摘要目的 探讨照顾者自我管理支持项目对痴呆患者家属照顾者自我效能、社会支持及患者精神行为症状的效果.方法 采用便利抽样法,选取2016年9月—2017年9月在上海市2所三级甲等医院记忆障碍门诊就诊的痴呆患者家属照顾者41名作为研究对象.根据研究对象意愿将其分为试验组(n=26)和对照组(n=15).试验组和对照组中各有4名研究对象中途退出本研究.试验组采用2周1次,共计6次的社会支持小组活动;对照组采用每月1次,共计3次的电话指导,所有参与者均发放由研究团队编制的照顾者宣教手册并在随访期间参与3次宣教讲座.采用中国家属照顾者自我效能问卷(Self-Efficacy Questionnaire for Chinese Family Caregivers,SEQCFC)、医疗社会支持量表(Medical Outcome Study Social Support Survey,MOS-SSS)、修订版记忆行为量表(Revised Memory and Behaviour Problems Checklist, RMBPC)比较干预的效果.结果 痴呆患者家属照顾者自我效能总分的时间效应显著(P＜0.01),社会支持得分的组别与时间的交互效应具有统计学差异(P＜0.05).试验组家属照顾者自我效能得分在干预和随访后均较基线值提高(P＜0.05).痴呆患者精神行为症状总分、记忆和抑郁相关问题维度得分的时间效应存在显著差异(P＜0.05).试验组患者精神行为症状总分在干预后和随访后、随访后的破坏行为维度得分、干预和随访后的抑郁维度得分均低于基线值(P＜0.05).结论 照顾者自我管理支持项目能提升家属照顾者的自我效能,减轻痴呆患者精神行为症状.

abstractsObjective To examine the effect of a Caregiving Self-Management Support (C-SMS) Program on self-efficacy, social support for family caregivers of people with dementia and psychological symptom of patients. Methods Using the convenient sampling method, 41 caregivers of dementia patients were selected as the study objects from September 2016 to September 2017 in the Memory Disorders Outpatient Department of two ClassⅢ Grade A hospitals in Shanghai. They were divided into the experimental group(n=26) and control group(n=15) according to their willingness. Totally 4 participants in each of the two groups dropped out of the study in the middle. In the experimental group, a total of 6 times, once in 2 weeks social support group activities were carried out; in the control group, a total of 3 telephone instruction, once a month was carried out, all participants were distributed with the Caregiver Educational Booklet prepared by the research team and participated 3 education seminars during the follow-up visit. Self-Efficacy Questionnaire for Chinese Family Caregivers(SEQCFC) and Medical Outcome Study Social Support Survey(MOS-SSS) and Revised Memory and Behaviour Problems Checklist(RMBPC) were used to compare the effect of intervention. Results The time effect of the total score of SEQCFC was significant (P＜ 0.01). There was a statistically significance in the interaction on social support score between groups and time (P＜ 0.05). After intervention and follow-up, the self-efficacy scores of family caregivers in the experimental group were higher than the baseline (P＜0.05). There were significant time effect in the total score of behavioral and psychological symptom behavioral symptoms, memory and depression related problems (P＜0.05). The total score of behavioral and psychological symptom, score of the disruptive behaviour dimension after follow-up visit, scores of the depression dimension after intervention and follow-up visit in the experimental group were all lower than the baseline (P＜ 0.05). Conclusions The self-management support project of caregivers can improve the self-efficacy of family caregivers and alleviate the behavioral and psychological symptom of dementia patients.