Propuesta de intervención con terapias de tercera generación para cuidadores de personas con demencia en el ámbito rural

  1. Pérez Lancho, Mª Cruz 1
  2. Tejido González, María 2
  1. 1 Universidad Pontificia de Salamanca
    info

    Universidad Pontificia de Salamanca

    Salamanca, España

    ROR https://ror.org/02jj93564

  2. 2 Psicóloga General Sanitaria
Zeitschrift:
International Journal of Developmental and Educational Psychology: INFAD. Revista de Psicología

ISSN: 0214-9877

Datum der Publikation: 2024

Titel der Ausgabe: Viviendo la edad en positivo. El envejecimiento como riqueza del ser humano

Ausgabe: 2

Nummer: 1

Seiten: 93-103

Art: Artikel

DOI: 10.17060/IJODAEP.2024.N1.V2.2701 DIALNET GOOGLE SCHOLAR lock_openOpen Access editor

Andere Publikationen in: International Journal of Developmental and Educational Psychology: INFAD. Revista de Psicología

Zusammenfassung

Family caregivers of people with dementia suffer a progressive overload in the task of caring, which makes them especially vulnerable to suffering psychological and health problems. In the case of caregivers who reside in rural areas, this challenge increases due to their high age, technological barriers and problems with access to specialized assistance resources. Third generation therapies offer us, in this context, new ways of understanding and doing psychotherapy, incorporating concepts such as acceptance, psychological flexibility or values, which can help prevent overload. Aim. To develop an intervention proposal with a hybrid design between the Acceptance and Commitment Therapy (ACT) models (Losada, 2015) and the Mindfulness and Self-Compassion (MSC) program. Methodology. A pre-post design is proposed, with two experimental groups (in-person and online) and a control group of caregivers of people with dementia. It is proposed to influence the variables: caregiver overload, anxiety, depression, quality of life, mindfulness, experiential avoidance and ambivalence. Results: The group program consists of ten sessions organized into five thematic blocks: knowing dementia, self-care, experiential avoidance, cognitive flexibility and values, interspersed with the practice of mindfulness techniques. A pre and post program evaluation is established, three monthly reinforcement sessions and finally three follow-up evaluations at 3, 6 and 12 months. Conclusions: Third generation psychological interventions may constitute a beneficial option to maintain the psychological well-being of family members who care for people with dementia. In our case, we propose a psychoeducational program adapted to the special characteristics of caregivers who live in rural environments.

