INTERVENTIONS TO CHANGE CAREGIVE & AD PATIENT OUTCOMES

这是对1989年10月1日提交审查的一份提案的修订。 这项为期5年的干预研究的主要目标是评估相关的 为照顾者提供技能的治疗方案的有效性 有必要改变患有阿尔茨海默病的配偶的问题行为 疾病，一种教会他们管理自己情感的干预 对护理挑战的反应，以及结合两者的干预 治疗策略。在对照顾者进行心理社会评估后 80名护理者/患者对患者的认知和行为评估 将被分配到以下四种干预条件之一：(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性问题；(2)情绪化自我 管理培训(ASM)旨在教照顾者增加愉悦 活动，减轻压力，提升积极情绪；(3)联合行为 管理技能和情感自我管理培训(COM)评估 以患者和照顾者为中心的干预措施的任何附加影响； 和(4)等待名单控制(WL)，其中联系训练员和一般 信息将通过“友好访问”的方式提供。每次干预 情况将持续12周；将在#年进行预评估和后评估 第1周和第13周，第2-11周进行训练。所有参与者都将是 干预周期后3个月和6个月重新评估。这些团体将 在许多护理人员和患者结果衡量标准上进行比较，包括 照顾者表达压力、负担、自我效能感、愤怒和 抑郁，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.