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Messina A, Amati R, Annoni AM, Bano B, Albanese E, Fiordelli M. Culturally Adapting the World Health Organization Digital Intervention for Family Caregivers of People With Dementia (iSupport): Community-Based Participatory Approach. JMIR Form Res 2024; 8:e46941. [PMID: 38265857 PMCID: PMC10851118 DOI: 10.2196/46941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/21/2023] [Accepted: 12/04/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Informal caregivers of people with dementia are at high risk of developing mental and physical distress because of the intensity of the care provided. iSupport is an evidence-based digital program developed by the World Health Organization to provide education and support for the informal everyday care of people living with dementia. OBJECTIVE Our study aims to describe in detail the cultural adaptation process of iSupport in Switzerland. We specifically focused on the participatory strategies we used to design a culturally adapted, Swiss version of iSupport that informed the development of the desktop version, mobile app, and printed manual. METHODS We used a mixed methods design, with a community-based participatory approach. The adaptation of iSupport followed the World Health Organization adaptation guidelines and was developed in 4 phases: content translation, linguistic and cultural revision by the members of the community advisory board, validation with formal and informal caregivers, and refinement and final adaptation. RESULTS The findings from each phase showed and consolidated the adjustments needed for a culturally adapted, Swiss version of iSupport. We collected feedback and implemented changes related to the following areas: language register and expressions (eg, from "lesson" to "chapter" and from "suffering from" dementia to "affected by" dementia), resources (hyperlinks to local resources for dementia), contents (eg, from general nonfamiliar scenarios to local and verisimilar examples), graphics (eg, from generalized illustrations of objects to human illustrations), and extra features (eg, a glossary, a forum session, and a read-aloud option, as well as a navigation survey). CONCLUSIONS Our study provides evidence on how to culturally adapt a digital program for informal caregivers of people living with dementia. Our results suggest that adopting a community-based participatory approach and collecting lived experiences from the final users and stakeholders is crucial to meet local needs and to inform the further development, testing, and implementation of digital interventions in a specific cultural context.
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Affiliation(s)
- Anna Messina
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Rebecca Amati
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Anna Maria Annoni
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Beatrice Bano
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Maddalena Fiordelli
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
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Ghezeljeh TN, Seyedfatemi N, Bolhari J, Kamyari N, Rezaei M. Effects of family-based dignity intervention and expressive writing on anticipatory grief in family caregivers of patients with cancer: a randomized controlled trial. BMC Psychiatry 2023; 23:220. [PMID: 37005577 PMCID: PMC10068160 DOI: 10.1186/s12888-023-04715-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 03/23/2023] [Indexed: 04/04/2023] Open
Abstract
Family caregivers of dying cancer patients may suffer from grief experiences and bereavement complications. Previous studies have proposed some psycho-emotional interventions for the management of these complications. However, little attention has been given to family-based dignity intervention and expressive writing. This study was conducted to examine the effects of family-based dignity intervention and expressive writing, combined and alone, on anticipatory grief in family caregivers of dying cancer patients. This was a randomized controlled trial, in which 200 family caregivers of dying cancer patients were randomly assigned to four intervention groups: family-based dignity intervention (n = 50), expressive writing intervention (n = 50), combined family-based single dignity intervention and expressive writing (n = 50), and control group (n = 50). In three times (baseline, 1 week, and 2 weeks after the interventions), anticipatory grief was assessed by a 13-item anticipatory grief scale (AGS). Finally, we found a significant reducing effect of family-based dignity intervention on AGS (-8.12 ± 1.53 vs. -1.57 ± 1.52, P = 0.01) and its subscales including behavioral (-5.92 ± 0.97 vs. -2.17 ± 0.96, P = 0.04) and emotional (-2.38 ± 0.78 vs. 0.68 ± 0.77, P = 0.03) subscales compared to the control group. However, no significant effect was seen for expressive writing intervention and combined interventions of expressive writing and family-based dignity intervention. In conclusion, family-based dignity intervention may be a safe intervention for relieving anticipatory grief among family caregivers of dying cancer patients. Additional clinical trials are needed to confirm our findings. Registration number: IRCT20210111050010N1. Trial registration date:2021-02-06.
