以家庭为基础的痴呆患者及其照顾者二元干预的心理生物学监测:评估治疗成功和了解潜在机制的附加价值。

A. Wuttke-Linnemann, Clara Henrici, N. Skoluda, U. Nater, K. Endres, A. Fellgiebel
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引用次数: 2

摘要

关于痴呆症患者(PwD)及其非正式照顾者(ic)的研究最近开始关注社会心理干预的二元方面。目的:采用双元心理社会干预,探讨其对日常生活中心理生物应激的影响。方法对24名残疾护理人员进行7次家访。作为门诊评估的一部分,在每次家访前后测量PwD和ic中的瞬时主观压力、唾液皮质醇(scot)和唾液α -淀粉酶(sAA),并在干预开始和结束时每天测量6次,每次2天。毛发皮质醇浓度(HCC)测定两次。结果每次家访后,ic患者的主观压力均有所降低。sCort在ICs和PwD中均较低,而sAA没有变化。在日常生活中,关于scot分泌的曲线下面积(area under the curve, AUCg)表明PwD在干预结束时scot日输出较低,而关于主观压力的AUCg表明PwD和ICs报告的主观压力均低于干预开始时。在两组中,与sAA相关的AUCg没有随时间变化。HCC不随时间变化,但随疾病严重程度的增加而增加。结论心理社会干预可降低PwD和ICs患者的心理生物应激,但对心理生物应激的影响存在差异。特别是,PwD的主观和生理应激标志物之间的差异强调了作为自我报告的补充,评估治疗成功和了解潜在机制的附加价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Psychobiological Monitoring of a Home-Based Dyadic Intervention for People Living with Dementia and Their Caregivers: Added Value to Evaluate Treatment Success and Understand Underlying Mechanisms.
BACKGROUND Research concerning people living with dementia (PwD) and their informal caregivers (ICs) has recently begun to focus on dyadic aspects of psychosocial interventions. OBJECTIVE We adapted a dyadic psychosocial intervention and examined its effects on psychobiological stress in daily life. METHODS Twenty-four PwD-caregiver dyads were visited seven times at home by specialized nursing staff. Momentary subjective stress, salivary cortisol (sCort), and salivary alpha-amylase (sAA) were measured in PwD and ICs before and after each home visit as well as six times per day at two days each at the beginning and end of the intervention as part of an ambulatory assessment. Hair cortisol concentrations (HCC) were measured twice. RESULTS After each home visit session, ICs reported lower subjective stress. sCort was lower in both ICs and PwD, whereas sAA did not change. In daily life, area under the curve (AUCg) concerning sCort secretion indicated that PwD had lower sCort daily output at the end of the intervention, and AUCg concerning subjective stress indicated that both PwD and ICs reported lower subjective stress than at the beginning of the intervention. AUCg concerning sAA did not change over time in either group. HCC did not vary over time but increased with disease severity. CONCLUSION The psychosocial intervention reduced psychobiological stress but affected psychobiological stress measures differently in PwD and ICs. In particular, the discrepancy between subjective and physiological markers of stress in PwD emphasizes the added value to evaluate treatment success and understand underlying mechanisms as a complement to self-reports.
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