Premium
照料者自主性支持: 成年慢性病患者及其照料者干预措施的叙述综合法系统回顾
Author(s) -
Stawnychy Michael A.,
Teitelman Anne M.,
Riegel Barbara
Publication year - 2021
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.14696
Subject(s) - psychological intervention , autonomy , narrative , narrative review , psychology , medicine , psychotherapist , gerontology , nursing , political science , law , linguistics , philosophy
Chronic illnesses cause significant mortality in adults. Caregivers (spouses, adult children, friends) support adults with chronic illness in multiple ways, for instance through support of their autonomous decisions about how and why to engage in self‐care. Aim To examine interventions designed to improve the health and well‐being of adults with chronic illness by enhancing the autonomy supportive behaviours of caregivers. Design Systematic review of randomized controlled trials with narrative synthesis. Data sources All available dates of publication through August 2020 conducted in PubMed, Medline, Ageline, PsychInfo, and CINAHL. Methods Randomized controlled interventions of adults with chronic illness and their caregivers with content to enhance caregiver autonomy support were included. Interventions involving healthcare personnel, adults without self‐care capacity, or not published in English were excluded. Quality was appraised using Joanna Briggs Institute recommendations. Common themes in autonomy support and associated outcomes (e.g., self‐care, social support) were synthesized. Results Search identified 1,426 studies with 16 included in review ( N = 2,486 dyads). Methodological quality was moderate. Successful interventions were skills‐based, targeted various communication styles, contained in‐person elements, and involved nurses. Half of the interventions assessed autonomy support outcomes; 63% (5 of 8) of these improved autonomy support. Results were generally positive for social support, mixed for self‐care, and null for caregiver burden. Heterogeneity and complexity of studies limited attribution of effects. Conclusion Behavioural interventions designed to enhance dyadic caregiver interpersonal communication to be autonomy supportive may positively influence caregiver skills and chronic illness outcomes. Future studies of autonomy support are needed to identify core intervention components. Impact This is the first systematic review examining interventions promoting caregiver to care‐receiver autonomy support. Modifying interpersonal communication to be autonomy supportive has potential to improve chronic illness outcomes. Findings can inform how clinicians and investigators enlist caregiver autonomy support to encourage behaviour change.