心理社会干预对痴呆患者家庭照护者抑郁心理及照护负担的影响研究

潘玉贤 张海瑛

摘 要 目的：評价心理社会干预对患者、照护者的抑郁心理及照护者照护负担的影响效果。方法：采取方便抽样方法选取2018年10月—2019年8月在上海市徐汇区虹梅街道社区卫生服务中心接受治疗的66例痴呆患者及66名主要家庭照护者，采用由计算机产生随机数字的方法将66例痴呆患者随机分为干预组及对照组各33例，对照组接受常规照护，干预组接受为期6个月的心理社会干预。干预前、后采用康奈尔痴呆抑郁量表评估痴呆患者的抑郁程度，采用老年抑郁量表和家属压力量表评估照护者的抑郁和压力程度，结果：经过6个月的心理社会干预后，干预组患者的康奈尔痴呆抑郁量表评分从（21.6±7.6）分降至（18.9±6.1）分（t=1.543，P=0.128），差异无统计学意义。经过6个月的心理社会干预后，干预组照护者的老年抑郁量表和家属压力量表评分均低于干预前（P<0.05）。结论：多元的、个体化的心理社会干预能够有效降低痴呆患者照护者的抑郁症状和照护压力，但其对痴呆患者的影响仍需进一步观察。

关键词 心理社会干预；痴呆；照护者；抑郁；负担

中图分类号：R749.1+6 文献标志码：A 文章编号：1006-1533（2020）16-0013-03

Study of the effect of psychosocial intervention on depressive psychology and care burden of family caregivers of dementia patients

PAN Yuxian， ZHANG Haiying

（Nursing Department of Hongmei Community Health Service Center of Xuhui District， Shanghai 200233， China）

ABSTRACT Objective： To evaluate the effect of psychosocial intervention on depression and care burden in patients with dementia and their family caregivers. Methods： Sixty-six dementia patients who were treated in the Hongmei Community Health Service Center of Xuhui District， Shanghai from October 2018 to August 2019 and 66 main family caregivers were selected by convenient sampling method， and using computer-generated random numbers， 66 dementia patients were randomly divided into an intervention group and a control group with 33 cases each. The control group received routine care， and the intervention group received a 6-month psychosocial intervention. Before and after the intervention， the Cornell dementia depression scale was used to evaluate the degree of depression of patients with dementia， and the elderly depression scale and family pressure scale are used to assess the degree of depression and stress of caregivers. Results： After 6 months psychosocial intervention， the Cornell scale for depression score of dementia patients decreased from （21.6±7.6） to （18.9±6.1）（t=1.543， P=0.128） with no significant difference between the two groups. After 6 months psychosocial intervention， the geriatric depression scale and relatives stress scale scores of caregivers in the intervention group were lower than the baseline with statistically significant（P<0.05）. Conclusion： Multiple and individual psychosocial interventions can effectively reduce the depression symptoms and care pressure of caregivers of dementia patients， but the depression symptoms of dementia patients still need to be further discussed.

KEY WORDS psychosocial intervention； dementia； caregiver； depression； burden

痴呆症是老年人的常见疾病，影响老年人在认知、实践和社会功能方面的表现、能力、情绪及生活质量[1]。在患病过程中，患者所表现出的认知功能损害会对其生活造成不同程度的影响。研究表明，照护罹患痴呆症的家庭成员与高度负担、社会孤立、机体亚健康及经济困难等显著相关[2]。国外对不同类型心理社会干预方案对痴呆患者照护者的影响进行了相关研究，Brodaty等[3]的Meta分析显示，心理社会干预可降低照护者的心理疾病发病率。Pinquart和S？rensen[4]的综述报道了心理教育多元干预对照护者抑郁影响的相关证据。……