目的:本研究的目的是确定在两个初级保健机构中为二元组(患有痴呆症或轻度认知障碍的患者和家庭照顾者)提供结构化诊断后信息和支持计划的可行性。
方法:由Bowen可行性框架指导的两阶段解释性混合方法,重点是可接受性,实施,适应,五部分计划的整合和效力。在第一阶段,该计划对二元计划接受者自我效能感的定量影响,生活质量,测量了二元关系和护理量。在第2阶段,归纳内容分析的重点是该计划的护士和二元参与者的经验。对定量和定性数据进行了审查,以得出可行性的每个要素。
方法:招募了四名在参与中心工作的注册护士,培训为方案促进者,并支持实施方案。在各自的初级保健诊所就诊的符合条件的双子党被邀请参加该计划,并在三个时间点完成调查:招募,方案后和3个月的后续行动。与二元组和方案主持人进行了方案后半结构化访谈。
结果:有29个二元组完成了该计划;大多数是配偶二元组。事实证明,该计划被保留率和完成率高的二元组合所接受。该方案的实施和纳入通常做法归因于护士作为方案促进者的动机和能力。关于方案效力,大多数二元组合报告说,他们为未来做好了更好的准备,并与家庭成员分享了他们在计划期间制定的计划。
结论:实施结构化的信息和支持计划是可行的,但是可持续性需要进一步调整或增加人力资源,以保持计划的忠诚度。未来的研究应考虑选择对痴呆症患者的独特需求敏感的疗效措施,并将随访时间延长至6个月。
结论:这项研究确定了注册护士为患有早期痴呆或轻度认知障碍的患者及其在初级护理机构中的非正式护理人员提供诊断后信息和支持计划的可行性。护士作为方案促进者的工作动机和能力确保了方案融入日常工作,但随着时间的推移,这被认为是不可持续的。家庭照顾者dyads报告了切实的结果,并获得了与家人和朋友分享诊断并寻求帮助的信心。这项研究的结果可用于为临床试验提供指导,以调查结构化信息和支持计划在初级保健环境中的有效性。
■作者坚持EQUATORSTROBE声明。
■一家公立医院记忆诊所和普通医疗实践参与了项目设计,研究协议开发和支持的实施。
OBJECTIVE: The aim of the study was to establish the feasibility of delivering a structured post-diagnosis information and support program to dyads (persons living with dementia or mild cognitive impairment and family carers) in two primary care settings.
METHODS: A two-phase explanatory mixed-method approach guided by the Bowen Feasibility Framework focused on acceptability, implementation, adaptation, integration and efficacy of a five-part programme. In phase 1, the quantitative impact of the programme on the dyadic programme recipients\' self-efficacy, quality of life, dyadic relationship and volume of care was measured. In phase 2, inductive content analysis focused on nurse and dyad participant experiences of the programme. Quantitative and qualitative data were reviewed to conclude each element of feasibility.
METHODS: Four registered nurses working within the participating sites were recruited, trained as programme facilitators and supported to deliver the programme. Eligible dyads attending the respective primary health clinics were invited to participate in the programme and complete surveys at three time points: recruitment, post-programme and 3-month follow-up. Post-programme semi-structured interviews were conducted with dyads and programme facilitators.
RESULTS: Twenty-nine dyads completed the program; the majority were spousal dyads. The programme proved acceptable to the dyads with high retention and completion rates. Implementation and integration of the programme into usual practice were attributed to the motivation and capacity of the nurses as programme facilitators. Regarding programme efficacy, most dyads reported they were better prepared for the future and shared the plans they developed during the programme with family members.
CONCLUSIONS: Implementing a structured information and support programme is feasible, but sustainability requires further adaptation or increased staff resources to maintain programme fidelity. Future research should consider selecting efficacy measures sensitive to the unique needs of people living with dementia and increasing follow-up time to 6 months.
CONCLUSIONS: This study established the feasibility of registered nurses delivering a post-diagnosis information and support programme for people living with early-stage dementia or mild cognitive impairment and their informal carers in primary care settings. The motivation and capacity of nurses working as programme facilitators ensured the integration of the programme into usual work, but this was not considered sustainable over time. Family carer dyads reported tangible outcomes and gained confidence in sharing their diagnosis with family and friends and asking for assistance. Findings from this study can be used to provide direction for a clinical trial investigating the effectiveness of the structured information and support programme in the primary care setting.
UNASSIGNED: The authors have adhered to the EQUATOR STROBE Statement.
UNASSIGNED: A public hospital memory clinic and general medical practice participated in project design, study protocol development and supported implementation.