and self-efficacy (SMD=0.19; 95% CI 0.05-0.33; P=.007) in dementia caregivers. No significant improvements were found in caregiver burden, coping competence, caregiver reactions to behavioral symptoms, or quality of life. Six studies assessed the unintended effects of internet-based supportive intervention access by caregivers on their care recipients. The results showed that internet-based supportive interventions had potential benefits on the quality of life and neuropsychiatric symptoms in care recipients. Internet-based supportive interventions are generally effective at ameliorating depressive symptoms, perceived stress, anxiety, and self-efficacy in dementia caregivers and have potential benefits on care recipients. Future studies are encouraged to adopt personalized internet-based supportive interventions to improve the health of family caregivers and their care recipients. PROSPERO CRD42020162434; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=162434
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