Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

An Experimental Study on the Effectiveness of a Mutual Support Group for Family Caregivers of a Relative with Dementia in Mainland China

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

An Experimental Study on the Effectiveness of a Mutual Support Group for Family Caregivers of a Relative with Dementia in Mainland China

Article excerpt

INTRODUCTION

In developed countries, the prevalence rates of dementia are estimated to increase from 2% in persons aged 65-75 years to more than 30% in those aged 85 and older (Chien, 2005; Cummings et al., 2002). In 2009, the prevalence rate of dementia in Guangzhou was about 4.2% overall or about 320,000 persons aged 65 years and older (All China Data Center, 2010). Dementia is characterized by progressive decline in cognitive and functional abilities, as well as psychological and behavioral disturbances such as psychotic and depressive symptoms and agitated and abnormal behaviors. People with dementia are increasingly dependent upon family members to provide daily care or fully depend on them at the latest illness stage (Heru, Ryan, & Iqbal, 2004).

Family members often experience a heavy burden and emotional distress in caring for a relative with dementia, which may also contribute psychosocial health problems and higher risks for mortality (Brodaty, Green, & Koschera, 2003). The negative outcomes associated with care-giving are well documented and involve a wide variety of health concerns. They include psychological disturbances (e.g., depression and anxiety), reduced physical functioning and immunological dysfunction, poor interpersonal relationships, and social activity restrictions (Belle et al., 2006; Mitrani & Czaja, 2000). An accumulation of these pressures can threaten caregivers' ability and self-efficacy in taking care of their relative with dementia at home.

To address the psychosocial health effects of dementia care, different psychosocial interventions were developed in the United States, such as the Resources for Enhancing Alzheimer's Caregiver Health (REACH) program and the Program of All-Inclusive Care for the Elderly (PACE). These programs mainly consisted of supportive and educational strategies in helping these caregivers understand the illness and its care (Belle et al., 2006). Some of them have indicated preliminary evidence of its effectiveness on improving caregivers' overall health condition and delaying clients' institutionalization (Brodaty et al., 2003; Schulz, Martire, & Klinger, 2005). However, only few indicated significant effect on reducing clients' behavioral problems and thus improving caregivers' distress or quality of life (Schulz & Martire, 2004). In addition, most family intervention studies have focused on Caucasian populations and few studies have been carried out with Chinese and Asian populations where great importance is attached to intimate interpersonal relationships with and a need for social support from family members (Chien & Lee, 2011). Therefore, this study was to test the effect of a family mutual support group program that incorporated educational, supportive and community mental health care components in a group of family members caring for a relative with dementia at home.

LITERATURE REVIEW

Family-centered intervention in dementia care

Among various intervention approaches to dementia care in the community, family focused psychosocial interventions are of utmost importance and more significant effects on both clients' and families' health outcomes (Brodaty et al., 2003). Skills requisition in behavioral techniques, symptom management and social problem-solving have been commonly used to help these caregivers manage the behavioral problems of their relatives with dementia and improve their ability in care-giving (Chien & Lee, 2011). Results of a single-centre controlled trial for home-resided clients with dementia in Hong Kong indicates that supportive family group intervention can improve caregivers' overall health conditions (Fung & Chien, 2002), whereas a family psycho-education group program for people with dementia produced positive effects on both clients' and their families' mental health and daily functioning (Chien & Wong, 2007).

Not only focused on the community care of people with dementia, the psychological and behavioral reactions of family caregivers towards this chronic and 'incurable' illness such as anticipatory grief, social restriction and their uncertainty about the hardships of long duration care- giving have been of great concerns (Asen, 2002). …

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