people living with dementia

  • 文章类型: Journal Article
    背景:辅助技术正变得越来越容易获得和负担得起,以支持痴呆症患者及其在家中生活的护理伙伴,具有基于技术的提示的强大潜力,以协助启动和跟踪复杂的,日常生活的多步骤活动。然而,有有限的直接比较不同的提示功能,以指导优化技术设计。
    目的:在3个实验中,我们调查了基于平板电脑的提示功能,这些提示可以最好地支持痴呆症患者完成在家的日常生活活动,测量及时的有效性,并从痴呆症患者及其护理伙伴那里获得关于他们经历的反馈。
    方法:跨实验,我们开发了一个专门的iPad应用程序,以便在延长的实验期间在家中收集痴呆症患者的数据。在实验1中,我们将提示改为3(视觉类型:文本指令,标志性图像,和摄影图像)×3(音频类型:无声音,象征性的声音,和口头指导)实验设计,在涉及单步活动的多个测试会话中使用重复措施。在实验2中,我们比较了3个条件(1-提示,3-提示,和7提示条件)。在实验3中,我们比较了涉及听觉音调或听觉音调结合口头指示的启动和维护警报。在整个过程中,我们要求痴呆症患者及其护理伙伴反思促进技术在日常生活中的有用性,以及可以开发哪些技术来更好地满足他们的需求。
    结果:首先,我们的结果显示,与基于语气或视觉提示相比,可听口头提示对任务完成更有用.第二,更细粒度的任务分解通常更有用,更多的独立使用,但这在不同的个体之间是不同的。第三,虽然语音或文本维护警报使痴呆症患者能够在更频繁的情况下坚持更长时间的多步骤任务,任务启动仍然经常需要护理伙伴的支持。
    结论:这些发现可以帮助辅助技术的开发人员了解促进家庭提示系统对痴呆症患者的有用性的设计功能,以及痴呆症患者及其护理伙伴对辅助技术设计的偏好和见解。
    BACKGROUND: Assistive technology is becoming increasingly accessible and affordable for supporting people with dementia and their care partners living at home, with strong potential for technology-based prompting to assist with initiation and tracking of complex, multistep activities of daily living. However, there is limited direct comparison of different prompt features to guide optimal technology design.
    OBJECTIVE: Across 3 experiments, we investigated the features of tablet-based prompts that best support people with dementia to complete activities of daily living at home, measuring prompt effectiveness and gaining feedback from people with dementia and their care partners about their experiences.
    METHODS: Across experiments, we developed a specialized iPad app to enable data collection with people with dementia at home over an extended experimental period. In experiment 1, we varied the prompts in a 3 (visual type: text instruction, iconic image, and photographic image) × 3 (audio type: no sound, symbolic sound, and verbal instruction) experimental design using repeated measures across multiple testing sessions involving single-step activities. In experiment 2, we tested the most effective prompt breakdown for complex multistep tasks comparing 3 conditions (1-prompt, 3-prompt, and 7-prompt conditions). In experiment 3, we compared initiation and maintenance alerts that involved either an auditory tone or an auditory tone combined with a verbal instruction. Throughout, we asked people with dementia and their care partners to reflect on the usefulness of prompting technology in their everyday lives and what could be developed to better meet their needs.
    RESULTS: First, our results showed that audible verbal instructions were more useful for task completion than either tone-based or visual prompts. Second, a more granular breakdown of tasks was generally more useful and increased independent use, but this varied across individuals. Third, while a voice or text maintenance alert enabled people with dementia to persist with a multistep task for longer when it was more frequent, task initiation still frequently required support from a care partner.
    CONCLUSIONS: These findings can help inform developers of assistive technology about the design features that promote the usefulness of home prompting systems for people with dementia as well as the preferences and insights of people with dementia and their care partners regarding assistive technology design.
