RESUMEN
BACKGROUND: In our environment, care of the dependent elderly is usually provided by family members, thereby ensuring autonomy and avoiding institutionalization of the dependent adult. Thirty-three percent of Spanish caregivers have acknowledged the importance of acquiring the knowledge and skills necessary for daily care. Consequently, several interventions have been developed by health professionals from distinct disciplines. OBJECTIVE: The purpose of this study was to systematically review and evaluate the efficacy of published interventions for the caregivers of dependent elderly individuals. MATERIAL AND METHODS: We conducted a systematic review of the literature on interventions in the caregivers of the dependent elderly (older than 65 years old) published between 1996 and 2006. The inclusion criteria included controlled clinical trials with outcome measures related to effectiveness in reducing caregiver burden, anxiety and depression. Our search yielded 15 reports. RESULTS: The interventions produced statistically significant reductions in burden (40%), anxiety (50%) and depression (90%). Interventions requiring active participation by caregivers and those based on cognitive-behavioral therapy were more effective than those focused on knowledge acquisition. CONCLUSION: Due to the heterogeneity of caregiving interventions, evaluation of both the clinical and statistical significance of these interventions is essential. Reducing the chronic stress experienced by caregivers is difficult to achieve. Consequently, future experimental designs should take into account the needs reported by caregivers as well as promote active participation.
Asunto(s)
Ansiedad , Cuidadores , Depresión , Anciano , Ansiedad/terapia , Depresión/terapia , Humanos , Carga de TrabajoRESUMEN
Introducción: el cuidado de un anciano dependiente en nuestroentorno social es asumido por los miembros de su familia o cuidadoresprincipales (CP); ellos son los responsables de mantenerla autonomía del anciano y de su permanencia en el entorno familiar.El 33% de los CP españoles manifiestan la importancia deadquirir conocimientos y habilidades para el cuidado, por lo queprofesionales de la salud de distintas disciplinas han diseñadodiferentes programas de intervención.Objetivo: el propósito de este estudio fue realizar una revisiónsistemática sobre la eficacia de las intervenciones dirigidas a CPde ancianos dependientes.Material y métodos: se realizó una revisión sistemática de la literaturacientífica publicada sobre intervenciones dirigidas a CPde personas mayores de 65 años dependientes, realizadas de1996 a 2006. Los criterios de inclusión fueron: artículos primarioscon selección aleatoria grupo experimental/grupo control y queanalizaran la eficacia de la intervención sobre la sobrecarga, laansiedad o la depresión. La muestra final la compusieron 15 estudiosque cumplían los criterios de inclusión.Resultados: las intervenciones mostraron resultados estadísticamentesignificativos sobre la sobrecarga (40%), la ansiedad(50%) y la depresión (90%).Las intervenciones con participación activa de los CP y basadasen terapia cognitivo conductual fueron más eficaces que aquellascuyo contenido se centró exclusivamente en la adquisiciónde conocimientos.Conclusiones: la heterogeneidad de las intervenciones hacenimprescindible, en esta área de estudio, valorar la relevancia clínicade los resultados además de la significación estadística. Dadoque los efectos del cuidado son estresores crónicos difícilmentemodificables, en futuros estudios se debería planteardiseños experimentales, sin olvidar las necesidades expresadaspor los propios CP y promoviendo su participación activa(AU)
Background: in our environment, care of the dependent elderlyis usually provided by family members, thereby ensuring autonomyand avoiding institutionalization of the dependent adult.Thirty-three percent of Spanish caregivers have acknowledgedthe importance of acquiring the knowledge and skills necessaryfor daily care. Consequently, several interventions have been developedby health professionals from distinct disciplines.Objective: the purpose of this study was to systematically reviewand evaluate the efficacy of published interventions for the caregiversof dependent elderly individuals.Material and methods: we conducted a systematic review of theliterature on interventions in the caregivers of the dependent elderly(older than 65 years old) published between 1996 and 2006.The inclusion criteria included controlled clinical trials with outcomemeasures related to effectiveness in reducing caregiverburden, anxiety and depression. Our search yielded 15 reports.Results: the interventions produced statistically significant reductionsin burden (40%), anxiety (50%) and depression (90%).Interventions requiring active participation by caregivers andthose based on cognitive-behavioral therapy were more effectivethan those focused on knowledge acquisition. Conclusion: due to the heterogeneity of caregiving interventions,evaluation of both the clinical and statistical significance of theseinterventions is essential. Reducing the chronic stress experiencedby caregivers is difficult to achieve. Consequently, future experimentaldesigns should take into account the needs reportedby caregivers as well as promote active participation(AU)