Ensaio controlado randomizado de um programa multicomponente para cuidadores informais de pacientes com Alzheimer

Autores

DOI:

https://doi.org/10.15649/cuidarte.2002

Palavras-chave:

Cuidador Familiar, Demência, Suporte Social, Sobrecarga, Programa Multicomponente

Resumo

Objetivo: Avaliar a eficácia do programa multicomponente mais alívio na sobrecarga e suporte social de cuidadores informais de pacientes com Transtorno Neurocognitivo Maior do tipo Alzheimer. Método: Ensaio controlado randomizado em paralelo em 58 cuidadores randomizados para um dos três grupos de comparação: Grupo de intervenção multicomponente mais alívio (n=19), grupo apenas alívio (n=19) e grupo de controle (n=20), foram avaliados a sobrecarga e suporte social usando as escalas de Zarit e Medical Outcomes Study, linha de base, pós-intervenção em 5 meses e um acompanhamento de 10 meses. A avaliação do efeito foi realizada usando um modelo de efeitos mistos de covariância não estruturada. Resultados: Os cuidadores eram, em sua maioria, filhos dos pacientes (72%), mulheres (76%) com uma de idade de média de 55,1 (12) anos e com escolaridade inferior ao ensino médio (58%). Foi encontrada uma redução significativa na sobrecarga de 13,1 (IC95% -19,3:6,9) pontos no grupo multicomponente mais alívio, com uma sustentação de efeito em 10 meses (p<0,001). Foi encontrado um aumento, embora não significativo, no suporte social pós-intervenção de 10,8 (-1,7; 23,4) para o grupo multicomponente e alívio, no entanto, o efeito aumentou ao longo do tempo, alcançando um aumento para 13,2 pontos (p=0,039) aos 10 meses de acompanhamento. Nenhum efeito significativo na sobrecarga ou suporte social foi observado para o grupo que apenas recebeu alívio. Conclusões: O programa de multicomponente mais alívio mostrou ter um efeito benéfico na sobrecarga e no suporte social dos cuidadores de Alzheimer.

Como citar este artigo: Cerquera Córdoba Ara Mercedes, Tiga-Loza Diana Carolina, Álvarez Anaya William Armando, Dugarte Peña Edwin, Jaimes Espíndola Lisseth Rocío, Plata Osma Leidy Johanna. Ensayo controlado aleatorizado de un programa multicomponente para cuidadores informales de pacientes con Alzheimer. Revista Cuidarte. 2021;12(2):e2002. http://dx.doi.org/10.15649/cuidarte.2002

Biografia do Autor

Ara Mercedes Cerquera Córdoba, Universidad Pontificia Bolivariana

Doctora en Ciencias Psicológicas, Decana de la Escuela de Ciencias Sociales, Universidad Pontificia Bolivariana Seccional Bucaramanga, Colombia.

Diana Carolina Tiga-Loza, Universidad Manuela Beltrán

Doctora en Epidemiología, Docente Investigadora, Universidad Manuela Beltrán Seccional Bucaramanga, Colombia.

William Armando Álvarez Anaya, Universidad Manuela Beltrán

Magíster en Educación, Coordinador del Programa de Fonoaudiología, Universidad Manuela Beltrán Seccional Bucaramanga, Colombia.

Edwin Dugarte Peña, Universidad Pontificia Bolivariana

Magíster en Ciencias – Estadísticas, Decano de la Escuela de Ingenierías, Universidad Pontificia Bolivariana Seccional Bucaramanga, Colombia.

Lisseth Rocío Jaimes Espíndola, Universidad Manuela Beltrán

Magíster en Discapacidad, Docente Investigadora, Universidad Manuela Beltrán Seccional Bucaramanga, Colombia.

Leidy Johanna Plata Osma, Universidad Pontificia Bolivariana

Magíster en Psicología, Docente Catedra de la Facultad de Psicología, Universidad Pontificia Bolivariana Seccional Bucaramanga, Colombia.

