背景:对痴呆症患者照顾者的多成分干预对照顾者和照顾者的健康和生活质量有积极影响。世界卫生组织的痴呆症iSupport是针对护理人员的基于证据的在线心理教育计划。然而,该计划主要是作为一种自学工具实施的,这可能限制了其对照顾者和照顾者的积极影响。关于纳入iSupport计划的护理人员在线多成分干预措施的证据仍然未知。
目的:本研究旨在与健康和社会护理组织合作,以评估促进者支持的在线多组分中国iSupport计划的效果,其中包括使用iSupport计划的心理教育,由辅导员支持的护理人员支持小组和获得护理服务。
方法:一项多中心随机对照试验。
方法:参与者是澳大利亚和大中华地区的家庭照顾者。我们从2021年11月1日至2022年6月30日招募了研究参与者。
方法:干预组接受了在线提供的中国iSupport计划。干预持续了6个月。我们的主要结果是护理人员的生活质量。我们的次要结果是护理人员的自我效能,社会支持,对改变行为的痛苦反应,护理接受者行为改变的频率,生活质量,计划外入院,急诊科介绍和永久入住疗养院。结果在基线(T0)测量,6个月(T1)和9个月(T2)。我们应用多元混合效应线性回归模型来捕捉群体效应,时间效应及其相互作用。
结果:总计,266名符合条件的家庭护理人员同意参与,并被随机分配到干预组(n=131)或常规护理组(n=135)。大多数照顾者是平均年龄为53岁的女性。干预组的心理健康相关生活质量得分较高(平均差异=4.1,95%CI:1.5,6.8,p=0.002),在T1时,控制令人沮丧的想法的自我效能(平均差异=7.1,95%CI:2.2,12.0,p=0.005)和对行为改变的痛苦反应得分较低(平均差异=-0.1,95%CI:-0.3,-0.03,p=0.012)。
结论:促进者支持的在线多组分中国iSupport计划对护理人员的心理健康相关生活质量具有积极影响,控制令人沮丧的想法和对痴呆症患者行为改变的痛苦反应。
背景:本研究于2021年3月12日在澳大利亚新西兰临床试验注册中心注册(ACTRN12621000276853)。
结论:促进者支持的在线多组分中国iSupport计划改善了家庭护理人员的心理健康相关生活质量,控制令人沮丧的想法和对痴呆症患者行为改变的痛苦反应。
BACKGROUND: Multicomponent interventions with carers of people with dementia demonstrate positive effects on the health and quality of life for carers and care recipients. The World Health Organization\'s iSupport for Dementia is an evidence-based online psychoeducation programme for carers. However, the programme was mainly implemented as a self-learning tool which might have limited its positive effects on carers and care recipients. Evidence for online multicomponent interventions with carers that incorporates the iSupport programme remains unknown.
OBJECTIVE: This study aimed to partner with health and social care organisations to evaluate the effects of a facilitator-enabled online multicomponent Chinese iSupport programme, which included psychoeducation using the iSupport programme, facilitator-enabled carer support groups and access to care services.
METHODS: A multicentre randomised controlled trial.
METHODS: Participants were family carers in Australia and greater China. We recruited participants to the study from 1st November 2021 to 30th June 2022.
METHODS: The intervention group received the Chinese iSupport programme delivered online. The intervention lasted for 6 months. Our primary outcome was carers\' quality of life. Our secondary outcomes were carers\' self-efficacy, social support, distress reactions to changed behaviours, care recipients\' frequency of changed behaviours, quality of life, unplanned hospital admissions, emergency department presentations and permanent admissions to nursing homes. The outcomes were measured at baseline (T0), 6 months (T1) and 9 months (T2). We applied a multivariate mixed effect linear regression model to capture the group effect, time effect and their interaction.
RESULTS: In total, 266 eligible family carers agreed to participate and were randomly assigned to an intervention group (n = 131) or a usual care group (n = 135). Most carers were women with a mean age of 53 years. The intervention group showed a statistically significant higher score of mental-health-related quality of life (mean difference = 4.1, 95 % CI: 1.5, 6.8, p = 0.002), self-efficacy in controlling upsetting thoughts (mean difference = 7.1, 95 % CI: 2.2, 12.0, p = 0.005) and lower score of distress reactions to changed behaviours (mean difference = -0.1, 95 % CI: -0.3, -0.03, p = 0.012) than the usual care group at T1.
CONCLUSIONS: The facilitator-enabled online multicomponent Chinese iSupport programme demonstrated positive effects for carers on mental health-related quality of life, controlling upsetting thoughts and distress reactions to changed behaviours of people with dementia.
BACKGROUND: This study is registered in the Australia New Zealand Clinical Trials Registry on 12th March 2021 (ACTRN12621000276853).
CONCLUSIONS: The facilitator-enabled online multicomponent Chinese iSupport programme improved family carers\' mental health-related quality of life, control of upsetting thoughts and distress reactions to changed behaviours of people with dementia.