INTERVENTIONS TO CHANGE CAREGIVING AND AD PATIENT OUTCOM

这是对1989年10月1日提交审查的提案的修订。 这项为期5年的干预研究的主要目标是评估 治疗计划的有效性，为护理人员提供技能， 有必要改变他们的配偶与阿尔茨海默氏症的问题行为 疾病，一种教会他们管理自己情感的干预， 应对挑战，以及将两者结合起来的干预措施 治疗策略。 在对照顾者进行心理社会评估后， 患者的认知和行为评估，80名护理人员/患者配对 将被分配到四个干预条件之一：（1）行为 管理技能培训（BM）旨在改变最频繁和/或 患者表现出的压力诱导问题;（2）情感性自我- 管理培训（ASM），旨在教照顾者增加愉快的 活动，减轻压力，增强积极情绪;（3）组合行为 管理技能和情感自我管理培训（COM），以评估 以患者和患者为中心的干预措施的任何叠加效应; 和（4）等待名单控制（WL），其中与培训师和一般 通过“友好访问，“每次干预 条件将运行12周;将在 第1周和第13周，以及第2-11周的训练。 所有参与者都有 干预周期后3个月和6个月重新评估。 工作组将 在许多护理人员和患者结局指标上进行比较，包括 照顾者表达压力，负担，自我效能，愤怒， 抑郁症，以及患者行为过度和缺陷的频率。

This is a revision of a proposal submitted for review on October 1, 1989. The major goal of this 5 year intervention study is to assess the relative efficacy of a treatment program that provides caregivers with the skills necessary to change the problem behaviors of their spouse with Alzheimer's Disease, an intervention which teaches them to manage their own affective responses to caregiving challenges, and an intervention which combines both treatment strategies. Following psychosocial assessment of caregivers and cognitive and behavioral assessment of patients, 80 caregiver/patient dyads will be assigned to one of four intervention conditions: (1) behavior management skills training (BM) designed to change the most frequent and/or stress inducing problems exhibited by the patient; (2) affective self- management training (ASM) designed to teach caregivers to increase pleasant activities, reduce stress, and enhance positive mood; (3) combined behavior management skills and affective self-management training (COM) to assess any additive effects of both patient- and caregiver-focused intervention; and (4) wait-list control (WL) in which contact with trainers and general information will be provided through "friendly visits." Each intervention condition will run for 12 weeks; pre- and post-assessments will occur in Weeks 1 and 13, and training in Weeks 2-11. All participants will be reassessed 3- and 6-months after the intervention cycle. The groups will be compared on a number of caregiver and patient outcome measures including caregiver expression of stress, burden, self-efficacy, anger, and depression, and frequency of patient's behavioral excesses and deficits.