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  • 文章类型: Journal Article
    目的:本综述研究了在社区中预防滥用痴呆症患者的干预措施的证据。
    方法:这些文章是从2000年到2023年从六个数据库中检索的,包括通过PubMed的MEDLINE,CINAHLPlus通过EBSCO,EMBASE,ProQuest医学图书馆,WebofScience,还有Scopus.这篇综述包括了一些研究文章,这些文章专注于发现干预措施在社区环境中预防痴呆症患者滥用的有效性。该综述仅包括随机对照试验和测试前测试后试验。使用ROB2和ROBINSII对合格研究进行质量评估。将研究结果制成表格并进行叙述综合。
    结果:在1831篇文章中,这次审查只包括了三个。本疗效评价仅包括两个RCT。两项研究都表明,干预措施在减少滥用方面并不有效。这些研究利用了家庭护理人员的干预措施,如心理干预和在线支持教育。该综述通过一些证据确定了心理干预措施。另一项研究是一项准实验研究,该研究使用辩证行为疗法作为干预措施,以减少滥用的发生。该研究显示证据不足,仅侧重于报告虐待老年人的结果。
    结论:这篇综述发现的研究很少,也无法得出关于干预措施对痴呆症患者滥用的有效性的结论。鉴于研究的匮乏,显然需要确定如何克服虐待老年人研究中面临的挑战,并进一步完善减少社区痴呆症患者中虐待老年人的方法.
    OBJECTIVE: This review examined the evidence for interventions to prevent the abuse of people living with dementia in the community.
    METHODS: The articles were retrieved from 2000 to 2023 from six databases, including MEDLINE via PubMed, CINAHL Plus via EBSCO, EMBASE, ProQuest Medical Library, Web of Science, and Scopus. The research articles that focused on finding the effectiveness of interventions for preventing abuse of people living with dementia in community settings were included in this review. The review included randomized controlled trials and pre-test post-test trials only. The quality appraisal of the eligible studies was done using ROB 2 and ROBINS II. The findings were tabulated and narratively synthesised.
    RESULTS: Out of 1831 articles, only three were included in this review. Only two RCTs were included in this efficacy review. Both the studies showed that the interventions were not effective in reducing abuse. The studies utilised family caregiver interventions like psychological interventions and online supportive education. The review identified psychological interventions with some evidence. Another study was a quasi-experimental study that used dialectical behaviour therapy as an intervention to reduce abuse occurrence. The study showed low evidence and focused only on reporting of elder abuse as an outcome.
    CONCLUSIONS: This review found very few studies and was not able to draw a conclusion on the effectiveness of interventions for abuse in people living with dementia. Given the paucity of research, there is a clear need to identify how to overcome the challenges faced in elder abuse research and further refine the development of approaches to reduce elder abuse among people living with dementia in community settings.
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  • 文章类型: Journal Article
    背景:没有适当的支持,照顾痴呆症患者可能成为家庭照顾者的负担。确定护理人员的需求可以帮助他们最大限度地减少护理负担,并为痴呆症患者提供优质护理。
    方法:在第一阶段,在印尼语版中对照顾者的痴呆症需求评估(CNA-D)进行了内容有效性测试.第二阶段,顺序解释性混合方法设计,分两个阶段对65名家庭护理人员进行了调查。第一阶段是横断面研究。进行了照顾者问题与照顾者负担之间的相关性测试。分析了具有统计学意义的护理人员问题,以揭示未满足的需求。还对一半以上的护理人员遇到的问题进行了需求分析。在第二阶段,我们进行了半结构化的个人访谈,并采用专题分析法对数据进行分析。
    结果:CNA-D仪器有效性测试的结果,印尼语版本,获得了很高的内容有效性价值。护理人员的主要问题是缺乏关于痴呆症的信息;然而,与照顾者负担无显著相关性.与照顾者负担相关性最高的照顾者问题是由于照顾而导致的倦怠。在这项研究中,SlemanRegency中超过50%的护理人员需求没有得到满足。未满足的最基本需求是咨询和心理治疗(83.3%-92%)。对痴呆症的个人理解,关怀中的精神价值,关怀中的文化价值观,获得医疗保健服务的障碍,在满足家庭照顾者的需求时,应考虑自我护理策略。
    结论:SlemanRegency痴呆症患者家庭照顾者的大部分需求,日惹,没有被满足。因此,它需要与多方专业人士和所有利益攸关方合作来满足这些需求。
    BACKGROUND: Without appropriate support, taking care of people living with dementia may become a burden for family caregivers. Identifying the needs for caregivers can help them minimise the burden of caring and meet quality care for people living with dementia.