Referências

Alzheimer’s Association. 2018 Alzheimer’s disease facts and figures. Alzheimer’s Dement [Internet]. 2018;14(3):367–429. https://doi.org/10.1016/j.jalz.2018.02.001

Meinerding M, DeFeis B, Sunderaraman P, Azar M, Lawless S, Perez-Vivaldo C, et al. Assessing Dependency in a Multiethnic Community Cohort of Individuals With Alzheimer’s Disease. Innov Aging. 2018;2(1):1–7. https://doi.org/10.1093/geroni/igy011

Organización Mundial de la Salud. (2017). Demencia. Recuperado de https://www.who.int/es/news-room/fact-sheets/detail/dementia

Ministerio de Salud y Protección Social. (2017). Boletín de salud mental Demencia (3). Recuperado de https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/PP/ENT/Boletin-demencia-salud-mental.pdf

Martínez-Pizarro S. Síndrome del cuidador quemado. Rev Clínica Med Fam [Internet]. 2020;13(1):97–100. Available from: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1699-695X2020000100013

Gutiérrez-Rojas L, Martínez-Ortega JM, Rodríguez-Martín FD. La sobrecarga del cuidador en el trastorno bipolar. An Psicol. 2013;29(2):624–32. https://doi.org/10.6018/analesps.29.2.124061

Salazar-Torres Lenis Judith, Castro-Alzate Elvis Siprian, Dávila-Vásquez Paola Ximena. Carga del cuidador en familias de personas con enfermedad mental vinculadas al programa de hospital de día de una institución de tercer nivel en Cali (Colombia). rev.colomb.psiquiatr. [Internet]. 2019;48(2):88-95 https://doi.org/10.1016/j.rcp.2017.08.002

Andreotti MAD, Rodrigues de Souza BM, Neri KH, Golghetto Casemiro F, Correa Figueiredo L, Leonardo de Oliveira Gaioli CC, et al. Comparative study between formal and informal caregivers of older adults. Cienc e Saude Coletiva. 2018;23(11):3789–98. https://doi.org/10.1590/1413-812320182311.16932016

Victor CR, Rippon I, Quinn C, Nelis SM, Martyr A, Hart N, et al. The prevalence and predictors of loneliness in caregivers of people with dementia: findings from the IDEAL programme. Aging Ment Heal [Internet]. 2020;0(0):1–7. https://doi.org/10.1080/13607863.2020.1753014

Courtin E, Knapp M. Social isolation, loneliness and health in old age: a scoping review. Heal Soc Care Community. 2017;25(3):799–812. https://doi.org/10.1111/hsc.12311

Muñoz L,Postogo S, Casado I, De Llanos F. El cuidador mayor de personas mayores. Sobrecarga y apoyo social. Rev. Rol enferm, 2015:852-858.

Antelo P, Espinosa P. La influencia del apoyo social en cuidadores de personas con deterioro cognitivo o demencia. Revista de estudios e investigación en Psicología y Educación, 2017:017-021. https://doi.org/10.17979/reipe.2017.0.14.2235

Holt-Lunstad J, Smith T, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect Psychol Sci. 2015;10(2):227–37. https://doi.org/10.1177/1745691614568352

Collins RN, Kishita N. The Effectiveness of Mindfulness- and Acceptance-Based Interventions for Informal Caregivers of People With Dementia: A Meta-Analysis. Gerontologist [Internet]. 2019;59(4):e363–79. https://doi.org/10.1093/geront/gny024

Cheng ST, Zhang F. A comprehensive meta-review of systematic reviews and meta-analyses on nonpharmacological interventions for informal dementia caregivers. BMC Geriatr. 2020;20(1). https://doi.org/10.1186/s12877-020-01547-2

Cheng S-T, Li K-K, Losada A, Zhang F, Au A, Thompson LW, et al. The effectiveness of nonpharmacological interventions for informal dementia caregivers: An updated systematic review and meta-analysis. Vol. 35, Psychology and Aging. Cheng, Sheung-Tak: Department of Health and Physical Education, The Education University of Hong Kong, 10 Lo Ping Road, N.T., Tai Po, Hong Kong, takcheng@eduhk.hk: American Psychological Association; 2020:55–77. https://doi.org/10.1037/pag0000401

Teri L, Logsdon RG, McCurry SM, Pike KC, McGough EL. Translating an Evidence-based Multicomponent Intervention for Older Adults With Dementia and Caregivers. Gerontologist [Internet]. 2020;60(3):548–57. Available from: https://doi.org/10.1093/geront/gny122 https://doi.org/10.1093/geront/gny122

Abrahams R, Liu KPY, Bissett M, Fahey P, Cheung KSL, Bye R, et al. Effectiveness of interventions for co-residing family caregivers of people with dementia: Systematic review and meta-analysis. Aust Occup Ther J [Internet]. 2018;65(3):208–24. https://doi.org/10.1111/1440-1630.12464

Laver K, Milte R, Dyer S, Crotty M. A Systematic Review and Meta-Analysis Comparing Carer Focused and Dyadic Multicomponent Interventions for Carers of People With Dementia. Vol. 29, Journal of Aging and Health. 2017:1308–1349p. https://doi.org/10.1177/0898264316660414

