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首页> 外文期刊>The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry >A Randomized Controlled Trial of a Community-Based Dementia Care Coordination Intervention: Effects of MIND at Home on Caregiver Outcomes
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A Randomized Controlled Trial of a Community-Based Dementia Care Coordination Intervention: Effects of MIND at Home on Caregiver Outcomes

机译：基于社区的痴呆症护理协调干预的随机对照试验：在家中MIND对护理者结局的影响

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Objective: To assess whether MIND at Home, a community-based, multicomponent, care coordination intervention, reduces unmet caregiving needs and burden in informal caregivers of persons with memory disorders. Methods: An 18-month randomized controlled trial of 289 community-living care recipient (CR)-caregiver (informal caregivers, i.e., unpaid individuals who regularly assisted the CR) dyads from 28 postal code areas of Baltimore, Maryland was conducted. All dyads and the CR's primary care physician received the written needs assessment results and intervention recommendations. Intervention dyads then received an 18-month care coordination intervention delivered by nonclinical community workers to address unmet care needs through individualized care planning, referral and linkage to dementia services, provision of caregiver dementia education and skill-building strategies, and care progress monitoring by an interdisciplinary team. Primary outcome was total percent of unmet caregiver needs at 18 months. Secondary outcomes included objective and subjective caregiver burden measures, quality of life (QOL), and depression. Results: Total percent of unmet caregiver needs declined in both groups from baseline to 18 months, with no statistically significant between-group difference. No significant group differences occurred in most caregiver burden measures, depression, or QOL. There was a potentially clinically relevant reduction in self-reported number of hours caregivers spent with the CR for MIND participants compared with control subjects. Conclusion: No statistically significant impacts on caregiver outcomes were found after multiple comparison adjustments. However, MIND at Home appeared to have had a modest and clinically meaningful impact on informal caregiver time spent with CRs.
机译：目的：评估基于社区的多成分护理协调干预措施在家中的MIND是否能减少记忆障碍患者非正式护理人员的未满足护理需求和负担。方法：对马里兰州巴尔的摩市的28个邮政编码地区的289位社区生活护理接受者（CR）护理者（非正式护理者，即定期提供CR的无酬人员）进行了为期18个月的随机对照试验。所有二联组和CR的初级保健医师均收到书面需求评估结果和干预建议。然后，干预二联体接受了由非临床社区工作者提供的为期18个月的护理协调干预，以通过个性化的护理计划，转诊和与痴呆服务的联系，提供照护者痴呆教育和技能建设策略以及由护理人员监控护理进度来解决未满足的护理需求。跨学科团队。主要结局是18个月未满足护理人员需求的总百分比。次要结果包括客观和主观照料者负担量度，生活质量（QOL）和抑郁症。结果：两组未满足的护理人员总需求从基线下降到18个月，两组之间无统计学差异。在大多数照料者负担措施，抑郁或QOL中，没有显着的群体差异发生。与对照组相比，MIND参与者在自我报告的护理人员陪伴CR上花费的小时数可能有临床相关的减少。结论：经过多次比较调整后，未发现对护理人员结局具有统计学意义的影响。但是，在家中的MIND似乎对花费在CR上的非正式护理人员的时间产生了适度的临床意义的影响。

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