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Affiliation(s)
- Tahereh Najafi Ghezeljeh
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Naima Seyedfatemi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Jafar Bolhari
- Spiritual Health Research Center, School of Behavioral Sciences and Mental Health, University of Medical Sciences, Tehran, Iran
| | - Naser Kamyari
- Department of Public Health, School of Health, Abadan University of Medical Sciences, Abadan, Iran
| | - Masoud Rezaei
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
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Leung T, Portz J, Fischer SM, Greenway E, Johnson RL, Knoepke CE, Matlock DD, Omeragic F, Peterson RA, Ranney ML, Betz ME. A Web-Based Decision Aid for Caregivers of Persons With Dementia With Firearm Access (Safe at Home Study): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e43702. [PMID: 36719721 PMCID: PMC9929727 DOI: 10.2196/43702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/17/2022] [Accepted: 12/17/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Firearm safety among individuals with Alzheimer disease and related dementias (ADRD) is an underdiscussed and underresearched concern in the United States, especially given the growing population of community-dwelling adults with ADRD. The "Safety in Dementia" (SiD) web-based decision aid was developed to support caregivers in addressing firearm access; the efficacy of SiD is unknown. OBJECTIVE Through the SiD decision aid, the Safe at Home (S@H) study aims to support caregivers in making decisions about home safety that align with their goals and values, and behaviors regarding firearm access for persons with ADRD and firearm access. METHODS The S@H study is a 2-armed randomized controlled trial to test the effect of the SiD decision aid on caregivers of community-dwelling adults with ADRD who have firearm access. S@H aims to recruit 500 ADRD caregivers (age ≥18 years, fluent in English or Spanish, and in the United States) through online or social media advertisements and through relevant organizations. Participants are randomized to view SiD or a control website at their own pace; all participants complete web-based questionnaires at baseline, 2 weeks, 2 months, and 6 months. The primary outcome is immediate preparation for decision-making; secondary outcomes include longitudinal decision outcomes and self-reported modifications to firearm access. The relative reach and effectiveness of each recruitment method (online/social media and through relevant organizations) will be assessed by examining differences in caregiver participation, retention rates, and relative cost. RESULTS The study enrollment began in May 2022. As of December 2022, a total of 117 participants had enrolled. CONCLUSIONS The S@H study is the first randomized trial of a firearm safety decision aid for ADRD caregivers. The results from this study will inform how best to support caregivers in decision-making regarding firearm safety. Further, results may guide approaches for recruiting caregivers and for dissemination of resources. TRIAL REGISTRATION ClinicalTrials.gov NCT05173922; https://clinicaltrials.gov/ct2/show/NCT05173922. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/43702.
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Affiliation(s)
| | - Jennifer Portz
- Division of General Internal Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Stacy M Fischer
- Division of General Internal Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Emily Greenway
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Rachel L Johnson
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Christopher E Knoepke
- Adult and Child Center for Outcomes Research and Delivery Science, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.,Division of Cardiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Daniel D Matlock
- Adult and Child Center for Outcomes Research and Delivery Science, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.,VA Eastern Colorado Geriatric Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States.,Division of Geriatric Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Faris Omeragic
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Ryan A Peterson
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Megan L Ranney
- Brown-Lifespan Center for Digital Health, Brown University, Providence, RI, United States.,School of Public Health, Brown University, Providence, RI, United States.,Department of Emergency Medicine, Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Marian E Betz
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.,Injury and Violence Prevention Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.,VA Eastern Colorado Geriatric Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States
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Rahimi F, Shakibazadeh E, Ashoorkhani M, Foroughan M. Barriers to home care for older adults from perspectives of Iranian informal caregivers: a qualitative study. BMJ Open 2022; 12:e065547. [PMID: 36600370 PMCID: PMC9730353 DOI: 10.1136/bmjopen-2022-065547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE A longer life expectancy increases the number of older adults who require long-term care. The presence of a caregiver at home prevents the placement of older adults in care facilities. Identifying the caregivers' viewpoints around the care clarifies key factors in providing quality care.This study aimed to assess barriers to home care from the perspective of Iranian informal caregivers of older adults. DESIGN This was a qualitative study with content analysis. Semistructured interviews were conducted via telephone in Persian with informal caregivers of older adults using open-ended questions. SETTING Social and health organisations in southern Tehran, Iran. PARTICIPANTS Seventeen informal caregivers were selected on purpose. Participants were eligible to participate in the study if they were 18 years or older, and had at least 1 month of care experience for a minimum of 6 hours per week. RESULTS Barriers to home care for older adults from informal caregivers' points of view were categorised into three domains: (1) Individual barriers include the physical, mental and social burden of care as well as personal characteristics of the caregiver; (2) interpersonal barriers include psychobehavioural characteristics of the older adult and misbehaviour of people around the caregiver and (3) care system barriers include inefficient institutional/organisational infrastructure, moral issues and inefficiency in public policy. CONCLUSIONS Our study showed multiple individual, interpersonal and care system barriers to home care for older adults. Specific contextual challenges among Iranian caregivers, such as their attitudes and beliefs, as well as a lack of social and healthcare support for families, hindered the quality of care. TRIAL REGISTRATION NUMBER IRCT20201012048999N1.
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Affiliation(s)
- Fatemeh Rahimi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Ashoorkhani
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahshid Foroughan
- Department of Aging, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Science, Tehran, Iran
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5
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Leung T, Wang J, van Boxtel M, Köhler S, Verhey F, de Vugt ME. Lessons Learned From an Effectiveness Evaluation of Inlife, a Web-Based Social Support Intervention for Caregivers of People With Dementia: Randomized Controlled Trial. JMIR Aging 2022; 5:e38656. [PMID: 36476485 PMCID: PMC9773030 DOI: 10.2196/38656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Informal care for people with dementia not only affects the well-being of the primary caregiver but also changes their roles and interactions with the social environment. New online interventions might facilitate access to social support. Recently, an online social support platform, Inlife, was developed in the Netherlands and aims to enhance social support and positive interactions in informal support networks. OBJECTIVE This study aimed to evaluate the effectiveness of Inlife for caregivers of people with dementia. METHODS A randomized controlled trial with 96 caregivers of people with dementia was performed. Participants were randomly assigned to the Inlife intervention or the waiting list control group. After 16 weeks of Inlife use, the waiting list control group could start using Inlife. Effects were evaluated at baseline (T0), 8 weeks (T1), and 16 weeks (T2). The 16-week follow-up assessment (T2) served as the primary endpoint to evaluate the results for the primary and secondary outcome variables evaluated with online self-report questionnaires. The primary outcomes included feelings of caregiver competence and perceived social support. The secondary outcomes included received support, feelings of loneliness, psychological complaints (eg, anxiety, stress), and quality of life. RESULTS No significant improvements were demonstrated for the intervention group (n=48) relative to the control group (n=48) for the primary outcomes (feeling of carer competence: b=-0.057, 95% CI -0.715 to 0.602, P=.87; perceived social support: b=-15.877, 95% CI -78.284 to 46.530, P=.62) or any secondary outcome. This contrasts with our qualitative findings showing the potential of Inlife to facilitate the care process in daily life. Adherence was not optimal for all Inlife users. Additional per-protocol and sensitivity analyses also revealed no beneficial results for high active Inlife users or specific subgroups. Inlife users were more active when part of a larger network. CONCLUSIONS Researchers should be modest regarding the effectiveness of online caregiver interventions in terms of quantitative measures of well-being and quality of life. Nevertheless, online tools have the potential to facilitate the caregiver process in daily life. Lessons learned include the importance of harnessing the power of human interaction in eHealth, making use of the user's social capital, and the need to develop research methods that can identify benefits in daily life that are ecologically valid for caregivers. TRIAL REGISTRATION Netherlands Trial Register NTR6131; https://trialsearch.who.int/Trial2.aspx?TrialID=NTR6131. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s13063-017-2097-y.
