Samenvatting
Wat is bekend?
Wat is nieuw?
Inleiding
Methode
Selectie van deelnemers
Interventie en controle
Metingen
Randomisatie
Statistische analyse
Resultaten
Onderzoekspopulatie
Interventiegroep (n = 96) | Controlegroep (n = 96) | |||
---|---|---|---|---|
Mantelzorger | ||||
| 67,8 | (9,8)* | 71,2 | (10,7) |
| 29 | (30,2) | 28 | (29,2) |
| 67 | (69,8) | 68 | (70,8) |
| 92 | (95,8) | 89 | (92,7) |
| 28 | (29,2) | 34 | (35,4) |
| 37 | (38,5) | 30 | (31,3) |
| 29 | (30,2) | 32 | (33,3) |
| ||||
| 13 | (13,5) | 8 | (8,3) |
| 23 | (24,0) | 23 | (24,0) |
| 59 | (61,5) | 65 | (67,7) |
Patiënt | ||||
| 72,8 | (9,1)* | 76,7 | (8,3) |
| 66 | (68,8) | 64 | (67,7) |
| 30 | (31,3) | 32 | (33,3) |
| 5,1 | (1,4) | 5,3 | (1,1) |
| 2,7 | (1,8) | 2,6 | (1,5) |
| 21,4 | (4,9) | 21,7 | (5,6) |
| ||||
| 54 | (56,3) | 56 | (58,3) |
| 42 | (44,8) | 40 | (41,7) |
Depressie en angst
Uitkomstmaat | Interventie (n = 96) | Controle (n = 96) | Effectmaat | |
---|---|---|---|---|
Dichotome uitkomstmaten | n | n | IRR | (95%-BI) |
| 38 | 34 | 0,98 | (0,69 tot 1,38) |
| 28 | 19 | 1,21 | (0,80 tot 1,84) |
| 28 | 27 | 0,89 | (0,51 tot 1,56) |
Continue uitkomstmaten | gemiddelde | gemiddelde | R*T | |
| –1,40 | (–3,91 tot 1,10) | ||
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| –0,55 | (–1,59 tot 0,49) | ||
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Verpleeghuisopname
Acceptatie van de interventie en per-protocolanalyse
Aanvullende analyses
Beschouwing
Te weinig contrast met gebruikelijke zorg
Te lage intensiteit
Matige compliantie
Verkeerde doelgroep, verkeerde timing
Generaliseerbaarheid
Conclusie
Literatuur
- 1.↲World Health Organization and Alzheimer’s Disease International. Dementia: A public health priority. Geneva: WHO, 2012.
- 2.↲Luppa M, Luck T, Brahler E, Konig HH, Riedel-Heller SG. Prediction of institutionalisation in dementia. A systematic review. Dement Geriatr Cogn Disord 2008;26:65-78.
- 3.↲Drentea P, Clay OJ, Roth DL, Mittelman MS. Predictors of improvement in social support: Five-year effects of a structured intervention for caregivers of spouses with Alzheimer’s disease. Soc Sci Med 2006;63:957-67.
- 4.↲Mittelman MS, Ferris SH, Shulman E, Steinberg G, Ambinder A, Mackell JA, et al. A comprehensive support program: effect on depression in spouse-caregivers of AD patients. Gerontologist 1995;35:792-802.
- 5.↲Mittelman MS, Roth DL, Coon DW, Haley WE. Sustained benefit of supportive intervention for depressive symptoms in caregivers of patients with Alzheimer’s disease. Am J Psychiatry 2004;161:850-6.
- 6.↲Mittelman MS, Ferris SH, Steinberg G, Shulman E, Mackell JA, Ambinder A, et al. An intervention that delays institutionalization of Alzheimer’s disease patients: Treatment of spouse-caregivers. Gerontologist 1993;33:730-40.
- 7.↲Mittelman MS, Ferris SH, Shulman E, Steinberg G, Levin B. A family intervention to delay nursing home placement of patients with Alzheimer disease: A randomized controlled trial. JAMA 1996;276:1725-31.
- 8.↲Mittelman MS, Haley WE, Clay OJ, Roth DL. Improving caregiver well-being delays nursing home placement of patients with Alzheimer disease. Neurology 2006;67:1592-9.
- 9.↲Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (MINI): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59 Suppl 20:22-33.
- 10.↲Joling KJ, Van Hout HP, Scheltens P, Vernooij-Dassen M, Van den Berg B, Bosmans J, et al. (Cost)-effectiveness of family meetings on indicated prevention of anxiety and depressive symptoms and disorders of primary family caregivers of patients with dementia: Design of a randomized controlled trial. BMC Geriatr 2008;8:2.
- 11.↲Joling KJ, Van Hout HP. Ondersteuning voor mantelzorgers van dementerenden: Het belang van familiegesprekken. Bijblijven 2009;25:63-7.
- 12.↲↲Joling KJ, Van Marwijk HW, Van der Horst HE, Scheltens P, Van de Ven PM, Appels BA, et al. Effectiveness of family meetings for family caregivers on delaying time to nursing home placement of dementia patients: A randomized trial. PLoS One 2012;7:e42145.
- 13.↲↲↲Joling KJ, Van Marwijk HW, Smit F, Van der Horst HE, Scheltens P, Van de Ven PM, et al. Does a family meetings intervention prevent depression and anxiety in family caregivers of dementia patients? A randomized trial. PLoS One 2012;7:e30936.
- 14.↲Radloff L. The CES-D scale: A self -report depression scale for research in the general population. Appl Psych Meas 1977;1:385-401.
- 15.↲Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361-70.
Reacties (1)
In het bijschrift van de figuur op pagina 163 is helaas een fout geslopen. Er staat: Overleving bij melanoom. Er moet staan: Stroomdiagram van een onderzoek.
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