■以人为中心的目标在个人环境中捕捉个人的优先事项。目标达成规模(GAS)已用于涉及痴呆症患者(PLWD)的药物试验,但GAS的特征是难以纳入试验和临床实践。我们在痴呆症研究(NIDUS)家族的独立新干预措施试验中使用了GAS,手动护理和支持干预,作为主要结果,并根据设定的目标调整干预措施。我们旨在评估基线目标设定的可行性和内容。
■我们为非临床促进者开发了培训,以便与PLWD和家庭照顾者dyads远程设定个性化的GAS目标,或者单独照顾者,在干预试验中,在COVID-19大流行期间。对设定的目标进行定性内容分析,探讨参与者的优先事项和未满足的需求,考虑如何在心理社会干预试验背景下扩展现有的GAS目标域。
■11名主持人成功地训练了GAS目标的设定和得分。总共有313/328(95%)的参与者能够与主持人合作设定三到五个目标。其中,302个随机参与的二元组设定1043个(平均3.5个,范围3到5个)目标。我们将719个(69%)目标演绎编码到五个现有的GAS域(情绪,行为,自我照顾,认知,和日常生活的工具性活动);324个(31%)目标被归纳编码为四个新领域:照顾者休息,照顾者的心情,照顾者行为,和照顾睡眠。最经常设定的目标与社会支持有关。根据设定目标的人的背景或流行病限制的程度,设定的目标类型几乎没有变化。
■对于未经临床培训的人来说,为社区中的PLWD和家庭护理人员设定GAS整体目标是可行的。GAS有可能促进护理和支持干预措施的个性化,例如NIDUS家庭,并促进推出更个性化的护理。
■目标达成规模(GAS)可以抓住痴呆症患者及其家庭照顾者的有意义的优先事项。心理社会干预RCT使用GAS作为主要结果指标,目标由未经临床培训的促进者合作设定。研究结果强调了使用GAS作为该人群结果指标的可行性。内容分析结果揭示了研究参与者的经验和优先事项的多样性。GAS有可能支持实施更多以人为本的痴呆症护理方法。
UNASSIGNED: Person-centered goals capture individual priorities in personal contexts. Goal Attainment Scaling (GAS) has been used in drug trials involving people living with dementia (PLWD) but GAS has been characterized as difficult to incorporate into trials and clinical practice. We used GAS in a
trial of New Interventions for Independence in Dementia
Study (NIDUS)-family, a manualized care and support intervention, as the primary outcome and to tailor the interventions to goals set. We aimed to assess the feasibility and content of baseline goal-setting.
UNASSIGNED: We developed training for nonclinical facilitators to set individualized GAS goals remotely with PLWD and family carer dyads, or carers alone, in the intervention
trial, during the COVID-19 pandemic. A qualitative content analysis of the goals set explored participants\' priorities and unmet needs, to consider how existing GAS goal domains might be extended in a psychosocial intervention
trial context.
UNASSIGNED: Eleven facilitators were successfully trained to set and score GAS goals. A total of 313/328 (95%) participants were able to collaboratively set three to five goals with the facilitators. Of these, 302 randomized participating dyads set 1043 (mean 3.5, range 3 to 5) goals. We deductively coded 719 (69%) goals into five existing GAS domains (mood, behavior, self-care, cognition, and instrumental activities of daily living); 324 (31%) goals were inductively coded into four new domains: carer break, carer mood, carer behavior, and carer sleep. The most frequently set goals pertained to social support. There was little variation in types of goals set based on the context of who set them or level of pandemic restrictions in place.
UNASSIGNED: It is feasible for people without clinical training to set GAS holistic goals for PLWD and family carers in the community. GAS has potential to facilitate personalization of care and support interventions, such as NIDUS-family, and facilitate the roll out of more personalized care.
UNASSIGNED: Goal Attainment Scaling (GAS) can capture meaningful priorities of people with dementia and their family carers.A psychosocial intervention RCT used GAS as the primary outcome measure and goals were set collaboratively by non-clinically trained facilitators.The findings underscore the feasibility of using GAS as an outcome measure with this population.The content analysis findings unveiled the diversity in experiences and priorities of the
study participants.GAS has the potential to support the implementation of more person-centred approaches to dementia care.