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Efficacy of a multicomponent support programme for the caregivers of disabled persons

A randomised controlled study

Effektivität eines abgestuften multidimensionalen Unterstützungsprogramms für pflegende Angehörige von behinderten Personen

Eine randomisierte kontrollierte Studie

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Abstract

Aim

The goal of the present work was to measure the efficacy of a multicomponent programme designed to provide tailored support for the caregivers of disabled persons.

Subjects

A total of 135 caregivers–care receiver dyads were randomly divided into an intervention group (n = 66) and a control group (n = 69). One-third of the care receivers were demented, and two-thirds had other diseases.

Setting

Health centres (publicly funded primary health care systems) in 8 rural and urban communities in southeast Finland.

Intervention

The multicomponent support programme for the caregivers consisted of a 2-week rehabilitation period. The control group received standard care.

Outcome measurements

Continuation of the caregiver and care receiver relationship, care receiver mortality at the 2-year follow-up as well as the health-related quality of life (15D scale) and Zung’s depression scale of the caregiver at the 1-year follow-up were evaluated.

Results

At the 2-year follow-up, the caregiver–care receiver relationship was terminated for any reason in 11 cases (17%) in the intervention group, and in 25 cases (36%) in the control group. After adjusting, the primary outcome (i.e., termination of care giving for any reason) indicated statistical significance (p = 0.04) with a hazard rate of 1.83 (95% confidence interval 1.03–3.29). With a similar adjustment, the difference in mortality and placement to institutional care between the two groups demonstrated a trend towards statistical significance. The caregivers’ health, as related to quality of life and depressive symptoms, remained unchanged in both groups at the 1-year follow-up.

Conclusion

These results indicate that a tailored support programme for caregivers may help the caregiver to continue the caregiver–care receiver relationship and delay institutionalization.

Zusammenfassung

Zielsetzung

Bestimmt werden sollte die Effektivität eines multidimensionalen, abgestuften Unterstützungsprogramms für pflegende Angehörige von behinderten Personen.

Patienten

Insgesamt 135 Pflegende-Behinderte-Beziehungen wurden randomisiert in eine Interventions- und eine Kontrollgruppe. Ein Drittel der Gepflegten war dement, zwei Drittel hatten andere Erkrankungen.

Setting

Gesundheitszentren in 8 ländlichen und städtischen Kommunen in Südost-Finnland, die vom öffentlichen Gesundheitssystem finanziert werden.

Intervention

Das multidimensionale Unterstützungsprogramm für pflegende Angehörige bestand aus einem 2-wöchigen Rehabilitationsprogramm. Die Kontrollgruppe erhielt die Standardbehandlung.

Outcome-Variablen

Beurteilt wurden die Kontinuität der Beziehung zwischen pflegenden Angehörigen und Gepflegten, die 2-Jahres-Mortalität der Pflegeempfänger sowie die gesundheitsbezogene Lebensqualität (15D-Skala) und Depression (Zungs Depressionsskala) der pflegenden Angehörigen nach 1 Jahr.

Ergebnisse

Nach einem Follow-up von 2 Jahren waren in der Interventionsgruppe 11 (17%) und in der Kontrollgruppe 25 (36%) der Pflegebeziehungen beendet. Dieser primäre Endpunkt war signifikant nach Adjustierung für verschiedene Variablen (p = 0,04). Die Hazard Ratio betrug 1,83 (95%-Konfidenzintervall: 1,03–3,29). Mortalität und Institutionalisierungsrate zeigten einen positiven Trend, ohne das Signifikanzniveau zu erreichen. Die Lebensqualität und das Ausmaß einer Depression hatten sich nach 1 Jahr nicht verändert.

Zusammenfassung

Die Ergebnisse weisen darauf hin, dass ein abgestuftes multidimensionales Unterstützungsprogramm für pflegende Angehörige die Beziehung zwischen Pflegenden und Gepflegten stabilisieren und die Institutionalisierungsrate verzögern kann.

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Grants

This study was supported by KELA (The Social Insurance Institution of Finland).

Conflict of interest

The corresponding author states the following: PN is an employee of Herttua rehabilitation centre.

Authors’ contributions

ST was the original main researcher. Before his death, he contributed to the designing the study, recruitment of subjects and organised the study until the beginning of follow-up period.

OPR was the main researcher since the follow-up period, contributed to the planning the study, analysing results and writing the manuscript. PT contributed to planning the study, executing the intervention, analysing results and writing the manuscript. ES contributed in statistics, analysing the results and writing the manuscript. OPR, ES and PT read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland

    O.-P. Ryynänen

  2. Kuopio University Hospital/General Practice, P.O. Box 1777, 70211, Kuopio, Finland

    O.-P. Ryynänen

  3. Veneenniementie 64, 58200, Kerimäki, Finland

    P. Nousiainen

  4. ESiOR Oy, P.O. Box 1188, 70211, Kuopio, Finland

    E.J.O. Soini

  5. Department of Social Pharmacy, University of Kuopio, Kuopio, Finland

    E.J.O. Soini

  6. -, -, -

    S. Tuominen

Authors
  1. O.-P. Ryynänen
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  2. P. Nousiainen
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  3. E.J.O. Soini
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  4. S. Tuominen
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Corresponding author

Correspondence to O.-P. Ryynänen.

Additional information

Registration number: ISRCTN16401432 (Current Controlled Trials, http://www.controlled-trials.com/)

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Ryynänen, OP., Nousiainen, P., Soini, E. et al. Efficacy of a multicomponent support programme for the caregivers of disabled persons. Z Gerontol Geriat 46, 449–455 (2013). https://doi.org/10.1007/s00391-012-0360-0

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  • DOI: https://doi.org/10.1007/s00391-012-0360-0

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