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Affiliation(s)
| | | | - Martin van Boxtel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Marjolein Elisabeth de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
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6
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Wilding C, Morgan D, Greenhill J, Perkins D, O'Connell ME, Bauer M, Farmer J, Morley C, Blackberry I. Web-Based Technologies to Support Carers of People Living With Dementia: Protocol for a Mixed Methods Stepped-Wedge Cluster Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e33023. [PMID: 35588366 PMCID: PMC9164093 DOI: 10.2196/33023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 02/15/2022] [Accepted: 04/26/2022] [Indexed: 11/24/2022] Open
Abstract
Background Informal carers play a significant role in supporting people living with dementia; however, carers in rural areas are often isolated, with limited access to support services. Although dementia-friendly communities provide valued support for carers, access to them is limited as they are few and geographically dispersed. Objective This study’s aim was to increase support and services for rural informal carers of people living with dementia by using information and communication technologies accessed through an integrated website and mobile app—the Verily Connect app. The objective of this protocol is to detail the research design used in a complex study that was situated in a challenging real-world setting integrating web-based and on-ground technology and communication. Therefore, it is anticipated that this protocol will strengthen the research of others exploring similar complex concepts. Methods A stepped-wedge, open-cohort cluster randomized controlled trial was conducted to implement Verily Connect across 12 rural Australian communities. The Verily Connect intervention delivered web-based, curated information about dementia, a localized directory of dementia services and support, group and individual chat forums, and peer support through videoconference. During the implementation phase of 32 weeks, Verily Connect was progressively implemented in four 8-weekly waves of 3 communities per wave. Usual care, used as a comparator, was available to carers throughout the study period. Participants and researchers were unblinded to the intervention. There were 3 cohorts of participants: carers, volunteers, and staff; participants were recruited from their communities. The primary outcome measure was perceived carer social support measured using the Medical Outcomes Study-Social Support Survey. Volunteers and staff provided feedback on their participation in Verily Connect as qualitative data. Qualitative data were collected from all cohorts of participants through interviews and focus groups. Process evaluation data were collected through interviews and memos written by research staff. Data on the costs of implementing Verily Connect were collected by the research team members and evaluated by a health economist. Results Between August 2018 and September 2019, a total of 113 participants were recruited. There were 37 (32.7%) carers, 39 (34.5%) volunteers, and 37 (32.7%) health service staff. The study was complex because of the involvement of multiple and varied communities of carers, volunteers, health service staff, and research team members originating from 5 universities. Web-based technologies were used as intervention strategies to support carers and facilitate the process of undertaking the study. Conclusions The Verily Connect trial enabled the testing and further development of a web-based approach to increasing support for carers of people living with dementia across a diverse rural landscape in Australia. This protocol provides an example of how to conduct a pragmatic evaluation of a complex and co-designed intervention involving multiple stakeholders. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12618001213235; https://tinyurl.com/4rjvrasf International Registered Report Identifier (IRRID) RR1-10.2196/33023
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Affiliation(s)
- Clare Wilding
- John Richards Centre for Rural Ageing Research, La Trobe Rural Health School, La Trobe University, Wodonga, Australia
| | - Debra Morgan
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - Jennene Greenhill
- Faculty of Health, Southern Cross University, Bilinga, Australia.,College of Medicine and Public Health, Flinders Medical Centre, Flinders University, Renmark, Australia
| | - David Perkins
- Centre for Rural and Remote Mental Health, The University of Newcastle, Orange, Australia.,Health Research Institute, University of Canberra, Canberra, Australia
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Michael Bauer
- Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Australia
| | - Jane Farmer
- Social Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
| | | | - Irene Blackberry
- John Richards Centre for Rural Ageing Research, La Trobe Rural Health School, La Trobe University, Wodonga, Australia
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7
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Rahimi F, Shakibazadeh E, Ashoorkhani M, Hosseini H, Foroughan M. Effect of "Mehrpishegan" web-based support group on depression, anxiety, and stress among elderly informal caregivers: a protocol for a randomized-controlled trial. Trials 2022; 23:413. [PMID: 35581609 PMCID: PMC9110945 DOI: 10.1186/s13063-022-06351-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Elderly population in low- and middle-income countries is rapidly growing, which indicates an increase in the number of dependent people needing long-term care. Caring for the elderly is difficult and stressful and threatens physical and mental health of informal caregivers. We aim to design a web-based support group and assess its effectiveness on depression, anxiety, and stress among elderly informal caregivers. Methods This is a protocol for a two-arm randomized controlled trial. A total of 160 informal elderly caregivers will be recruited from the southern area of Tehran. Eligible participants will be randomly allocated to two intervention and control groups. The inclusion criteria include not receiving salary for caring, having primary responsibility for care, having smartphone/tablet/computer, being able to use the contents and web applications, having at least one month of experience in caring for the elderly, and having access to the Internet at least once weekly. The intervention will be implemented by giving an account access to the designed website. Depression, anxiety, and stress will be assessed using the DASS21 questionnaire at baseline, and at the end of third and sixth months. Discussion Our findings can pave the way for improving the mental health of informal caregivers of the elderly through provision of web-based supportive services. This study stands as an opportunity to address the needs of caregivers and help them support each other in a novel way. Trial registration Iran Randomized Clinical Trial Center IRCT20201012048999N1. Registered on 25 December 2020 (current status: ongoing). The World Health Organization Trial Registration Data Set is in Additional file 1 Protocol version Second version 2021-05-27 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06351-4.