Bibliographische Referenzen

  • Alves, G. S., Casali, M. E., Veras, A. B., Carrilho, C. G., Costa, E. B., Rodrigues, V. M. y Dourado, M. C. (2020). A systematic review of home-setting psychoeducation interventions for behavioral changes in dementia: Some lessons for the COVID-19 pandemic and post-pandemic assistance. Frontiers in Psychiatry, 11, 1-17. https://doi.org/10.3389/fpsyt.2020.577871
  • Arsenault-Lapierre, G., Bui, T.X., Le Berre, M., Le Berre, M., Bergman, H. & Vedel, I. (2023). Rural and urban differences in quality of dementia care of persons with dementia and caregivers across all domains: A systematic review. BMC Health Serv Res, 23, 1-15. https://doi.org/10.1186/s12913-023-09100-8
  • Baer, R., Smith, G., Hopkins, J., Krietemeyer, J., y Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27-45.
  • Barakou, V., Mantzorou, M., Katsouri, I.G., Kalogianni, A. (2023) The effectiveness of psychoeducation in reducing the burden of caregivers of patients with dementia. Hellenic Journal of Nursing, 62(2), 13-26 https://www.researchgate.net/publication/372910305_The_effectiveness_of_psychoeducation_in_reducing_the_burden_of_caregivers_of_patients_with_dementia/citations
  • Barrera-Caballero, S., Romero-Moreno, R., del Sequeros Pedroso-Chaparro, M., Olmos, R., Vara-García, C., Gallego-Alberto, L., Cabrera, I., Márquez-González, M., Olazarán, J., & Losada-Baltar, A. (2021). Stress, cognitive fusion and comorbid depressive and anxiety symptomatology in dementia caregivers. Psychology and Aging, 36(5), 667–676. https://doi.org/10.1037/pag0000624
  • Bonoso García, R. M. y Del Pino Casado, R. (2018). Intervenciones no farmacológicas para reducir la depresión, sobrecarga y ansiedad en personas cuidadoras de mayores con demencia: un metaanálisis. Metas de Enfermería, 21. https://doi.org/10.35667/MetasEnf.2019.21.1003081191
  • Camarero, L., Cruz, F., González, M., del Pino, J. A., Oliva, J., & Sampedro, R. (2009). La población rural de España. Colección Estudios Sociales, 27. “Fundación la Caixa”.
  • Custodio, N., Montesinos, R., & Alarcón, J. O. (2018). Evolución histórica del concepto y criterios actuales para el diagnóstico de demencia. Revista de Neuro-Psiquiatría, 81(4), 235-249. http://dx.doi.org/10.20453/rnp.v81i4.3438
  • Del Pino-Casado, R., Priego-Cubero, E., López-Martínez, C., & Orgeta, V. (2021). Subjective caregiver burden and anxiety in informal caregivers: A systematic review and meta-analysis. PloS one, 16(3), e0247143.
  • Fernández, E. M. A., Fernández, C. A., & Pesqueira, G. S. (2002). Adaptación al español del cuestionario «Perfil de los Estados de Ánimo» en una muestra de deportistas. Psicothema, 14(4), 708-713.
  • Fowler, N. R., Judge, K. S., Lucas, K., Gowan, T., Stutz, P., Shan, M., ... & Johns, S. A. (2021). Feasibility and acceptability of an acceptance and commitment therapy intervention for caregivers of adults with Alzheimer’s disease and related dementias. BMC geriatrics, 21, 1-10. https://doi.org/10.1186/s12877-021-02078-0
  • Frías, C. E., Garcia Pascual, M., Montoro, M., Ribas, N., Risco, E., & Zabalegui, A. (2020). Effectiveness of a psychoeducational intervention for caregivers of People With Dementia with regard to burden, anxiety and depression: A systematic review. Journal of Advanced Nursing, 76(3), 787-802. https://doi.org/10.1111/jan.14286
  • Gallego-Alberto, L., Márquez-González, M., Romero-Moreno, R., Cabrera, I., & Losada, A. (2021). Pilot study of a psychotherapeutic intervention for reducing guilt feelings in highly distressed dementia family caregivers (Innovative practice). Dementia, 20(2), 759-769. doi:10.1177/1471301219886761
  • García-Castro, F. J. (2021). Relacion entre fortalezas psicologicas y salud mental en cuidadores informales de personas con demencia. Escritos de Psicología (Internet), 14(1), 20-29. Epub 20 de septiembre de 2021.https://dx.doi.org/10.24310/espsiescpsi.v14i1.12680
  • Germer, C. K., & Neff, K. D. (2013). Self compassion in clinical practice. Journal of Clinical Psychology, 69(8), 856-867.