    METHODS: In the first phase, a content validity test was conducted on the Carers\' Needs Assessment of Dementia (CNA-D) in the Indonesian version. The second phase, a sequential explanatory mixed-methods design, was conducted on 65 family caregivers in two stages. The first stage was a cross-sectional study. A correlation test between caregiver problems and caregiver burden was conducted. The caregiver problems that were statistically significant were analyzed to reveal the unmet needs. A needs analysis was also conducted on problems experienced by more than half of the caregivers. In the second stage, we conducted a semi-structured individual interview, and thematic analysis was used to analyze the data.
    RESULTS: The result of the validity test of the CNA-D instrument, Indonesian version, obtained a high value for content validity. The main problem of caregivers is a lack of information about dementia; however, it does not have a significant correlation with caregiver burden. The caregiver problem with the highest correlation to caregiver burden is burnout due to caring. More than 50% of caregivers\' needs in Sleman Regency were not met in this research. The most essential needs that were not met were counselling and psychotherapy (83.3%-92%). The personal understanding of dementia, spiritual values in caring, cultural values in caring, barriers to accessing healthcare services, and self-care strategies should be considered in fulfilling family caregiver needs.
    CONCLUSIONS: Most of the needs of family caregivers of people living with dementia in Sleman Regency, Yogyakarta, have not been met. Therefore, it requires collaboration with multi-professionals and all stakeholders to fulfil these needs.
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  • 文章类型: Journal Article
    有选择住在家里和社区尽可能长的时间是痴呆症患者的愿望。然而,对许多人来说,由于缺乏适当的支持,这不是现实,不合适的住房和建筑环境,社会排斥,和耻辱。名为“痴呆症友好社区”的全球运动旨在解决这些障碍并带来积极的变化。在地方一级,痴呆症友好社区倡议通常由委员会计划和实施,然而,人们对他们如何制定痴呆症友好社区原则知之甚少。使用微观人种学和案例研究方法,研究了两个澳大利亚-昆士兰痴呆症友好社区委员会及其活动,以更好地了解地方一级的实施情况。这涉及16次半结构化面试,参与者观察和现场笔记确定目标,方法,和紧张。虽然这两个委员会都有能力提高对影响痴呆症患者的问题的认识,在纳入痴呆症患者和照顾者的关键痴呆症友好社区原则的实施方面存在实质性差异.主要区别在于痴呆症患者的定位方式以及他们在委员会中的角色,他们是否被赋予权力和价值,或者被象征性地包括在内,但还没有听取。实践的三个方面是更有意义的包容的核心:参与,权力共享,和领导力。由痴呆症患者及其照顾者领导和领导的地方行动小组,在当地主要人士和组织的支持下,帮助在当地发展痴呆症友好社区。
    Having the choice to stay living in one\'s home and community for as long as possible is a desire of people living with dementia. Yet, for many, this is not a reality due to a lack of appropriate support, unsuitable housing and built environments, social exclusion, and stigma. The global movement called Dementia Friendly Communities aims to address such barriers and bring about positive change. At the local place-based level, Dementia Friendly Community initiatives are typically planned and implemented by committees, yet little is known about how they operate to enact Dementia Friendly Community principles. Using micro-ethnography and a case study approach, two Australian - Queensland Dementia Friendly Community committees and their activities were studied to better understand implementation at the local level. This involved 16 semi-structured interviews, participant observation and field notes identifying goals, approaches, and tensions. While both committees showed the capacity to raise awareness of issues impacting people living with dementia, there were substantial differences in the implementation of the key Dementia Friendly Community principle of inclusion of people living with dementia and carers. Key differences were the way people living with dementia were positioned and the part they were expected to play in committees, whether they were empowered and valued or tokenistically included yet not listened to. Three aspects of practice are central to more meaningful inclusion: engagement, power-sharing, and leadership. Local action groups directed and led by people living with dementia and their carers, with the support of key local people and organizations, help to progress Dementia Friendly Communities locally.
