Impact of a psychoeducational intervention on caregiver response to behavioral problems

Nurs Res. 2002 Nov-Dec;51(6):363-74. doi: 10.1097/00006199-200211000-00004.

Abstract

Background: Eighty percent of persons with Alzheimer's disease and related disorders are cared for by family members who often lack adequate support and training for this all-consuming job.

Objective: To evaluate the efficacy of a longitudinal, multisite, community-based intervention designed to teach home caregivers to manage behavioral problems in persons with Alzheimer's disease.

Methods: Usable data were analyzed from 237 caregiver/care recipient dyads (n = 132 Experimental; n = 105 Comparison). The experimental group received a psychoeducational nursing intervention that was conceptually grounded in the Progressively Lowered Stress Threshold model (Hall & Buckwalter, 1987). The comparison group received routine information and referrals for case management, community-based services, and support groups. Although a variety of psychosocial outcomes were compared between caregivers in the two groups, this article focuses on frequency and response to behavioral problems and functional decline.

Results: The Progressively Lowered Stress Threshold intervention had a statistically significant effect on spousal response to memory/behavioral problems (p <.01) for all caregivers and on response to activities of daily living problems (p <.01) for spousal caregivers. In addition, nonspouses in the experimental group reported a reduction in the frequency of memory/behavioral problems (p <.01). No intervention effect on reports of activities of daily living frequencies was found for either spouses or nonspouses.

Conclusions: This Progressively Lowered Stress Threshold-based intervention had a positive impact on both the frequency of and response to problem behaviors among spousal caregivers.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Activities of Daily Living
  • Adaptation, Psychological
  • Aged
  • Alzheimer Disease / complications*
  • Arizona
  • Caregivers / education*
  • Caregivers / psychology*
  • Disease Progression
  • Family / psychology*
  • Female
  • Geriatric Assessment
  • Health Education / organization & administration*
  • Home Nursing / education*
  • Home Nursing / psychology*
  • Humans
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / etiology
  • Mental Disorders / prevention & control*
  • Middle Aged
  • Midwestern United States
  • Models, Psychological
  • Nursing Evaluation Research
  • Severity of Illness Index
  • Stress, Psychological / prevention & control*
  • Stress, Psychological / psychology