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Affiliation(s)
- Fatemeh Rahimi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,South Tehran Health Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mahnaz Ashoorkhani
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Hosseini
- Center of Research and Training in Skin Disease and Leprosy, Tehran University of Medical Sciences, Tehran, Iran.,Clinical Trial Center (CTC), Tehran University of Medical Sciences, Tehran, Iran
| | - Mahshid Foroughan
- Iranian Research Center on Aging, Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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8
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McCreedy E, Gilmore-Bykovskyi A, Dorr DA, Lima J, McCarthy EP, Meyers DJ, Platt R, Vydiswaran VGV, Bynum JP. Barriers to identifying residents with dementia for embedded pragmatic trials: A call to action. J Am Geriatr Soc 2022; 70:638-641. [PMID: 34727369 PMCID: PMC8821246 DOI: 10.1111/jgs.17539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/11/2021] [Accepted: 10/17/2021] [Indexed: 02/03/2023]
Affiliation(s)
- Ellen McCreedy
- Department of Health Services, Policy, and Practice, Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI
| | | | - David A. Dorr
- Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR USA
| | - Julie Lima
- Department of Health Services, Policy, and Practice, Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI
| | - Ellen P. McCarthy
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - David J. Meyers
- Department of Health Services, Policy, and Practice, Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI
| | - Richard Platt
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA
| | - V. G. Vinod Vydiswaran
- Department of Learning Health Sciences, University of Michigan, Ann Arbor, Michigan, USA,School of Information, University of Michigan, Ann Arbor, Michigan, USA
| | - Julie P.W. Bynum
- Department of Internal Medicine, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
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9
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Seyedfatemi N, Ghezeljeh TN, Bolhari J, Rezaei M. Effects of family-based dignity intervention and expressive writing on anticipatory grief of family caregivers of patients with cancer: a study protocol for a four-arm randomized controlled trial and a qualitative process evaluation. Trials 2021; 22:751. [PMID: 34711262 PMCID: PMC8552199 DOI: 10.1186/s13063-021-05718-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Family caregivers of dying cancer patients are affected by grief experiences and bereavement complications. Several approaches such as psycho-emotional care and an increase in spirituality have been suggested to diminish these complications. However, the knowledge about the effects of family-based dignity intervention and expressive writing on anticipatory grief in family caregivers of dying cancer patients is limited. This is a study protocol describing a hospital-based mixed-methods study on the effects of family-based dignity intervention and expressive writing on anticipatory grief in family caregivers of dying cancer patients. METHODS This mixed-methods study will be done in an embedded explanatory design with two quantitative and qualitative phases. In the first phase (quantitative), a randomized clinical trial will be done, in which 200 family caregivers of dying cancer patients will be randomly assigned to one of the four groups: family-based single dignity intervention (group 1), expressive writing intervention (group 2), combined family-based single dignity intervention and expressive writing (group 3), and control (group 4). At baseline, 1 week and 2 weeks after the interventions, anticipatory grief will be assessed by a 13-item anticipatory grief scale. After the quantitative phase, the qualitative phase will be conducted through the conventional content analysis approach of Granheim and Lundman, in which an individual semi-structured interview will be taken from participants in the first phase to collect data on their experiences on interventions. Finally, data from the quantitative and qualitative phases will be analyzed and discussed. DISCUSSION Family caregivers of dying cancer patients usually experience depression, anxiety, and psychological distress due to isolation and inadequate social support. Psychological interventions such as dignity and expressive writing interventions may help caregivers to obtain a better understanding of themselves and to increase their abilities to cope with caregiving difficulties. Therefore, there is a need for a comprehensive study confirming the effects of mentioned interventions on family caregivers of dying cancer patients. TRIAL REGISTRATION Iranian Registry of Clinical Trials ( www.irct.ir ) identifier: IRCT20210111050010N1. Date of trial registration: Feb 6, 2021. This is the first version of this protocol.