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  • 文章类型: Journal Article
    目标:在英国,有100,000名痴呆症患者在家中由配偶或亲戚照顾。很少有研究考虑了无薪护理人员的ICT需求和经验。这项研究探讨了ICT无偿护理人员使用的类型,他们使用ICT的方式,ICT使用的影响,以及他们关于ICT如何更支持他们作为照顾者的角色的想法。
    方法:由32名痴呆症患者的无偿照顾者组成的六个焦点小组讨论了他们使用ICT的经验和障碍。根据三种类型的ICT(主流,可访问和正式)和五个功能(支持国内任务,护理管理,监测,通信、信息和教育)。
    结果:参与者主要使用主流ICT设备,如笔记本电脑和智能手机,以及支持互联网的应用程序,包括视频会议和社交媒体平台,以支持他们的日常活动,并帮助他们发挥关爱作用。一些与会者讨论了使用可访问的设备,如存储器时钟和正式的远程医疗和护理电话服务来实现护理管理和监测功能。参与者的改进想法集中在个性化通信应用程序上,这些应用程序可以促进远程互动并促进痴呆症患者的独立性。其他人则对使用信通技术获得正式护理服务的需求日益增加以及一些养老院信通技术基础设施不足表示关切。
    结论:无薪照顾者大多求助于现成的主流ICT来支持他们的个人和护理活动。需要进一步的研究,以了解信息和通信技术在整个健康领域的日益依赖的社会影响,社会和住宿护理服务部门。改善无薪照顾者之间的合作,技术开发人员和护理服务提供商可以使信息和通信技术的开发与痴呆症患者家庭的需求和经验保持一致,并协助无偿护理人员确定最佳支持其个人情况的信息和通信技术。
    OBJECTIVE: Several 100,000s of people living with dementia in the UK are cared for at home by a spouse or relative. Few studies have considered the ICT needs and experiences of unpaid carers. This study explores the types of ICT unpaid carers use, the ways they use ICT, the impact of ICT-use, and their ideas for how ICT could be more supportive of their role as a carer.
    METHODS: Six focus groups with 32 unpaid carers of people living with dementia discussed their experiences of - and barriers to - using ICT. Transcripts were analysed thematically according to three types of ICT (mainstream, accessible and formal) and five functions (supporting domestic tasks, care management, monitoring, communication and information and education).
    RESULTS: Participants predominantly used mainstream ICT devices such as laptops and smartphones and internet-enabled applications including videoconferencing and social media platforms to support their daily activities and assist them in their caring role. A few participants discussed using accessible devices such as memory clocks and formal telecare and care-phone services for care management and monitoring functions. Participants\' ideas for improvements centred on personalised communication applications that facilitate remote interactions and promote persons living with dementia\'s independence. Others expressed concerns about the growing need to use ICT to access formal care services and the inadequacy of the ICT infrastructure in some care homes.
    CONCLUSIONS: Unpaid carers mostly turn to readily available mainstream ICT to support their personal and care activities. Further research is required to understand the social impact of the increasing reliance of ICT across health, social and residential care service sectors. Improved cooperation between unpaid carers, technology developers and care services providers could align ICT development to the needs and experiences of families living with dementia and assist unpaid carers with identifying ICTs that optimally support their personal circumstances.
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  • 文章类型: Journal Article
    背景:来自世界各地的研究报告了双语对认知老化和痴呆的积极影响。然而,对于外语学习是否可以作为已经患有痴呆症的人的干预措施,人们知之甚少。然而,在确定语言课程作为痴呆症患者(PLWD)干预措施的有效性之前,有必要确定这种干预是否可行。我们的研究探索了这种可能性。
    方法:我们进行了一项探索性研究,以检查在两个苏格兰痴呆症资源中心(DRC)中,在早期阶段对PLWD进行为期2周的意大利初学者课程及其家庭照顾者的可行性和耐受性。这些课程是由LingoFlamingo训练有素的导师提供的,专门为老年学习者和痴呆症学习者提供语言教学的社会企业。12名PLWD和7名护理人员参与了这项研究。焦点小组在课程之前和之后。对刚果民主共和国管理人员进行了额外的课后公开采访,大约一年后通过电话进行了随访。
    结果:定性内容分析产生了12个主题,5反映在面试时间表中,7反映在焦点小组和面试中。总的来说,PLWD对课程的看法是积极的,看护者,和刚果民主共和国经理,尽管也提到了一些具有后勤和语言挑战性的方面。这些课程被发现通过增加自尊和产生成就感来积极影响个人,以及通过创造社区意识来影响团体。值得注意的是,没有不良反应(特别是没有混乱或沮丧)的报告.