  • Ghosh, M., Dunham, M. & O’Connell, B. (2022). Systematic review of dyadic psychoeducational programs for persons with dementia and their family caregivers. Journal of Clinical Nursing, jocn.16570. https://doi.org/10.1111/jocn.16570
  • Gómez-Gallego, M., Gómez-Amor, J., & Gómez-García, J. (2012). Validation of the Spanish version of the QoLAD scale in Alzheimer disease patients, their carers, and health professionals. Neurología (English Edition), 27(1), 4-10. doi: 10.1016/j.nrl.2011.03.006
  • Hayes, S. C., Pistorello, J., & Levin, M. E. (2012). Acceptance and commitment therapy as a unified model of behavior change. The Counseling Psychologist, 40(7), 976-1002. https://doi.org/10.1177/00110000124608
  • Hayes, S. C.; Strosahl, K. D. & Wilson, K. G. (2014). Terapia de Aceptación y Compromiso. Proceso y práctica del cambio consciente (Mindfulness). Desclée De Brouwer. ISBN: 978-84-330-2695-8
  • Hazzan, A. A., Dauenhauer, J., Follansbee, P., Hazzan, J. O., Allen, K., & Omobepade, I. (2022). Family caregiver quality of life and the care provided to older people living with dementia: Qualitative analyses of caregiver interviews. BMC Geriatrics, 22(1), 1-11.
  • Lloyd, J., Muers, J., Patterson, T. G., Marczak, M. (2019). Self-compassion, coping strategies, and caregiver burden in caregivers of people with dementia. Clin. Gerontol 42(1), 47–59.
  • Losada Baltar, A., Montorio Cerrato, I., Izal Fernández de Trocóniz, M., & Márquez González, M. (2006). Estudio e intervención sobre el malestar psicológico de los cuidadores de personas con demencia. El papel de los pensamientos disfuncionales (No. 12005). IMSERSO.
  • Losada, A., Márquez-González, M., Romero-Moreno, R., & López, J. (2014). Development and validation of the Experiential Avoidance in Caregiving Questionnaire (EACQ). Aging & Mental Health, 18(7), 897-904.http://dx.doi.org/10.1080/13607863.2014.896868
  • Losada, A., Márquez-González, M., Romero-Moreno, R., López, J., Fernández-Fernández, V., & Nogales- González, C. (2015). Atendiendo a las variadas problemáticas de los cuidadores familiares de personas con demencia: aportaciones de la terapia cognitivo-conductual y de la terapia de aceptación y compromiso. Clínica y Salud, 26(1), 41-48. https://dx.doi.org/10.1016/j.clysa.2015.02.001
  • Losada, A., Márquez-González, M., Romero-Moreno, R., Mausbach, B. T., López, J., Fernández-Fernández, V., & Nogales-González, C. (2015). Cognitive–behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for dementia family caregivers with significant depressive symptoms: Results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 83(4), 760-772.https://doi.org/10.1037/ccp0000028
  • Losada, A., Pillemer, K., Márquez-González, M., Romero-Moreno, R., & Gallego-Alberto, L. (2017). Measuring ambivalent feelings in dementia family caregivers: The caregiving ambivalence scale. The Gerontologist, 57(3), e37-e46. https://doi.org/10.1093/geront/gnw144
  • Luciano Soriano, M. C., & Valdivia Salas, M. S. (2006). La terapia de aceptación y compromiso (Act). Fundamentos, características y evidencia. Papeles del Psicólogo, 27(2), 79-91.
  • Márquez-González, M., Romero-Moreno, R., & Losada, A. (2010). Caregiving issues in a therapeutic context: New insights from the acceptance and commitment therapy approach. Casebook of Clinical Geropsychology: International Perspectives on Practice (pp.33-53).
  • Martín Carrasco, M., Franco, M., Pelegrín, C., Roy, P., Iglesias, C., Ros, S., Gobart, A. L., Pons, S., & Balañá, M.B. (2009). Effectiveness of a psychoeducational intervention program in the reduction of caregiver burden in Alzheimer’s disease patients’ caregivers. International Journal of Geriatric Psychiatry: A Journal of the Psychiatry of Late Life and Allied Sciences, 24(5), 489-499.
  • Ministerio de Sanidad, Consumo y Bienestar Social. Plan Integral de Alzheimer y otras Demencias (2019-2023). https://www.sanidad.gob.es/profesionales/saludPublica/docs/Plan_Integral_Alhzeimer_Octubre_2019.pdf
