| ObjectiveTo explore the current situation and influencing factors of family caregivers’ burden of dementia patients,construct an acceptance and commitment therapy intervention plan,and then verify the intervention effect of this plan on caregiver care burden,psychological flexibility,and affiliated stigma for dementia patients.MethodsThis study includes two parts: a survey on the current burden of care for caregivers of dementia patients and the construction and application of intervention plans.1.Survey on the current situation and influencing factors of caregiver burden in families of dementia patients: Using the convenience sampling method,211 caregivers of dementia patients in outpatient and inpatient departments of 2 tertiary first-class hospitals in Zhengzhou City,Henan Province were selected from October 2021 to April 2022.The general information questionnaire,Zarit Caregiver Burden Interview(ZBI)The second edition of the Acceptance and Action Questionnaire(AAQ-II)and the Affiliated Stigma Scale(ASS)were used for questionnaire surveys.The data were analyzed and processed using t-tests,analysis of variance,and multiple linear regression analysis.2.Construction and Application of an ACT Intervention Plan for the Care Burden of Family Caregivers of Dementia Patients: The first draft of the intervention plan was developed based on current situation survey,literature review,acceptance commitment therapy psychotherapy model,and stress-cognitive evaluation-coping theory.Then,the intervention plan was revised through expert consultation,and further modifications and improvements were made after the pre-experiment,ultimately forming the final draft of the ACT intervention plan.From July to September 2022,64 family caregivers of dementia patients who met the inclusion and exclusion criteria in the outpatient and inpatient departments of two tertiary first-class hospitals in Zhengzhou,Henan Province were selected as the research subjects.To ensure the quality and effectiveness of intervention,the study subjects were first numbered according to the order in which outpatient and inpatient patients registered for intervention,numbered 1,2,3,and until the 60 th.Then,the study subjects were randomly divided into an intervention group and a control group using a random number table method,with 32 patients in each group.The control group received routine health education,while the intervention group received ACT on the basis of the control group.Questionnaire evaluation was conducted on the intervention group and control group before and immediately after intervention,using ZBI,AAQ-II,and ASS to evaluate the intervention effect of acceptance and commitment therapy.Use frequency(percentage)and mean ± standard deviation,independent sample t-test or c2-test to describe and statistically analyze the data.Result1.Cross-sectional study: The score of caring burden of dementia caregivers was(44.50±11.68).Patients’ self-care ability in daily life,caregivers’ educational level,age,caring time,psychological flexibility and affiliate stigma were the main influencing factors of caregivers’ caring burden(β=2.428,-1.933,-2.331,2.113,0.266,0.261,P<0.05).2.Intervention plan construction: We have constructed an intervention plan that includes eight stages:establishing relationships to promote communication,accepting diseases and emotions,maintaining distance between cognitive dissociation and unreasonable beliefs and ideas,focusing on the present,taking oneself as the scene,clarifying values and clarifying values,and committing to action to continue moving forward.The intervention time was once a week for 8 weeks,8 times,40 to 60 minutes each time.The intervention location was in the outpatient classroom of the hospital,and the intervener was a neurology nurse who had been working for 20 years,assisted by the researcher himself.The intervention form was group intervention,with 4 people in each group and a total of 8 groups.3.Application of intervention plans: Before intervention,there was no statistically significant difference between the two groups in caregiving burden,psychological flexibility and affiliated stigma scores(P>0.05).Immediately after intervention,the scores of caregivers in the intervention group were lower than those in the control group in terms of caregiving burden and psychological flexibility,and the scores of affiliate stigma,affective dimension,cognitive dimension and behavioral dimension were lower than those in the control group,with statistical significance(P<0.001).Conclusion1.The burden of care for family caregivers of dementia patients is at a moderate level,with factors such as caregiver age,education level,daily care time,psychological flexibility,and affiliate stigma,as well as the severity of dementia and the patient’s ability to take care of themselves in daily life.2.Implementing ACT interventions based on the Acceptance and Commitment Therapy Psychotherapy Model and the Lazarus Stress and Coping Model can effectively enhance family caregivers’ ability to accept patients’ diseases,alleviate care pressure and pain,thereby in the short-term reducing their care burden and affiliated stigma,and improving psychological flexibility.3.ACT intervention has high feasibility and is suitable for the family caregivers of dementia patients,which is worth further promotion and application. |
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