Improving caregiving competence, stress coping, and mental well-being in informal dementia carers

摘要

AIM: To study the effectiveness of Reitman Centre "Coaching, Advocacy, Respite, Education, Relationship, and Simulation"(CARERS) program, which uses problem-solving techniques and simulation to train informal dementia carers. METHODS: Seventy-three carers for family members with dementia were included in the pilot study. Preand post-intervention data were collected from carers using validated measures of depression, mastery, role captivity and overload, caregiving competence and burden, and coping styles. To assess program effec-tiveness, mean differences for these measures were calculated. One-way ANOVA was used to determine if change in scores is dependent on the respective baseline scores. Clinical effects for measures were expressed as Cohen's D values. RESULTS: Data from 73 carers were analyzed. The majority of these participants were female(79.5%). A total of 69.9% were spouses and 30.1% were children of the care recipient. Participants had an overall mean age of 68.34 ± 12.01 years. About 31.5% of participating carers had a past history of psychiatric illness(e.g., depression), and 34.2% sustained strained relationships with their respective care recipients. Results from carers demonstrated improvement in carers' selfperception of competence(1.26 ± 1.92, P < 0.0001), and significant reduction in emotion-focused coping(measured by the Coping Inventory of Stressful Situations,-2.37 ± 6.73, P < 0.01), Geriatric Depression scale(-0.67 ± 2.63, P < 0.05) and Pearlin's overload scale(-0.55 ± 2.07, P < 0.05), upon completion of the Program. Secondly, it was found that carers with more compromised baseline scores benefited most from the intervention, as they experienced statistically significant improvement in the following constructs: competence, stress-coping style(less emotion-oriented), sense of mastery, burden, overload. CONCLUSION: Study results supported the effectiveness of the CARERS Program in improving caregiving competence, stress coping ability and mental well-being in carers caring for family members with dementia.