  • Morimoto, H. (2022). Acceptance and commitment improve the work–caregiving interface among dementia family caregivers. Psychology and Aging, 37(6), 749–765. https://doi.org/10.1037/pag0000698
  • Navarro, M., Jiménez, L., García, M. C., de Perosanz, M., & Blanco, E. (2018). Los enfermos de Alzheimer y sus cuidadores: intervenciones de enfermería. Gerokomos, 29(2), 79-82.
  • Omranifard, V., Haghighizadeh, E., & Akouchekian, S. (2018). Depression in main caregivers of dementia patients: Prevalence and predictors. Advanced Biomedical Research, 7. doi: 10.4103/2277-9175.225924
  • Parra-Vidales, E., Soto-Pérez, F., Perea-Bartolomé, M. V., Franco-Martín, M. A. & Muñoz-Sánchez, J. L. (2017). Intervenciones online para cuidadores de personas con demencia: revisión sistemática. Actas Españolas de Psiquiatria, 45(3), 116-126
  • Peralta, L. A., Barranco, A. B., & Sebastián, A. R. (2019). Demencias. Medicine-Programa de Formación Médica Continuada Acreditado, 12(74), 4329-4337.
  • Pérez Lancho, M. C. & Vega-Hazas Monje, C. (2023). Intervención psicoeducativa y eficacia del autocuidado en cuidadores informales de personas con demencia. International Journal of Developmental and Educational Psychology, 1(2), 27-36. https://doi.org/10.17060/ijodaep.2023.n1.v2.2475
  • Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385-401.
  • Schulz, R., McGinnis, K. A., Zhang, S., Martire, L. M., Hebert, R. S., Beach, S. R., ... & Belle, S. H. (2008). Dementia patient suffering and caregiver depression. Alzheimer Disease and Associated Disorders, 22(2), 170. doi: 10.1097/WAD.0b013e31816653cc
  • Sitges E. & Bonete B. (2014). Desarrollo de un programa psicoeducativo en inteligencia emocional para cuidadores principales de enfermos de Alzheimer. European Journal of Investigation in Health, Psychology and Education, 4(3), 257-256.
  • Spigelmyer, P. C., Kalarchian, M., Lutz, C., & Brar, P. (2023). Mindfulness Self-Compassion: Helping family caregivers cope with cognitive behaviors of dementia. Journal of Holistic Nursing, 41(2), 118-129. https: //doi.org/10.1177/089801012211237
  • Van den Kieboom, R., Snaphaan, L., Mark, R., & Bongers, I. (2020). The trajectory of caregiver burden and risk factors in dementia progression: A systematic review. Journal of Alzheimer’s Disease, 77(3), 1107-1115.
  • Vandepitte, S., Van Den Noortgate, N., Putman, K., Verhaeghe, S., Faes, K., & Annemans, L. (2016). Effectiveness of supporting informal caregivers of people with dementia: A systematic review of randomized and non-randomized controlled trials. Journal of Alzheimer’s Disease, 52(3), 929-965. DOI: 10.3233/JAD-151011
  • Vellone, E., Piras, G., Talucci, C., & Cohen, M. Z. (2008). Quality of life for caregivers of people with Alzheimer’s disease. Journal of Advanced Nursing, 61(2), 222-231. https://doi.org/10.1111/j.1365-2648.2007.04494.x
  • Weisman de Mamani, A., Weintraub, M. J., Maura, J., Martinez de Andino, A., & Brown, C. A. (2018). The interplay among mindfulness, caregiver burden, and mental health in family members of individuals with dementia. Professional Psychology: Research and Practice, 49(2), 116–123. https://doi.org/10.1037/pro0000181
  • Yorulmaz, E., y Dirik, G. (2021). Dementia caregivers and cognitive behavioral therapy. Psikiyatride Guncel
  • Yaklasimlar - Current Approaches in Psychiatry, 13(2), 170-191. cap_13_02_01_en.pdf (psikguncel.org) https://www.bing.com/search?q=https://doi.org/10.18863/pgy.732086ycvid=8a33246e1c2f4079bebb43045a34e9f6yform=WSBBST
  • Zarit, S. H., Reever, K. E., Msg, M. P. A., &; Bach-peterson, J. (1980). Relatives of the Impaired Elderly: Correlates of Feelings of Burden. The Gerontologist, 20(6), 649-655.
  • Zulkifley, N. H., Ismail, S., Manaf, R. A. & Ying, L. P. (2020). Educational intervention for informal caregivers of person with dementia: A systematic review. Malaysian Journal of Medicine and Health Sciences. 16(1), 325- 331. http://mymedr.afpm.org.my/publications/90875