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Affiliation(s)
- Naima Seyedfatemi
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Tahereh Najafi Ghezeljeh
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran.,Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Jafar Bolhari
- Spiritual Health Research Center, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Rezaei
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
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10
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Johnson PC, Markovitz NH, Gray TF, Bhatt S, Nipp RD, Ufere N, Rice J, Reynolds MJ, Lavoie MW, Topping CEW, Clay MA, Lindvall C, El-Jawahri A. Association of Social Support With Overall Survival and Healthcare Utilization in Patients With Aggressive Hematologic Malignancies. J Natl Compr Canc Netw 2021:1-7. [PMID: 34653964 DOI: 10.6004/jnccn.2021.7033] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/02/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Social support plays a crucial role for patients with aggressive hematologic malignancies as they navigate their illness course. The aim of this study was to examine associations of social support with overall survival (OS) and healthcare utilization in this population. METHODS A cross-sectional secondary analysis was conducted using data from a prospective longitudinal cohort study of 251 hospitalized patients with aggressive hematologic malignancies at Massachusetts General Hospital from 2014 through 2017. Natural Language Processing (NLP) was used to identify the extent of patients' social support (limited vs adequate as defined by NLP-aided chart review of the electronic health record). Multivariable regression models were used to examine associations of social support with (1) OS, (2) death or readmission within 90 days of discharge from index hospitalization, (3) time to readmission within 90 days, and (4) index hospitalization length of stay. RESULTS Patients had a median age of 64 years (range, 19-93 years), and most were White (89.6%), male (68.9%), and married (65.3%). A plurality of patients had leukemia (42.2%) followed by lymphoma (37.9%) and myelodysplastic syndrome/myeloproliferative neoplasm (19.9%). Using NLP, we identified that 8.8% (n=22) of patients had limited social support. In multivariable analyses, limited social support was associated with worse OS (hazard ratio, 2.00; P=.042) and a higher likelihood of death or readmission within 90 days of discharge (odds ratio, 3.11; P=.043), but not with time to readmission within 90 days or with index hospitalization length of stay. CONCLUSIONS In this cohort of hospitalized patients with aggressive hematologic malignancies, we found associations of limited social support with lower OS and a higher likelihood of death or readmission within 90 days of hospital discharge. These findings underscore the utility of NLP for evaluating the extent of social support and the need for larger studies evaluating social support in patients with aggressive hematologic malignancies.
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Affiliation(s)
- P Connor Johnson
- 1Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital
- 2Harvard Medical School
| | - Netana H Markovitz
- 1Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital
| | - Tamryn F Gray
- 2Harvard Medical School
- 3Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute
| | - Sunil Bhatt
- 1Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital
| | - Ryan D Nipp
- 1Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital
- 2Harvard Medical School
| | - Nneka Ufere
- 2Harvard Medical School
- 4Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital; and
| | - Julia Rice
- 5Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Matthew J Reynolds
- 5Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Mitchell W Lavoie
- 5Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Carlisle E W Topping
- 5Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Madison A Clay
- 5Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Charlotta Lindvall
- 2Harvard Medical School
- 3Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute
| | - Areej El-Jawahri
- 1Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital
- 2Harvard Medical School
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Petkovic J, Duench S, Trawin J, Dewidar O, Pardo Pardo J, Simeon R, DesMeules M, Gagnon D, Hatcher Roberts J, Hossain A, Pottie K, Rader T, Tugwell P, Yoganathan M, Presseau J, Welch V. Behavioural interventions delivered through interactive social media for health behaviour change, health outcomes, and health equity in the adult population. Cochrane Database Syst Rev 2021; 5:CD012932. [PMID: 34057201 PMCID: PMC8406980 DOI: 10.1002/14651858.cd012932.pub2] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Social networking platforms offer a wide reach for public health interventions allowing communication with broad audiences using tools that are generally free and straightforward to use and may be combined with other components, such as public health policies. We define interactive social media as activities, practices, or behaviours among communities of people who have gathered online to interactively share information, knowledge, and opinions. OBJECTIVES We aimed to assess the effectiveness of interactive social media interventions, in which adults are able to communicate directly with each other, on changing health behaviours, body functions, psychological health, well-being, and adverse effects. Our secondary objective was to assess the effects of these interventions on the health of populations who experience health inequity as defined by PROGRESS-Plus. We assessed whether there is evidence about PROGRESS-Plus populations being included in studies and whether results are analysed across any of these characteristics. SEARCH METHODS We searched CENTRAL, CINAHL, Embase, MEDLINE (including trial registries) and PsycINFO. We used Google, Web of Science, and relevant web sites to identify additional studies and searched reference lists of included studies. We searched for published and unpublished studies from 2001 until June 1, 2020. We did not limit results by language. SELECTION CRITERIA We included randomised controlled trials (RCTs), controlled before-and-after (CBAs) and interrupted time series studies (ITSs). We included studies in which the intervention website, app, or social media platform described a goal of changing a health behaviour, or included a behaviour change technique. The social media intervention had to be delivered to adults via a commonly-used social media platform or one that mimicked a commonly-used platform. We included studies comparing an interactive social media intervention alone or as a component of a multi-component intervention with either a non-interactive social media control or an active but less-interactive social media comparator (e.g. a moderated versus an unmoderated discussion group). Our main outcomes were health behaviours (e.g. physical activity), body function outcomes (e.g. blood glucose), psychological health outcomes (e.g. depression), well-being, and adverse events. Our secondary outcomes were process outcomes important for behaviour change and included knowledge, attitudes, intention and motivation, perceived susceptibility, self-efficacy, and