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Psychother Psychosom Med Psychol 2012; 62(09/10): 375-382
DOI: 10.1055/s-0032-1321881
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Der Problemlöse-Ansatz in der Beratung pflegender Angehöriger von Schlaganfall-Betroffenen – Eine inhaltliche Analyse bearbeiteter Themen

Problem-Solving Counselling for Caregivers of Stroke Survivors – An Analysis of the Addressed Topics
Denis Beische
1   Robert-Bosch-Krankenhaus, Klinik für Geriatrische Rehabilitation, Stuttgart
,
Martin Hautzinger
2   Abteilung für Klinische Psychologie und Entwicklungspsychologie, Universität Tübingen
,
Clemens Becker
1   Robert-Bosch-Krankenhaus, Klinik für Geriatrische Rehabilitation, Stuttgart
,
Klaus Pfeiffer
1   Robert-Bosch-Krankenhaus, Klinik für Geriatrische Rehabilitation, Stuttgart
› Author Affiliations
Further Information

Publication History

eingereicht 20 March 2012

akzeptiert 26 June 2012

Publication Date:
01 October 2012 (online)

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Zusammenfassung

Problemlöse-Ansätze werden in zahlreichen Interventionen für pflegende Angehörige angewendet. Selten wird in Studien berichtet, welche Problembereiche bearbeitet wurden. Diese Arbeit bezieht sich auf die 3-monatige Hauptinterventionszeit eines telefonbasierten Problemlösetrainings für pflegende Angehörige älterer Schlaganfall-Betroffener (TIPS-Studie). Die vorgestellten Daten wurden an 47 Pflegenden erhoben, die ihre Partner (n=42) oder (Groß-)Eltern (n=5) pflegten. Die Ergebnisse zeigen, dass durch die Bearbeitung von vom Pflegenden priorisierten Alltagsproblemen mit wenigen Kontakten wirkungsvolle Verbesserungen der Pflegebelastung erreicht werden konnten. Belastungen, die als wenig kontrollierbar empfunden wurden und ein eher emotionsfokussiertes Coping erfordert hätten, wurden dagegen vergleichsweise selten aufgegriffen. Möglichkeiten der Anpassung des Ansatzes und der Umsetzung im Rahmen der Pflegeberatung durch andere Berufsgruppen werden diskutiert.

Abstract

Problem-solving therapies for family caregivers have been described for different dyads and care recipients with various chronic conditions. Only little attention is directed to the specific topics worked on with informal caregivers. This study focuses on the intensive intervention period of 3 months of an individualized mainly telephone-based problem-solving training for informal carers of stroke survivors (TIPS-Study). We present data of 47 strained caregivers who cared for their spouses and partners (n=42) or (grand-)parents (n=5). Results show that effective changes in burden can be achieved with only few contacts concentrating on problems that can be controlled by problem-focused coping mechanisms. Problems that require emotion-focused coping were processed rarely. Future perspectives of the approach are discussed.

Schlüsselwörter

Problemlöse-Ansatz - Kartensortieren - pflegende Angehörige - Schlaganfall-Betroffener