Belle SH, Burgio L, Burns R, Coon D, Czaja SJ, Gallagher-thompson D, et al. Enhancing the Quality of Life of Dementia Caregivers from Different Ethnic or Racial Groups: A Randomized, Controlled Trial. Ann Intern Med. 2006;145(10):727–38. https://doi.org/10.7326/0003-4819-145-10-200611210-00005

Cheng ST, Au A, Losada A, Thompson LW, Gallagher-Thompson D. Psychological Interventions for Dementia Caregivers: What We Have Achieved, What We Have Learned. Curr Psychiatry Rep. 2019;21(7). https://doi.org/10.1007/s11920-019-1045-9

Morris L, Horne M, McEvoy P, Williamson T. Communication training interventions for family and professional carers of people living with dementia: a systematic review of effectiveness, acceptability and conceptual basis. Aging Ment Heal [Internet]. 2018;22(7):863–80. https://doi.org/10.1080/13607863.2017.1399343

Nguyen H, Terry D, Phan H, Vickers J, McInerney F. Communication training and its effects on carer and care-receiver outcomes in dementia settings: A systematic review. J Clin Nurs. 2019;28(7–8):1050–69. https://doi.org/10.1111/jocn.14697

Shata ZN, Amin MR, El-Kady HM, Abu-Nazel MW. Efficacy of a multi-component psychosocial intervention program for caregivers of persons living with neurocognitive disorders, Alexandria, Egypt: A randomized controlled trial. Avicenna J Med [Internet]. 2017;7(2):54–63. Available from: https://pubmed.ncbi.nlm.nih.gov/28469987

Jensen M, Agbata IN, Canavan M, McCarthy G. Effectiveness of educational interventions for informal caregivers of individuals with dementia residing in the community: Systematic review and meta‐analysis of randomised controlled trials. Vol. 30, International Journal of Geriatric Psychiatry. 2015:130–43. https://doi.org/10.1002/gps.4208

Dam AEH, de Vugt ME, Klinkenberg IPM, Verhey FRJ, van Boxtel MPJ. A systematic review of social support interventions for caregivers of people with dementia: Are they doing what they promise? Maturitas [Internet]. 2016;85:117–30. https://doi.org/10.1016/j.maturitas.2015.12.008

Ploeg J, Ali MU, Markle-Reid M, Valaitis R, Bartholomew A, Fitzpatrick-Lewis D, et al. Caregiver-focused, web-based interventions: Systematic review and meta-analysis (Part 2). J Med Internet Res. 2018;20(10):1–11. https://doi.org/10.2196/11247

Amador-Marín B, Guerra-Martín MD. Eficacia de las intervenciones no farmacológicas en la calidad de vida de las personas cuidadoras de pacientes con enfermedad de Alzheimer. Gac Sanit [Internet]. 2017;31(2):154–60. https://doi.org/10.1016/j.gaceta.2016.09.006

Milders M, Bell S, Lorimer A, Jackson H, McNamee P. Improving access to a multi-component intervention for caregivers and people with dementia. Dementia. 2019;18(1):347–59. https://doi.org/10.1177/1471301216672745

Ducharme FC, Lévesque LL, Lachance LM, Kergoat MJ, Legault AJ, Beaudet LM, Zarit SH. “Learning to become a family caregiver” efficacy of an intervention program for caregivers following diagnosis of dementia in a relative. The Gerontologist, 2011;51(4):484-494. https://doi.org/10.1093/geront/gnr014

Martín-Carrasco M, Otermin P, Perez Camo V, Pujol J, Agüera L, Martín MJ, et al. EDUCA study: Psychometric properties of the Spanish version of the Zarit Caregiver Burden Scale. Aging Ment Health. 2010;14:705–11. https://doi.org/10.1080/13607860903586094

Rodríguez Á, Cerquera A, Pabón D. Escala de sobrecarga del cuidador zarit: estructura factorial en cuidadores informales de Bucaramanga. Rev Psicol Univ Antioquia [Internet]. 2016;8(2):87–99. Available from: http://aprendeenlinea.udea.edu.co/revistas/index.php/psicologia/article/view/327888/20784934

Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med [Internet]. 1991;32(6):705–14. https://doi.org/10.1016/0277-9536(91)90150-B