social support. DATA COLLECTION AND ANALYSIS We used a pre-tested data extraction form and collected data independently, in duplicate. Because we aimed to assess broad outcomes, we extracted only one outcome per main and secondary outcome categories prioritised by those that were the primary outcome as reported by the study authors, used in a sample size calculation, and patient-important. MAIN RESULTS We included 88 studies (871,378 participants), of which 84 were RCTs, three were CBAs and one was an ITS. The majority of the studies were conducted in the USA (54%). In total, 86% were conducted in high-income countries and the remaining 14% in upper middle-income countries. The most commonly used social media platform was Facebook (39%) with few studies utilising other platforms such as WeChat, Twitter, WhatsApp, and Google Hangouts. Many studies (48%) used web-based communities or apps that mimic functions of these well-known social media platforms. We compared studies assessing interactive social media interventions with non-interactive social media interventions, which included paper-based or in-person interventions or no intervention. We only reported the RCT results in our 'Summary of findings' table. We found a range of effects on health behaviours, such as breastfeeding, condom use, diet quality, medication adherence, medical screening and testing, physical activity, tobacco use, and vaccination. For example, these interventions may increase physical activity and medical screening tests but there was little to no effect for other health behaviours, such as improved diet or reduced tobacco use (20,139 participants in 54 RCTs). For body function outcomes, interactive social media interventions may result in small but important positive effects, such as a small but important positive effect on weight loss and a small but important reduction in resting heart rate (4521 participants in 30 RCTs). Interactive social media may improve overall well-being (standardised mean difference (SMD) 0.46, 95% confidence interval (CI) 0.14 to 0.79, moderate effect, low-certainty evidence) demonstrated by an increase of 3.77 points on a general well-being scale (from 1.15 to 6.48 points higher) where scores range from 14 to 70 (3792 participants in 16 studies). We found no difference in effect on psychological outcomes (depression and distress) representing a difference of 0.1 points on a standard scale in which scores range from 0 to 63 points (SMD -0.01, 95% CI -0.14 to 0.12, low-certainty evidence, 2070 participants in 12 RCTs). We also compared studies assessing interactive social media interventions with those with an active but less interactive social media control (11 studies). Four RCTs (1523 participants) that reported on physical activity found an improvement demonstrated by an increase of 28 minutes of moderate-to-vigorous physical activity per week (from 10 to 47 minutes more, SMD 0.35, 95% CI 0.12 to 0.59, small effect, very low-certainty evidence). Two studies found little to no difference in well-being for those in the intervention and control groups (SMD 0.02, 95% CI -0.08 to 0.13, small effect, low-certainty evidence), demonstrated by a mean change of 0.4 points on a scale with a range of 0 to 100. Adverse events related to the social media component of the interventions, such as privacy issues, were not reported in any of our included studies. We were unable to conduct planned subgroup analyses related to health equity as only four studies reported relevant data. AUTHORS' CONCLUSIONS This review combined data for a variety of outcomes and found that social media interventions that aim to increase physical activity may be effective and social media interventions may improve well-being. While we assessed many other outcomes, there were too few studies to compare or, where there were studies, the evidence was uncertain. None of our included studies reported adverse effects related to the social media component of the intervention. Future studies should assess adverse events related to the interactive social media component and should report on population characteristics to increase our understanding of the potential effect of these interventions on reducing health inequities.
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Affiliation(s)
| | | | | | - Omar Dewidar
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Jordi Pardo Pardo
- Ottawa Hospital Research Institute, The Ottawa Hospital - General Campus, Ottawa, Canada
| | - Rosiane Simeon
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Marie DesMeules
- Social Determinants and Science Integration/ Direction des déterminants sociaux et de l'intégration scientifique, Public Health Agency of Canada/Agence de santé publique du Canada, Ottawa, Canada
| | - Diane Gagnon
- Department of Communication, University of Ottawa, Ottawa, Canada
| | | | - Alomgir Hossain
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Canada
| | - Kevin Pottie
- Family Medicine, University of Ottawa, Ottawa, Canada
| | - Tamara Rader
- Canadian Agency for Drugs and Technologies in Health (CADTH), Ottawa, Canada
| | - Peter Tugwell
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Vivian Welch
- Methods Centre, Bruyère Research Institute, Ottawa, Canada
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12
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Zhao C, Xu H, Lai X, Yang X, Tu X, Ding N, Lv Y, Zhang G. Effects of Online Social Support and Perceived Social Support on the Relationship Between Perceived Stress and Problematic Smartphone Usage Among Chinese Undergraduates. Psychol Res Behav Manag 2021; 14:529-539. [PMID: 33976576 PMCID: PMC8106527 DOI: 10.2147/prbm.s302551] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/26/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Recent research has identified a relationship between perceived stress and problematic smartphone usage. However, little is known about the underlying mediating and moderating mechanisms. The present study aimed to test the relationship between perceived stress and problematic smartphone usage as well as the mediating role of online social support and the moderating role of perceived social support among Chinese undergraduates. PATIENTS AND METHODS A sample of 1123 college students participated in the study. The Perceived Stress Scale, Mobile Phone Addiction Index Scale, Online Social Support Questionnaire, and Perceived Social Support Scale were used. RESULTS Perceived stress was significantly and positively associated with problematic smartphone usage, and online social support partially mediated the relationship between perceived stress and problematic smartphone usage. Moderated mediation analysis suggested that perceived social support moderated the association between perceived stress and online social support. This relationship became stronger for college students with lower levels of perceived social support. CONCLUSION The results of this study can contribute to a better understanding of how perceived stress increases the risk of problematic smartphone usage. The importance of reducing online social support and enhancing perceived social support in preventing undergraduates' problematic smartphone usage is highlighted. The findings should be taken with caution given the convenience sampling and cross-sectional study design.