    结论:我们研究的积极结果为未来的研究开辟了一条新的途径,以探索外语训练在痴呆症中的干预措施及其意义。
    BACKGROUND: A body of research from around the world has reported positive effects of bilingualism on cognitive ageing and dementia. However, little is known about whether foreign language learning could be applied as an intervention for people already living with dementia. Yet, before it is possible to determine the efficacy of language courses as an intervention for people living with dementia (PLWD), it is necessary to establish whether such an intervention is feasible. Our study explored this possibility.
    METHODS: We conducted an exploratory study to examine the feasibility and tolerability of 2-week Italian beginner courses for PLWD in early stages and their family carers in two Scottish Dementia Resource Centres (DRCs). The courses were delivered by trained tutors from Lingo Flamingo, a social enterprise specialising in language teaching for older learners and learners with dementia. Twelve PLWD and seven carers participated in the study. Focus groups preceded and followed the courses. Additional post-course open interviews with the DRC managers were conducted, with a follow-up via telephone approximately one year later.
    RESULTS: Qualitative content analysis resulted in 12 themes, 5 reflected in the interview schedule and 7 arising from the focus groups and interviews. Overall, the courses were perceived positively by PLWD, carers, and DRC managers, although a few logistically and linguistically challenging aspects were also mentioned. The courses were found to positively impact both the individual by increasing self-esteem and producing a sense of accomplishment as well as the group by creating a sense of community. Notably, no adverse effects (in particular no confusion or frustration) were reported.
    CONCLUSIONS: The positive outcomes of our study open a novel avenue for future research to explore foreign language training in dementia as an intervention and its implications.
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  • 文章类型: Journal Article
    虽然促进了现有的衰老技术,以支持护理伙伴和痴呆症患者,在家庭之间的使用决策以及学术界和工业界的讨论中,痴呆症患者的观点代表性不足。这项混合方法研究检查了29名患有轻度阿尔茨海默病(AD)的人对四类技术的使用偏好:位置跟踪,家用传感器,网络摄像机,和虚拟伴侣机器人。参与者完成了一项新的二元干预,让我们谈谈技术,他们记录了他们对四种技术类别的偏好,以进行护理计划。对测试后的访谈进行了主题分析,并提供了对选择过程的见解。技术偏好在患有轻度AD的参与者之间和内部差异很大。除了位置跟踪,非技术和低技术选择比特色技术更可取。对技术使用的控制对于患有AD的人们非常重要。对技术偏好选择的考虑不完全适合为老年人开发的新健康技术接受模型(H-TAM)。这些发现强调了将痴呆症患者纳入支持家庭护理的技术决策的重要性,以及需要进一步个性化和可定制的技术设备来适应和符合他们的偏好。
    While technologies for aging in place are promoted to support care partners and people living with dementia, perspectives of people living with dementia are underrepresented in both use decisions among families and discussions within academia and industry. This mixed-methods study examined the use preferences of twenty-nine people living with mild Alzheimer\'s disease (AD) for four categories of technologies: location tracking, in-home sensors, web-cameras, and virtual companion robots. Participants completed a novel dyadic intervention, Let\'s Talk Tech, where they documented their preferences of the four technology categories for care planning purposes. Post-test interviews were thematically analyzed and provide insight into selection processes. Technology preferences varied considerably by and within participant living with mild AD. Excepting location tracking, non-technology and low-technology options were more desirable than the featured technologies. Control over technology use was of great importance to people living with AD. Considerations given to technology preference selection imperfectly fit within the new Health Technology Acceptance Model (H-TAM) developed for older adults. These findings underscore the importance of including people living with dementia in decision making about technologies to support care at home and the need for further personalization and tailorable technological devices to accommodate and align with their preferences.
