The Lancet Psychiatry：应对策略疗法显著改善老年痴呆症护理人员精神健康与生活质量

2014-11-20 马宏伟译医学论坛网

发表在《柳叶刀精神病学》杂志的一项研究发现，便捷的应对策略疗法在无额外开销的标准护理中，可为对老年痴呆症家庭护理者提供减轻沮丧感并提高幸福感的作用。该研究由英国伦敦大学学院老年人精神学研究部门吉尔利文斯顿教授发起，他发现接受START(STrAtegies 针对 RelaTives)项目的家庭护理者可显著减轻其忧郁程度，获益时间至少持续两年。而未接受项目治疗的人，其进展为临床显著忧郁症的概率高

发表在《柳叶刀精神病学》杂志的一项研究发现，便捷的应对策略疗法在无额外开销的标准护理中，可为对老年痴呆症家庭护理者提供减轻沮丧感并提高幸福感的作用。

该研究由英国伦敦大学学院老年人精神学研究部门吉尔利文斯顿教授发起，他发现接受START(STrAtegies 针对 RelaTives)项目的家庭护理者可显著减轻其忧郁程度，获益时间至少持续两年。而未接受项目治疗的人，其进展为临床显著忧郁症的概率高7倍。

三分之二的老年痴呆患者在家居住，接受家庭成员提供的护理。在英国大约有67万这样的家庭护理着，美国有超过1500万人口的家庭护理者。然而，约40%的家庭成员护理者最终进展为临床抑郁症或焦虑，这些可导致护理的终结，促使老年痴呆症患者被送入疗养院。

Livingston和他的同事们将260位家庭护理着随机分配，这些人在研究之初无忧郁症疾患，在试验中173人接受8疗程的 START项目治疗，87人接受常规项目治疗(包括针对忧郁症的医学、精神、社会服务)。

使用医学焦虑忧郁量表(HADS)对这些受试者进行评估，成本效益在两年以上。

平均来讲，将START组的家庭护理者与普通组相比，在短期(8个月)和长期(24个月)两个时间点进行比较后发现，前者的HADS总分(2.58分)显著提高。不仅如此，START的花费未超过常规护理的价格，说明其费效比可达最佳值。

根据Livingston教授的说法，在全球范围内有440万人口受到忧郁症困扰，而这一数据还以每二十年为周期的速度翻番增加。大多数人都会忽视与老年痴呆症相关的抑郁症患者对家庭成员护理所起到的显著作用。政策导向认为家庭成员将成为主要支持者。该新兴项目是一种有效的方法，能够支持护理者，并提高他们的精神健康和生活品质，这一方法值得全球化推广。

来自英国苏塞克斯布莱顿大学的抑郁症学研究的Sube Banerjee教授评论道，“ATART介入项目应作为个体化疗法提供给所有的老年痴呆症家庭护理者，并作为支持即时诊断的一部分。START项目应当成为老年痴呆症诊断服务中一项组成部分(诸如记忆恢复服务)，并得到英国的临床调试组的委任。”

原始出处

Prof Gill Livingston MD a g , Julie Barber PhD b, Penny Rapaport DClinPsych a, Prof Martin Knapp PhD c, Mark Griffin MSc b, Derek King PhD c, Renee Romeo PhD d, Debbie Livingston MChS a, Cath Mummery ，etc.Long-term clinical and cost-effectiveness of psychological intervention for family carers of people with dementia: a single-blind, randomised, controlled trial.The Lancet Psychiatry, Early Online Publication, 19 November 2014

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2015-03-26 diushouji

#Psychiatry#

71 0
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2015-06-26 一叶知秋

#护理人员#

70 0
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2015-06-11 wingjoy2009

mark

145 0
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2015-04-17 howi

#Lancet#

73 0
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2015-01-06 Boyinsh

#痴呆症#

81 0
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2015-02-10 paperyu

#应对策略#

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The Lancet Psychiatry：应对策略疗法显著改善老年痴呆症护理人员精神健康与生活质量

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