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Affiliation(s)
- Chengjia Zhao
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, People’s Republic of China
| | - Huihui Xu
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, People’s Republic of China
| | - Xinyi Lai
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, People’s Republic of China
| | - Xue Yang
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China
| | - Xiaolian Tu
- School of Renji, Wenzhou Medical University, Wenzhou, 325035, China
| | - Nani Ding
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, 325035, People’s Republic of China
| | - Yijun Lv
- Wenzhou Medical University, Wenzhou, 325035, People’s Republic of China
| | - Guohua Zhang
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, People’s Republic of China
- The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, 325007, People’s Republic of China
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13
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Wójcik D, Szczechowiak K, Konopka P, Owczarek M, Kuzia A, Rydlewska-Liszkowska I, Pikala M. Informal Dementia Caregivers: Current Technology Use and Acceptance of Technology in Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063167. [PMID: 33808644 PMCID: PMC8003488 DOI: 10.3390/ijerph18063167] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/10/2021] [Accepted: 03/16/2021] [Indexed: 01/10/2023]
Abstract
(1) Background: Given the increased social isolation caused by the COVID-19 pandemic, the challenges faced by informal dementia caregivers have increased. An increasing use of technology, both in care and dementia clinical trials, depends upon caregivers' abilities as a user. Accordingly, the aim of our study was to verify the current technology (smartphone and computer) use and acceptance in care, regarding socio-demographic variables; (2) Methods: Questionnaires were distributed to 102 dementia caregivers, mostly of patients with moderate dementia; (3) Results: The majority of participants were women (63%), and large number of them used technological devices such as a smartphone (91%) or computer (81%). Results revealed differences between age, gender, and education level on technology acceptance. Interestingly, smartphone use and acceptance seemed to be feasible, regardless of age, whereas computer use was negatively correlated with age. Technology was perceived by respondents as most useful for patients' activities including locomotion, toileting, and meals; (4) Conclusions: The future of technology use in dementia care should indicate solutions tailored to individual characteristics such as new technology solutions (GPS trackers, smartphone apps, dietary intervention, and meal planning apps).
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Affiliation(s)
- Daniel Wójcik
- Department of Management and Logistics in Health Care, Medical University of Lodz, Poland InterDoktorMen Medical University of Lodz, 90-419 Lodz, Poland;
- Wroclaw’s Alzheimer Center, 53-659 Wroclaw, Poland;
- Department of Epidemiology and Biostatistics, Social and Preventive Medicine of the Medical University of Lodz, 90-752 Lodz, Poland;
- Correspondence: ; Tel.: +48-505134649
| | | | - Patrycja Konopka
- Institute of Psychology, Polish Academy of Sciences, 00-378 Warsaw, Poland;
| | - Mateusz Owczarek
- Institute of Psychology, University of Wroclaw, 50-527 Wroclaw, Poland; (M.O.); (A.K.)
| | - Agata Kuzia
- Institute of Psychology, University of Wroclaw, 50-527 Wroclaw, Poland; (M.O.); (A.K.)
| | - Izabela Rydlewska-Liszkowska
- Department of Management and Logistics in Health Care, Medical University of Lodz, Poland InterDoktorMen Medical University of Lodz, 90-419 Lodz, Poland;
| | - Małgorzata Pikala
- Department of Epidemiology and Biostatistics, Social and Preventive Medicine of the Medical University of Lodz, 90-752 Lodz, Poland;
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14
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Christie HL, Boots LMM, Tange HJ, Verhey FRJ, de Vugt ME. Implementations of Evidence-Based eHealth Interventions for Caregivers of People With Dementia in Municipality Contexts (Myinlife and Partner in Balance): Evaluation Study. JMIR Aging 2021; 4:e21629. [PMID: 33544085 PMCID: PMC8081156 DOI: 10.2196/21629] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/28/2020] [Accepted: 11/09/2020] [Indexed: 01/22/2023] Open
Abstract
Background Very few evidence-based eHealth interventions for caregivers of people with dementia are implemented into practice. Municipalities are one promising context in which to implement these interventions due to their available policy and innovation incentives regarding (dementia) caregiving and prevention. In this study, two evidence-based eHealth interventions for caregivers of people with dementia (Partner in Balance and Myinlife) were implemented in 8 municipalities in the Euregion Meuse-Rhine. Partner in Balance is a blended care, 8-week, self-management intervention intervention designed to aid caregivers of people with dementia in adapting to their new roles that is delivered through coaches in participating health care organizations who are trained to use it to offer online support to their clients. Myinlife is an eHealth/mHealth intervention integrated into the Dutch Alzheimer’s Association website and available from the App Store or Google Play, designed to help caregivers of people with dementia use their social network to better organize care and share positive (caregiving) experiences. Objective This study’s objectives were to evaluate the success of the implementation of Myinlife and Partner in Balance and investigate determinants of their successful implementation in the municipality context. Methods This study collected eHealth use data, Partner in Balance coach evaluation questionnaires, and information on implementation determinants. This was done by conducting interviews with the municipality officials based on the measurement instrument for determinants of implementation (MIDI). These data from multiple sources and perspectives were integrated and analyzed to form a total picture of the determinants (barriers and facilitators to implementation in the municipality context). Results The municipality implementation of Partner in Balance and Myinlife showed varying levels of success. In the end, 3 municipalities planned to continue the implementation of Partner in Balance, while none planned to continue the implementation of Myinlife. The 2 Partner in Balance municipalities that did not consider the implementation to be successful viewed the implementation as an external project. For Myinlife, it was clear that more face-to-face contact was needed to engage the implementing municipality and target groups. Successful implementations were linked to implementer self-efficacy and sense of ownership, which seemed to be absent in unsuccessful implementations. Conclusions The experiences of implementing these interventions suggested that this implementation context was feasible regarding the required budget and infrastructure. The need to foster sense of ownership and self-efficacy in implementers will be integrated into future implementation protocols as part of standard implementation materials for municipalities and organizations implementing Myinlife and Partner in Balance.
