Effectiveness of an intervention in groups of family caregivers of dependent patients for their application in primary health centers. Study protocol.

BACKGROUND: Although Primary Health Care (PHC) Teams are used to deal with prevention and treatment of sanitary problems in adults with chronic diseases, they usually have a lack of experience in development of psychotherapeutic interventions. However, these interventions are the ones that achieve better results to reduce symptomatology and improve emotional state of caregivers.The study aims to evaluate the effectiveness of an intervention of psychotherapy in improving the mental health and Quality of life of caregivers. This intervention is based on theoretical approaches to care adjusted to cognitive theory, in order to be applied in primary health care centres. METHODS/DESIGN: This is multicentre clinical trials study, randomized in two parallel groups, carry out in two PHC, Study population: 150 caregivers will be included by consecutive sampling and they will be randomized the half to experimental group and the other half to control group. They provide mostly all the assistance to care-dependent familiars receiving attention in PHC Centers. MEASUREMENTS: Each caregiver will be evaluated on a personal interview. The caregivers' assessment protocol: 1) Assessment of different socio-demographic related to care, and caregiver's personal situation. 2)Care-dependent individuals will also be assessed by Barthel Index and Pfeiffer Questionnaire (SPMSQ). 3)Change in caregivers will be the principal measure: family function (Family APGAR Questionnaire), burden short questionnaire (Short Zarit Burden Interview), quality of life (Ruiz & Baca: 1993 Questionnaire), the Duke-UNK Functional Social Support Questionnaire, the General Health Questionnaire-12, and changes in Dysfunctional Thoughts about caring. 4) Intervention implementation measures will also be assessed. INTERVENTION: A psychotherapeutic intervention will be 8 sessions of 90 minutes in groups. This intervention has been initially developed for family caregivers of patients with dementia. DISCUSSION: Psychotherapeutic interventions have been proved to obtain better results to reduce symptomatology and improve emotional state of caregivers. Moreover, this intervention has been proved to be effective in a different setting other than PHC, and was developed by professionals of Mental Health. If we found that this intervention is effective in PHC and with our professionals, it would be an important instrument to offer to caregivers of care-dependent patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT01177696.

Función familiar y salud mental del cuidador de familiares con dependencia / Family function and the mental health of the career of the dependent relative

ObjetivoAnalizar la influencia de la función familiar en la salud mental percibida por los cuidadores de familiares con dependencia.DiseñoEstudio observacional descriptivo transversal.EmplazamientoDos centros de salud urbanos.ParticipantesCiento cincuenta y tres cuidadores de familiares dependientes.Mediciones principalesVariables sociodemográficas del cuidador y del paciente dependiente y consumo de psicofármacos por el cuidador. Se utilizaron cuestionarios en el cuidador para valorar la salud mental general (GHQ [General Health Questionnaire ‘cuestionario general de salud’]-12 de Goldberg), la función familiar (APGAR [adaptation, partnership, growth, affection and resolve ‘adaptación, asociación, crecimiento, afecto y resolución’] familiar) y el apoyo social (Duke University-University of North Carolina). En el paciente dependiente, el deterioro cognitivo se evaluó con el cuestionario de Pfeiffer y el grado de dependencia funcional con el índice de Barthel.ResultadosLa edad media de los cuidadores fue de 63,8 años; 111 (72,5%) eran mujeres, el 57% tenía estudios primarios y el 37,1% tomaba psicofármacos. Más del 40% de los familiares dependientes presentó deterioro cognitivo importante y el grado de dependencia funcional total fue del 49,7%. Un 27% de los cuidadores presentaba deterioro de la salud mental, las familias se percibían como disfuncionales en un 31,3% y un 32,7% tenía escaso apoyo social. Las variables asociadas al deterioro de la salud mental de los cuidadores fueron el consumo de psicofármacos, la disfuncionalidad familiar, el escaso apoyo social y el bajo nivel educativo.ConclusiónLa función familiar es un importante predictor de la salud mental de los cuidadores de pacientes dependientes(AU)

ObjectiveTo analyse the influence of family function on the caregiver's perceived mental health.DesignCross-sectional study.SettingTwo primary care urban health centres.Participants153 caregivers of dependent people.MeasurementSociodemographic variables of caregiver and dependent relative and psychoactive drugs prescribed to caregiver. Caregiver questionnaires: mental health evaluated with General Health Questionnaire (GHQ-12), family function with adaptation, partnership, growth, affection and resolve (APGAR), and Duke University-University of North Carolina functional social support questionnaire. Care-recipient questionnaires: cognitive disorders with Pfeiffer and functional dependence level with Barthel.ResultsCaregiver's mean age was 63.8 years; 72.5% (n=111) were female; 57.5% have only primary school studies; and 37.1% take psychoactive drugs. More than 40% of the care-receivers have cognitive disorders and 49.7% have total functional impairment. According to the GHQ-12, 27% of the caregivers had mental health disorders; 31.3% of the families were dysfunctional and 32.7% had poor social support. The variables that significantly contributed to the explanation of caregiver's mental health have been: psychoactive drug intake, family function, social support and educational level.ConclusionFamily function is an important predictor of caregiver's mental health(AU)

[Family function and the mental health of the caregiver of dependent relatives]. / Función familiar y salud mental del cuidador de familiares con dependencia.

OBJECTIVE: To analyse the influence of family function on the caregiver's perceived mental health. DESIGN: Cross-sectional study. SETTING: Two primary care urban health centres. PARTICIPANTS: 153 caregivers of dependent people. MEASUREMENT: Sociodemographic variables of caregiver and dependent relative and psychoactive drugs prescribed to caregiver. Caregiver questionnaires: mental health evaluated with General Health Questionnaire (GHQ-12), family function with adaptation, partnership, growth, affection and resolve (APGAR), and Duke University-University of North Carolina functional social support questionnaire. Care-recipient questionnaires: cognitive disorders with Pfeiffer and functional dependence level with Barthel. RESULTS: Caregiver's mean age was 63.8 years; 72.5% (n=111) were female; 57.5% have only primary school studies; and 37.1% take psychoactive drugs. More than 40% of the care-receivers have cognitive disorders and 49.7% have total functional impairment. According to the GHQ-12, 27% of the caregivers had mental health disorders; 31.3% of the families were dysfunctional and 32.7% had poor social support. The variables that significantly contributed to the explanation of caregiver's mental health have been: psychoactive drug intake, family function, social support and educational level. CONCLUSION: Family function is an important predictor of caregiver's mental health.