减少成人日托中心受照顾者的破坏性行为的行为干预:一项随机临床试验(PROCENDIAS研究)

Abstract Aim This study assesses the effect of an intervention to reduce the disruptive behaviours (DB) presented by care recipient users of adult day care centres (ADCC), thereby reducing caregiver overload. While ADCC offer beneficial respite for family caregivers, the DB that many care recipients show promote resistance to attending these centres, which can be a great burden on their family caregivers. Design Randomized controlled clinical trial. Methods The study was carried out with 130 family caregivers of people attending seven ADCC in the municipality of Salamanca (Spain), randomly distributed into intervention and control groups. The intervention was applied across eight sessions, one per week, in groups of 8–10 people where caregivers were trained in the Antecedent‐Behavior‐Consequence (ABC) model of functional behaviour analysis. The primary outcome was the reduction of DB measured with the Revised Memory and Behavior Problems Checklist (RMBPC). Results An average reduction in the RMBPC of 4.34 points was obtained in the intervention group after applying the intervention ( p  < 0.01 ( U de Mann–Whitney); Cohen d  = 1.00); furthermore, differences were found in the Center for Epidemiologic Studies Depression Scale (CES‐D) ( U  = −2.67; p  = 0.008; Cohen d  = 0.50) and in the Short Zarit Burden Interview (Short ZBI) ( t  = −4.10; p  < 0.01; Cohen d  = 0.98). Conclusion The results obtained suggest that the implementation of this intervention could reduce both the frequency of DB occurrence and the reaction of the caregiver to their appearance. Improvement was also noted in the results regarding overload and emotional state of the family caregiver. Impact To our knowledge, this is the first randomized clinical trial to show that an intervention based on the ABC model could reduce the frequency and reaction of DB of care recipients in ADCC increasing their quality of life, and improving the mental health and overload of their family caregivers.