title: Impact of a psychoeducational intervention on caregiver response to behavioral problems.
abstract: BACKGROUND
  Eighty percent of persons with Alzheimer's disease and related disorders are cared for by family members who often lack adequate support and training for this all-consuming job.
  
  
  OBJECTIVE
  To evaluate the efficacy of a longitudinal, multisite, community-based intervention designed to teach home caregivers to manage behavioral problems in persons with Alzheimer's disease.
  
  
  METHODS
  Usable data were analyzed from 237 caregiver/care recipient dyads (n = 132 Experimental; n = 105 Comparison). The experimental group received a psychoeducational nursing intervention that was conceptually grounded in the Progressively Lowered Stress Threshold model (Hall & Buckwalter, 1987). The comparison group received routine information and referrals for case management, community-based services, and support groups. Although a variety of psychosocial outcomes were compared between caregivers in the two groups, this article focuses on frequency and response to behavioral problems and functional decline.
  
  
  RESULTS
  The Progressively Lowered Stress Threshold intervention had a statistically significant effect on spousal response to memory/behavioral problems (p <.01) for all caregivers and on response to activities of daily living problems (p <.01) for spousal caregivers. In addition, nonspouses in the experimental group reported a reduction in the frequency of memory/behavioral problems (p <.01). No intervention effect on reports of activities of daily living frequencies was found for either spouses or nonspouses.
  
  
  CONCLUSIONS
  This Progressively Lowered Stress Threshold-based intervention had a positive impact on both the frequency of and response to problem behaviors among spousal caregivers.
authors.affiliation: School of Nursing, University of Minnesota, 6-101 Weaver-Densford Hall, 308 Harvard Street S.E., Minneapolis, MN 55455, USA. gerdn001@umn.edu
authors.forename: Linda A
authors.initials: LA
authors.lastname: Gerdner
authors.forename: Kathleen C
authors.initials: KC
authors.lastname: Buckwalter
authors.forename: David
authors.initials: D
authors.lastname: Reed
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D000544:Alzheimer Disease / Q000150:complications*; D001130:Arizona; D017028:Caregivers / Q000193:education* / Q000523:psychology*; D018450:Disease Progression; D005190:Family / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment; D006266:Health Education / Q000458:organization & administration*; D006701:Home Nursing / Q000193:education* / Q000523:psychology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D015146:Midwestern United States; D008960:Models, Psychological; D015403:Nursing Evaluation Research; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000517:prevention & control* / Q000523:psychology