Keywords

problem-solving - card-sorting - caregiver - stroke survivor
 

  • Literatur

  • 1 Berg A, Palomaki H, Lonnqvist J et al. Depression among caregivers of stroke survivors. Stroke 2005; 639-643
    PubMedGoogle Scholar
  • 2 Forsberg-Warleby G, Moller A, Blomstrand C. Psychological well-being of spouses of stroke patients during the first year after stroke. Clin Rehabil 2004; 430-437
    PubMedGoogle Scholar
  • 3 Han B, Haley WE. Family caregiving for patients with stroke. Review and analysis. Stroke 1999; 1478-1485
    PubMedGoogle Scholar
  • 4 Jungbauer J, von Cramon DY, Wilz G. Langfristige Lebensveränderungen und Belastungsfolgen bei Ehepartnern von Schlaganfallpatienten. Nervenarzt 2003; 1110-1117
    PubMedGoogle Scholar
  • 5 Haley WE, Allen JY, Grant JS et al. Problems and benefits reported by stroke family caregivers: results from a prospective epidemiological study. Stroke 2009; 40: 2129-2133
    CrossrefPubMedGoogle Scholar
  • 6 Vitaliano PP. Physiological and physical concomitants of caregiving: introduction. Ann Behav Med 1997; 19: 75-77
    CrossrefPubMedGoogle Scholar
  • 7 Wilz G, von Cramon DY. Abschlussbericht zum Teilprojekt B7 – Die Integration von Angehörigen in die Behandlung und Rehabilitation von Schlaganfallpatienten: Konzeption und Evaluation geeigneter Interventionsmaßnahmen. Reha-Forschungsverbund Berlin-Brandenburg-Sachsen (BBS). Abgeschlossenes Forschungsprojekt 11/01–08/06. Förderung: BMBF; 2006
    Google Scholar
  • 8 D’Zurilla TJ, Nezu A. Problem-Solving Therapy: A Positive Approach to Clinical Intervention. New York: Springer; 2006
    Google Scholar
  • 9 D’Zurilla TJ, Goldfried MR. Problem solving and behavior modification. J Abnorm Psychol 1971; 78: 107-126
    CrossrefPubMedGoogle Scholar
  • 10 D’Zurilla TJ, Nezu AM, Maydeu-Olivares A. Social problem solving: Theory and assessment. In: Chang E, D’Zurilla TJ, Sanna LJ. (eds.). Social problem solving: theory, research and training. Washington, D.C.: American Psychological Association; 2004: 11-27
    CrossrefGoogle Scholar
  • 11 Lazarus RS. Stress and emotion: A new synthesis. New York: Springer; 1999
    Google Scholar
  • 12 Wheeler DD, Janis IL. A practical guide for making decisions. New York: Free Press; 1980
    Google Scholar
  • 13 Rivera P, Elliott TR, Berry JW et al. Predictors of caregiver depression among community-residing families living with traumatic brain injury. NeuroRehabilitation 2007; 22: 3-8
    CrossrefPubMedGoogle Scholar
  • 14 Dreer LE, Elliott TR, Shewchuk R et al. Family Caregivers of Persons With Spinal Cord Injury: Predicting Caregivers at Risk for Probable Depression. Rehabil Psychol 2007; 52: 351-357
    CrossrefPubMedGoogle Scholar
  • 15 Grant JS, Weaver M, Elliott TR et al. Family caregivers of stroke survivors: characteristics of caregivers at-risk for depression. Rehabil Psychol 2004; 49: 172-179
    CrossrefPubMedGoogle Scholar
  • 16 Gitlin LN, Winter L, Corcoran M et al. Effects of the home environmental skill-building program on the caregiver-care recipient dyad: 6-month outcomes from the Philadelphia REACH Initiative. Gerontologist 2003; 43: 532-546
    CrossrefPubMedGoogle Scholar
  • 17 Elliott TR, Brossart D, Berry JW et al. Problem-solving training via videoconferencing for family caregivers of persons with spinal cord injuries: a randomized controlled trial. Behav Res Ther 2008; 46: 1220-1229
    CrossrefPubMedGoogle Scholar
  • 18 Sander AM, Clark AN, Atchison TB et al. A web-based videoconferencing approach to training caregivers in rural areas to compensate for problems related to traumatic brain injury. J Head Trauma Rehabil 2009; 24: 248-261
    CrossrefPubMedGoogle Scholar
  • 19 Rivera PA, Elliott TR, Berry JW et al. Problem-solving training for family caregivers of persons with traumatic brain injuries: a randomized controlled trial. Arch Phys Med Rehabil 2008; 89: 931-941
    CrossrefPubMedGoogle Scholar
  • 20 Elliott T, Shewchuk R. Problem-solving therapy for family caregivers of persons with severe physical disabilities. In: Radnitz C. (ed.). Cognitive-behavioral interventions for persons with disabilities. Northvale, NJ: Jason Aronson; 2000: 309-327
    Google Scholar