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  • 文章类型: Journal Article
    背景:研究结果的概括是研究的重要方面,对于循证实践至关重要。虽然泛化在定量研究中很常见,定性研究缺乏普遍性。本文介绍了痴呆症患者设计(MinD)项目在满足要求以加强对痴呆症患者生活经验的研究结果的概括以及他们参与共同创造设计以增强其日常生活能力方面所面临的经验和挑战。方法:采用Polit和Beck(2010)的策略来概括定性发现:(1)抽样中的复制;(2)研究的复制;(3)研究结果的荟萃综合;(4)反身性和概念化;(5)沉浸在数据中;(6)厚描述。结果:虽然有可能通过抽样的复制来增加定性证据的普遍性,在不同和多个背景和环境中的异质样本;实施健全和强大的研究;对紧急主题进行深入的分析和解释;并满足厚描述要求,由于条件的原因,项目团队在实施Polit和Beck的一些策略时面临挑战,即痴呆症,我们的参与者所拥有的。面临的其他挑战是:团队中的语言和文化多样性;不同的工作和组织程序;以及与查询方法有关的跨学科差异,进行研究的方法和技术。在项目开始时,需要在强有力的领导下确定和解决这些挑战,以确保顺利完成项目。研究人员和参与者之间的信任,建立这种信任的时间对于招募和参与研究至关重要;这些因素在涉及患有痴呆症等疾病的参与者的研究中至关重要。
    Background: Generalisation of findings is an important aspect of research and essential for evidence-based practice. While generalisation is common in quantitative research, there is a lack of generalisability in qualitative research. This paper presents the experience and challenges faced by the Designing for People with Dementia (MinD) project in meeting the requirements to strengthen the generalisation of findings on the lived experience of people living with dementia and their engagement to co-create designs to empower their everyday living.   Methods: Polit and Beck (2010)\'s strategies to generalise qualitative findings were applied: (1) replication in sampling; (2) replication of studies; (3) meta-synthesis of findings; (4) reflexivity and conceptualization; (5) immersion with the data; and (6) thick description. Results: While it is possible to increase the generabilisabilty of qualitative evidence through the replication of the sampling to attain a large, heterogeneous sample in different and multiple contexts and environments; implementation of sound and robust research; conducting in-depth analysis and interpretation collaboratively for emergent themes; and meeting the thick description requirement, there are challenges that the project team faced in implementing some of the Polit and Beck\'s strategies because of the condition, namely dementia, that our participants are having. Other challenges faced were: the language and cultural diversity in the team; diverse  work and organisational procedures; and the inter-disciplinary differences relating to the methods of enquiry, approaches and techniques to conduct research. These challenges will need to be identified and addressed at the start of the project with a strong leadership to ensure a seamless journey to complete the project successfully. Trust between the researchers and participants, and time to build this trust are critical to recruitment and participation in the study; these factors are of utmost important in research involving participants with condition such as dementia.
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  • 文章类型: Journal Article
    南非有必要了解现有护理和支持的状况,以加强对痴呆症的反应。这项研究提供了对当前健康规定的情况分析,对老年人的照顾和支持,南非的痴呆症患者及其家人。这是描述需求和可用服务的第一步,并提供了一个证据基础,为加强南非对痴呆症的反应提供优先考虑的信息。这种情况分析分三个阶段进行:(1)在综合专题指南的指导下进行案头审查,其中包括世卫组织的全球痴呆症观察站指标;(2)多部门利益攸关方访谈,以核实案头审查中使用的次要来源,并确定政策和服务规定中的差距和机会;(3)SWOT分析,弱点,南非当前护理和支持条款中的机会和威胁。我们的研究结果突出了当前服务提供的差距和机会,并显示了结构性因素如何造成诊断障碍,支持,和关心。迫切需要采取部门间政策对策,以支持和加强当前的健康,社会关怀,和长期支持系统,使痴呆症患者及其家人能够生活和年龄良好。本文是加强对痴呆症的反应的更大研究的一部分(STRIDE项目)。
    There is a need in South Africa to understand the status of available care and support to strengthen responses to dementia. This study provides a situational analysis of the current provisions of health, care and support for older persons, people living with dementia and their families in South Africa. It is a first step towards describing the landscape of needs and services available, and provides an evidence base to inform priority-setting for strengthening responses to dementia in South Africa. This situational analysis was conducted in three phases: (1) a desk review guided by a comprehensive topic guide which includes the WHO\'s Global Dementia Observatory indicators; (2) multi-sectoral stakeholder interviews to verify the secondary sources used in the desk review, and to identify gaps and opportunities in policy and service provisions; and (3) a SWOT-analysis examining the strengths, weaknesses, opportunities and threats in current care and support provisions in South Africa. Our findings highlight the gaps and opportunities with current service provision and show how structural factors create barriers to diagnosis, support, and care. There is an urgent need for intersectoral policy responses to support and strengthen current health, social care, and long-term support systems so that people living with dementia and their families can live and age well. This paper forms part of a larger study on strengthening responses to dementia (The STRIDE project).
