Sālmand (Apr 2016)
Effectiveness of Group Cognitive-Behavioral Therapy on Strategies for Coping With Stress of Family Caregivers of Patients With Alzheimer’s Disease
Abstract
Objectives: Alzheimer’s disease is a progressive and degenerative disease of the brain that severely damages the thinking and memory functions of human beings. This disease is the most common form of dementia, which comprises a set of signs and symptoms such as loss of memory, judgment, and reasoning that subsequently changes the attitude, behavior, and communication ability. Taking care of people with Alzheimer’s disease can become very stressful for their families. Group cognitivebehavioral therapy has played an important role in teaching how to use compatible coping strategies. Thus, this research aimed to investigate the effectiveness of group cognitive-behavioral therapy on strategies for coping with stress of family caregivers of patients with Alzheimer’s disease. Methods & Materials: This research was conducted using a quasi-experimental design. The study sample comprised 32 voluntary caregivers as per Iran's Alzheimer Community Care in 2011. They were selected by convenience sampling method and were randomly assigned into experimental and control groups. We used the questionnaire of coping inventory with stressful situations (CISS), which was completed before group therapy and after the treatment course in 3 stages of pretest, posttest, and follow-up. Data analysis was performed by analysis of covariance, multivariate analysis of covariance, and repeated measures. Results: The results showed that the components of compatible strategies (problem-oriented and social entertainment) in the experimental group were significantly increased compared to pretest and control group due to cognitive-behavioral therapy (P=0.001). However, the components of incompatible strategies (emotionoriented and attention processing) due to cognitive-behavioral therapy was significantly decreased in the experimental group compared to the pretest and control group (P=0.001). The results of repeated measuring plan between 3 stages of pretest, posttest, and follow-up showed that the effects of cognitive-behavioral therapy on increasing compatible coping style (problem-oriented and social entertainment) and decreasing incompatible coping style (emotion-oriented and attention processing) as well as the effect of intergroup actions and repetition were significant. There was also a significant difference between experimental group and control group. With regard to the above-mentioned results, cognitive-behavioral group therapy could have significant effects on increasing use of coping strategies with compatible stress and decreasing use of coping strategies with incompatible stress in the family members of Alzheimer’s patients. Moreover, the time factor was ineffective in lowering the effect of cognitive-behavioral therapy from posttest to follow-up period. Conclusion: Based on the results, the group cognitive-behavioral therapy can increase the use of compatible strategies for coping with stress and decrease the use of incompatible strategies. This issue is related to factors such as complete understanding of Alzheimer’s disease and its effects, creating an atmosphere for presentation and an opportunity for social interaction, understanding the importance of sport and allocating time for recreational activities, learning body relaxation in stressful situations, understanding life problems, solving problem techniques, feeling of control, and time management. Thus, we recommend using group cognitivebehavioral therapy as a low-cost treatment for family caregivers of patients with Alzheimer’s and patients with chronic diseases.