  • 21 Caress AL, Chalmers K, Luker K. A narrative review of interventions to support family carers who provide physical care to family members with cancer. Int J Nurs Stud 2009; 46: 1516-1527
    CrossrefPubMedGoogle Scholar
  • 22 Bambara JK, Owsley C, Wadley V et al. Family caregiver social problem-solving abilities and adjustment to caring for a relative with vision loss. Invest Ophthalmol Vis Sci 2009; 50: 1585-1592
    PubMedGoogle Scholar
  • 23 Bevans M, Castro K, Prince P et al. An individualized dyadic problem-solving education intervention for patients and family caregivers during allogeneic hematopoietic stem cell transplantation: a feasibility study. Cancer Nurs 2010; 33: E24-E32
    CrossrefPubMedGoogle Scholar
  • 24 Grant JS, Elliott TR, Weaver M et al. Telephone intervention with family caregivers of stroke survivors after rehabilitation. Stroke 2002; 33: 2060-2065
    CrossrefPubMedGoogle Scholar
  • 25 Demiris G, Oliver DP, Washington K et al. A Problem Solving Intervention for hospice caregivers: a pilot study. J Palliat Med 2010; 13: 1005-1011
    CrossrefPubMedGoogle Scholar
  • 26 Sahler OJ, Fairclough DL, Phipps S et al. Using problem-solving skills training to reduce negative affectivity in mothers of children with newly diagnosed cancer: report of a multisite randomized trial. J Consult Clin Psychol 2005; 73: 272-283
    PubMedGoogle Scholar
  • 27 Toseland RW, Blanchard CG, McCallion P. A problem solving intervention for caregivers of cancer patients. Soc Sci Med 1995; 40: 517-528
    CrossrefPubMedGoogle Scholar
  • 28 GKV-Spitzenverband Hrsg Telefongestützte Intervention für Pflegende Angehörige von Schlaganfall-Betroffenen. Schriftenreihe Modellprogramm zur Weiterentwicklung der Pflegeversicherung Band 8. Berlin: GKV-Spitzenverband; 2012
    Google Scholar
  • 29 Kurylo M, Elliott T, Shewchuk R. FOCUS on the family caregiver: a problem-solving training intervention. J couns Dev 2001; 79: 275-281
    CrossrefPubMedGoogle Scholar
  • 30 Visser-Meily A, van HC, Post M et al. Intervention studies for caregivers of stroke survivors: a critical review. Patient Educ Couns 2005; 56: 257-267
    CrossrefPubMedGoogle Scholar
  • 31 Nezu CM, Palmatier AD, Nezu AM. Problem-solving therapy for caregivers. In: Chang E, D’Zurilla TJ, Sanna LJ. (eds.). Social problem solving: theory, research and training. Washington, D.C.: American Psychological Association; 2004: 223-238
    CrossrefGoogle Scholar
  • 32 Márquez-González M, Romero-Moreno R, Losada A. Caregiving issues in a therapeutic context: new insights from the Acceptance and Commitment Therapy approach. In: Pachana AP, Laidlaw K, Knight BG. (eds.). Casebook of Clinical Geropsychology. New York: Oxford University Press; 2010: 33-53
    CrossrefGoogle Scholar
  • 33 Pflege- und Wohnberatung Ahlen 2007. Modellprojekt zur „Evaluation der Effektivität und Effizienz eines integrierten Versorgungssystems für ältere hilfs- und pflegebedürftige Menschen am Beispiel der Pflege und Wohnberatung in Ahlen“ Download vom 25.05.2011. http://www.gkv-spitzenverband.de/upload/Gesamtbericht_VDAK_Ahlen_2004_bis_2007 _zwv_1664.pdf
    PubMedGoogle Scholar
  • 34 Grassel E, Trilling A, Donath C et al. Support groups for dementia caregivers–predictors for utilisation and expected quality from a family caregiver’s point of view: a questionnaire survey part I*. BMC Health Serv Res 2010; 10: 219
    CrossrefPubMedGoogle Scholar
  • 35 Grassel E, Luttenberger K, Romer H et al. Voluntary help in dementia – predictors for utilisation and expected quality from a family caregiver’s point of view. Fortschr Neurol Psychiatr 2010; 78: 536-541
    Article in Thieme ConnectPubMedGoogle Scholar
  • 36 Donath C, Bleich S, Grassel E. Day hospitals – predictors for utilisation and quality expectations from the perspective of family caregivers of dementia patients. Psychiatr Prax 2009; 36: 175-181
    Article in Thieme ConnectPubMedGoogle Scholar
  • 37 GKV Spitzenverband. Empfehlungen des GKV-Spitzenverbandes nach § 7a Abs. 3 Satz 3 SGB XI zur Anzahl und Qualifikation der Pflegeberaterinnen und Pflegeberater vom 29. August 2008. Download vom 24.05.2011 www.gkv-spitzenverband.de/upload/2008_-_08-29_Empfehlungen_%C2%A7_7a_Abs_3_2351.pdf
    PubMedGoogle Scholar
  • 38 Hautzinger M, Bailer M, Hofmeister D et al. Allgemeine Depressionsskala. Göttingen: Hogrefe; 2012
    Google Scholar