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  • 文章类型: Journal Article
    背景:在COVID-19大流行期间,远程医疗获得了大量关注,医疗保健环境中的报销政策增加了对远程护理模式的访问。远程医疗有可能减轻痴呆症患者及其家庭护理人员的护理问题。关于远程医疗服务的性能和用户体验的知识匮乏,尤其是在大流行期间照顾二元体。
    目的:本研究旨在描述实施,有效性,用户体验,以及在COVID-19大流行期间,痴呆症患者及其护理人员获得和使用远程医疗服务的障碍。
    方法:遵循PRISMA-ScR(系统审查的首选报告项目和范围审查的荟萃分析扩展)清单,我们搜索了7个数据库(PubMed,PsycINFO,AgeLine,CINAHL,社会服务摘要,WebofScience,和Scopus)和基于网络的搜索引擎(谷歌学者)。2020年3月至2022年8月,同行评审英文出版物的纳入标准包括与痴呆症患者及其家庭护理人员的远程医疗服务相关的研究,以及在COVID-19大流行期间进行的研究。
    结果:共纳入来自10个不同国家的24篇文章(10项定量研究和14项定性研究)。经审查的文章的主要发现被提取并分为以下4个主题:研究设计特征-采取了策略来改善痴呆症患者的可及性和经验-照顾者二分体;远程医疗服务的疗效结果-缺乏关于面对面服务相对有效性的有力证据;痴呆症患者和照顾者的感知经验-大多数经审查的研究报告了使用远程医疗服务的积极经验以及参与者的个人和社会利益;以及访问和使用与远程健康相关的障碍基础设施,并确定了远程医疗环境。
    结论:尽管其有效性的证据仍然有限,远程医疗被广泛认为是高危人群亲自护理的可行替代方案,比如痴呆症患者和他们的照顾者。未来的研究应该包括为资源有限和技术素养低的人扩大数字访问,采用随机对照试验设计,建立不同服务提供模式的比较有效性,增加样本的多样性。
    Telehealth has gained substantial attention during the COVID-19 pandemic, and reimbursement policies in health care settings have increased access to remote modes of care delivery. Telehealth has the potential to mitigate care concerns for people living with dementia and their family caregivers. There is a paucity of knowledge on the performance of telehealth services and user experiences, especially among caregiving dyads during the pandemic.
    This study aims to describe the implementation, effectiveness, user experience, and barriers to accessing and using telehealth services for people living with dementia and their caregivers during the COVID-19 pandemic.
    Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist, we searched 7 databases (PubMed, PsycINFO, AgeLine, CINAHL, Social Services Abstracts, Web of Science, and Scopus) and a web-based search engine (Google Scholar). The inclusion criteria for peer-reviewed English publications from March 2020 to August 2022 consisted of studies related to telehealth services for people living with dementia and their family caregivers and studies conducted during the COVID-19 pandemic.
    A total of 24 articles (10 quantitative and 14 qualitative studies) from 10 different countries were included. The major findings of the reviewed articles were extracted and organized into the following 4 themes: study design characteristics-strategies were adopted to improve the accessibility and experience of people living with dementia-caregiver dyads; efficacy outcomes of telehealth services-robust evidence is lacking on the comparative effectiveness of in-person services; perceived experiences of people living with dementia and caregivers-most reviewed studies reported positive experiences of using telehealth services and perceived personal and social benefits from their participants; and barriers to accessing and using telehealth services-several barriers related to individuals, infrastructure, and telehealth environments were identified.
    Although evidence of its effectiveness is still limited, telehealth is widely accepted as a viable alternative to in-person care for high-risk groups, such as people living with dementia and their caregivers. Future research should include expanding digital access for those with limited resources and low technology literacy, adopting randomized controlled trial designs to establish the comparative effectiveness of different modes of service delivery, and increasing the sample diversity.
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