Arredondo NHL, Rogers HL, Tang JFC, Posada Gómez SL, Arizal NLO, Pérez MÁJ, et al. Validation of the Colombian MOS social support survey. Int J Psychol Res. 2012;5(1):142–50. https://doi.org/10.21500/20112084.770

Hébert R, Bravo G, Préville M. Reliability, Validity and Reference Values of the Zarit Burden Interview for Assessing Informal Caregivers of Community-Dwelling Older Persons with Dementia. Canadian Journal on Aging / La Revue Canadienne Du Vieillissement, 2000;19(4):494-507. https://doi.org/10.1017/S0714980800012484

Martín-Carrasco M, Martín MF, Valero CP, Millán PR, García CI, Montalbán SR, et al. Effectiveness of a psychoeducation intervention program in the reduction of caregiver burden in Alzheimer’s Disease patients’ caregivers. Int J Geriatr Psychiatry. 2009;24(5):489–99. https://doi.org/10.1002/gps.2142

StataCorp LP. Stata Statistical Software: Release 16. College Station, TX; 2019.

Valle-Pedroso R, Icassatti Corazza D, De Almeida Andreatto CA, Gomes Dos Santos J, Stein AM, Huamaní OG, et al. Los predictores motores de la deficiencia de las funciones ejecutivas en pacientes con enfermedad de alzheimer. Univ Psychol. 2016;15(5). https://doi.org/10.11144/Javeriana.upsy15-5.pmdf

Negovanska V, Hergueta T, Guichart-Gomez E, Dubois B, Sarazin M, Bungener C. Beneficial effect of a cognitive behavioral and multidisciplinary program in Alzheimer Disease on spouse caregiver anxiety: French study ELMMA. Rev Neurol (Paris) [Internet]. 2011;167(2):114—122. https://doi.org/10.1016/j.neurol.2010.07.002

Adler G, Ott L, Jelinski M, Mortimer J, Christensen R. Institutional Respite Care: Benefits and Risks for Dementia Patients and Caregivers. Int Psychogeriatrics [Internet]. 1993;5(1):67–77. https://doi.org/10.1017/S1041610293001401

Andrén S, Elmståhl S. Effective psychosocial intervention for family caregivers lengthens time elapsed before nursing home placement of individuals with dementia: A five-year follow-up study. Int Psychogeriatrics. 2008;20(6):1177–92. https://doi.org/10.1017/S1041610208007503

Lund DA, Utz RL, Caserta MS, Wright SD, Llanque SM, Lindfelt C, et al. Time for living and caring: An intervention to make respite more effective for caregivers. Int J Aging Hum Dev. 2014;79(2):157–78. https://doi.org/10.2190/AG.79.2.d

Carreño, Sonia Patricia; Chaparro-Díaz, Lorena. Agrupaciones de cuidadores familiares en Colombia: perfil, habilidad de cuidado y sobrecarga. Pensamiento Psicológico, 2017:15(1):87-101.

Angulo Hurtado AM, Ramírez Quintana AS. Relación entre la calidad de vida en salud y la carga física en cuidadores de personas con enfermedad de Alzheimer. Rev Colomb Salud Ocup. 2016;6(1):20–6. https://doi.org/10.18041/2322-634X/rcso.1.2016.4887

Torres-Avendaño B, Agudelo-Cifuentes M, Pulgarin-Torres A, Berbesi-Fernández D. Factors associated with overloading in the primary caregiver. Medellin, 2017. Univesalidad y Salud [Internet]. 2018;20(3):261–9. https://doi.org/10.22267/rus.182003.130

Viale M, Cáceres M, Pruvost M, Miranda AL, Rimoldi MF. Programas de intervención para el manejo del estrés de cuidadores de pacientes con demencia. Rev Neuropsicol Latinoam. 2016;8(1):35–41.

Zarit SH, Lee JE, Barrineau MJ, Whitlatch CJ, Femia EE. Fidelity and acceptability of an adaptive intervention for caregivers: an exploratory study. Aging Ment Health [Internet]. 2012/09/04. 2013;17(2):197–206. https://doi.org/10.1080/13607863.2012.717252

Publicado

2021-07-22

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Cerquera Córdoba AM, Tiga-Loza DC, Álvarez Anaya WA, Dugarte Peña E, Jaimes Espíndola LR, Plata Osma LJ. Ensaio controlado randomizado de um programa multicomponente para cuidadores informais de pacientes com Alzheimer. Revista Cuidarte [Internet]. 22º de julho de 2021 [citado 24º de novembro de 2024];12(2). Disponível em: https://revistas.udes.edu.co/cuidarte/article/view/2002

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