Aim: This study assesses the effect of an intervention to reduce the disruptive behaviours (DB) presented by care recipient users of adult day care centres (ADCC), thereby reducing caregiver overload. While ADCC offer beneficial respite for family caregivers, the DB that many care recipients show promote resistance to attending these centres, which can be a great burden on their family caregivers.
Design: Randomized controlled clinical trial.
Methods: The study was carried out with 130 family caregivers of people attending seven ADCC in the municipality of Salamanca (Spain), randomly distributed into intervention and control groups. The intervention was applied across eight sessions, one per week, in groups of 8-10 people where caregivers were trained in the Antecedent-Behavior-Consequence (ABC) model of functional behaviour analysis. The primary outcome was the reduction of DB measured with the Revised Memory and Behavior Problems Checklist (RMBPC).
Results: An average reduction in the RMBPC of 4.34 points was obtained in the intervention group after applying the intervention (p < 0.01 (U de Mann-Whitney); Cohen d = 1.00); furthermore, differences were found in the Center for Epidemiologic Studies Depression Scale (CES-D) (U = -2.67; p = 0.008; Cohen d = 0.50) and in the Short Zarit Burden Interview (Short ZBI) (t = -4.10; p < 0.01; Cohen d = 0.98).
Conclusion: The results obtained suggest that the implementation of this intervention could reduce both the frequency of DB occurrence and the reaction of the caregiver to their appearance. Improvement was also noted in the results regarding overload and emotional state of the family caregiver.
Impact: To our knowledge, this is the first randomized clinical trial to show that an intervention based on the ABC model could reduce the frequency and reaction of DB of care recipients in ADCC increasing their quality of life, and improving the mental health and overload of their family caregivers.
目的: 本研究旨在评估以减少成人日托中心(ADCC)受照顾者破坏性行为(DB)为目的的干预行为的效果,从而能够减少护理者的工作负担。虽然成人日托中心能为不少家庭看护人提供休息时间,然而一些受照顾者所表现出来的破坏性行为却增加了他们进入成人日托中心的阻力,这对于他们的家庭护理人来说是一个巨大的负担。 设计: 随机对照临床试验。 方法: 本试验由来自西班牙萨拉曼卡市七个成人日托中心的130名家庭护理人员参与,他们被随机分为了干预组和对照组。干预分八个周期实施,一周一次,每组8至10人,家庭护理人员则是在功能性行为分析的前因-行为-结果(ABC)模型中接受培训。主要成果是基于修正记忆和行为问题清单(RMBPC),破坏性行为减少。 结果: 在实施干预后(p < 0.01 (U de Mann-Whitney),干预组的修正记忆和行为问题清单平均下降了4.34个点。此外,在流行病学研究中心的抑郁测量表(CES-D)中(U = −2.67; p = 0.008; Cohen d = 0.50)和Zarit负担简谈(Short ZBI)中(t = −4.10; p < 0.01; Cohen d = 0.98),也发现了差异。 结论: 试验结果表明,实施这种干预能够降低破坏性行为的发生频率和护理人员对于他们表现的反应程度。并且在家庭护理人员的超负荷状态和情感状态方面,也有所改善。 影响: 据我们所知,这是首个基于ABC模型的随机临床试验,本试验表明基于ABC模型实施干预可以降低成人日托中心受照顾者破坏性行为的发生频率,提高他们的生活质量,并改善他们家庭护理人员的心理健康和减少工作负担。.
Keywords: caregiver; dependence; disruptive behaviours; nursing; overload; stress.
© 2020 John Wiley & Sons Ltd.