Social distancing policies adopted in the COVID-19 pandemic generated a negative psychological impact on the general population and can affect caregivers of people with dementia more severely. Objective: This study screened for indications of mental health problems among informal caregivers of people with dementia. Main changes in the people’s routine and behavior resulting from the social isolation measures adopted due to the pandemic were also investigated. Method: Thirty-five informal caregivers of people with dementia from a medium-sized Brazilian city responded to a telephone interview. Results: Risks for mental health problems were found in 31.4% of the sample. These participants stated that they found it very difficult to deal with routine care changes during the pandemic. The variables related to the caregiver’s characteristics and those related to changes in routine significantly affected the caregiver’s mental health scores. Discussion: Indices of mental disorders in the studied sample did not differ from the prevalence of mental health problems in the general population during COVID-19 pandemic; however, participants reported worsening symptoms such as nervousness, sadness, and sleep during quarantine. Conclusions: Results show the complexity of this topic and the need for individual care for this group, especially in situations like the COVID-19 pandemic.
ABSTRACT. The COVID-19 pandemic has created the need to develop psychological interventions to support people with dementia and their caregivers in the context of social distancing. This study sought to investigate, systematize, and report results of scientific studies published in the past 5 years on synchronous online psychological interventions using videoconferencing for informal caregivers of people with dementia. The PubMed, BIREME, and Web of Science databases were searched using the descriptors “caregiver,” “dementia,” “online,” and “intervention.” Six international studies were included in the review. Results demonstrated, in general, that this modality of intervention was acceptable, feasible, and promoted benefits for the health, quality of life, and well-being of caregivers. A need was identified for further studies investigating synchronous online interventions that include follow-up and a control group to further the evidence on the effectiveness and feasibility of this type of therapeutic intervention.
Cuidadoras de pessoas com demência apresentam dificuldades para lidar com comportamentos desafiadores dos idosos, sobretudo durante situações naturalmente estressantes, como a pandemia de Covid-19. O objetivo desta pesquisa foi avaliar os efeitos de duas intervenções breves (uma grupal e uma individual), online, dirigidas a cuidadores de adultos mais velhos (AMV) com Transtorno Neurocognitivo Maior (TNM), com foco na análise do funcional (AF) e manejo de comportamentos desafiadores. Para avaliação da efetividade da intervenção grupal foram utilizadas como variáveis dependentes diretas as medidas de sobrecarga, depressão, ansiedade, qualidade de vida e esperança dessas cuidadoras. Na intervenção individual a variável dependente era a frequência de emissão de comportamentos desafiadores dos AMV com TNM. Participaram da etapa grupal 17 cuidadoras de familiares com diagnóstico de TNM. Foram coletadas medidas de depressão, ansiedade, qualidade de vida, sobrecarga e estresse, e esperança antes (pré-teste) e depois da intervenção (pós-teste). A intervenção teve cinco sessões em formato online para ensino AF. Ao final da etapa grupal as cuidadoras aprenderam a realizar análise funcional de comportamentos-alvo, houve diminuição de sintomas de depressão, ansiedade e menor impacto emocional dos comportamentos desafiadores sobre as cuidadoras. Da etapa individual participaram três cuidadoras de familiares com demência. A intervenção ocorreu em formato online, por videochamadas e mensagens de texto. Foi utilizado o delineamento de linha de base múltipla entre comportamentos. A intervenção consistiu de cinco etapas: selecionar comportamentos-alvo, realizar análises funcionais, ensinar o registro e envio de frequência diária dos comportamentos-alvo por mensagem de texto, planejar a intervenção e orientar/acompanhar as cuidadoras durante a implementação. Foram selecionados para intervenção os comportamentos de autolesão, recusa a tomar banho, perguntar quem são os familiares próximos, fazer perguntas repetitivas, pedidos para ir para casa, recusa para atender pedidos e agressividade física. Todas as intervenções realizadas consistiram de alterações de antecedentes: alterar a forma de realizar os pedidos, propor atividades reforçadoras, e montagem e manuseio de um caderno de memória. As intervenções foram implementadas de maneira satisfatória, com redução de todos os comportamentos-alvo, exceto o comportamento de perguntar o nome dos familiares. Discute-se a viabilidade e importância de intervenções online, tanto individuais quanto grupais, para manejo de comportamentos desafiadores, e sua acessibilidade para essa população, levando em consideração a realidade das condições das cuidadoras. Ressalta-se que intervenções online podem auxiliar as cuidadoras a manejar comportamentos desafiadores, melhorando a qualidade de vida das cuidadoras e do AMV com TNM. Palavras-chave: comportamentos desafiadores, cuidadoras informais, intervenção online. Souza, Y. L. P. (2022). Evaluation of the effectiveness of two online intervention modaliti...
Behavioral symptoms of people with dementia can negatively affect the mental health of informal caregivers. The aims of this study were to describe the behavioral symptoms of adults diagnosed with dementia based on the report of their caregivers and to characterize the caregivers regarding the level of hope, burden and stress related to care. Twenty informal caregivers participated in the study, with an average age of 54 years, predominantly daughters and wives of the patients, who granted an interview and responded to instruments regarding burden and stress, hope, patient’s characteristics and behavioral problems. Despite a high level of hope, the participants had a burden level compatible with that of caregivers of chronic patients. The most mentioned challenging behaviors were difficulties in carrying out activities of daily living and aggressiveness, predominantly characterized as behavioral excesses. We emphasize the importance of interventions with caregivers of people with neurocognitive disorder, oriented to the management of challenging behaviors.
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