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Affiliation(s)
- Hannah Liane Christie
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, Netherlands
| | - Lizzy Mitzy Maria Boots
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, Netherlands
| | - Huibert Johannes Tange
- Department of Family Practice, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Frans Rochus Josef Verhey
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, Netherlands
| | - Marjolein Elizabeth de Vugt
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, Netherlands
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15
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González-Fraile E, Ballesteros J, Rueda JR, Santos-Zorrozúa B, Solà I, McCleery J. Remotely delivered information, training and support for informal caregivers of people with dementia. Cochrane Database Syst Rev 2021; 1:CD006440. [PMID: 33417236 PMCID: PMC8094510 DOI: 10.1002/14651858.cd006440.pub3] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Many people with dementia are cared for at home by unpaid informal caregivers, usually family members. Caregivers may experience a range of physical, emotional, financial and social harms, which are often described collectively as caregiver burden. The degree of burden experienced is associated with characteristics of the caregiver, such as gender, and characteristics of the person with dementia, such as dementia stage, and the presence of behavioural problems or neuropsychiatric disturbances. It is a strong predictor of admission to residential care for people with dementia. Psychoeducational interventions might prevent or reduce caregiver burden. Overall, they are intended to improve caregivers' knowledge about the disease and its care; to increase caregivers' sense of competence and their ability to cope with difficult situations; to relieve feelings of isolation and allow caregivers to attend to their own emotional and physical needs. These interventions are heterogeneous, varying in their theoretical framework, components, and delivery formats. Interventions that are delivered remotely, using printed materials, telephone or video technologies, may be particularly suitable for caregivers who have difficulty accessing face-to-face services because of their own health problems, poor access to transport, or absence of substitute care. During the COVID-19 pandemic, containment measures in many countries required people to be isolated in their homes, including people with dementia and their family carers. In such circumstances, there is no alternative to remote delivery of interventions. OBJECTIVES To assess the efficacy and acceptability of remotely delivered interventions aiming to reduce burden and improve mood and quality of life of informal caregivers of people with dementia. SEARCH METHODS We searched the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group, MEDLINE, Embase and four other databases, as well as two international trials registries, on 10 April 2020. We also examined the bibliographies of relevant review papers and published trials. SELECTION CRITERIA We included only randomised controlled trials that assessed the remote delivery of structured interventions for informal caregivers who were providing care for people with dementia living at home. Caregivers had to be unpaid adults (relatives or members of the person's community). The interventions could be delivered using printed materials, the telephone, the Internet or a mixture of these, but could not involve any face-to-face contact with professionals. We categorised intervention components as information, training or support. Information interventions included two key elements: (i) they provided standardised information, and (ii) the caregiver played a passive role. Support interventions promoted interaction with other people (professionals or peers). Training interventions trained caregivers in practical skills to manage care. We excluded interventions that were primarily individual psychotherapy. Our primary outcomes were caregiver burden, mood, health-related quality of life and dropout for any reason. Secondary outcomes were caregiver knowledge and skills, use of health and social care resources, admission of the person with dementia to institutional care, and quality of life of the person with dementia. DATA COLLECTION AND ANALYSIS Study selection, data extraction and assessment of the risk of bias in included studies were done independently by two review authors. We used the Template for Intervention Description and Replication (TIDieR) to describe the interventions. We conducted meta-analyses using a random-effects model to derive estimates of effect size. We used GRADE methods to describe our degree of certainty about effect estimates. MAIN RESULTS We included 26 studies in this review (2367 participants). We compared (1) interventions involving training, support or both, with or without information (experimental interventions) with usual treatment, waiting list or attention control (12 studies, 944 participants); and (2) the same experimental interventions with provision of information alone (14 studies, 1423 participants). We downgraded evidence for study limitations and, for some outcomes, for inconsistency between studies. There was a frequent risk of bias from self-rating of subjective outcomes by participants who were not blind to the intervention. Randomisation methods were not always well-reported and there was potential for attrition bias in some studies. Therefore, all evidence was of moderate or low certainty. In the comparison of experimental interventions with usual treatment, waiting list or attention control, we found that the experimental interventions probably have little or no effect on caregiver burden (nine studies, 597 participants; standardised mean difference (SMD) -0.06, 95% confidence interval (CI) -0.35 to 0.23); depressive symptoms (eight studies, 638 participants; SMD -0.05, 95% CI -0.22 to 0.12); or health-related quality of life (two studies, 311 participants; SMD 0.10, 95% CI -0.13 to 0.32). The experimental interventions probably result in little or no difference in dropout for any reason (eight studies, 661 participants; risk ratio (RR) 1.15, 95% CI 0.87 to 1.53). In the comparison of experimental interventions with a control condition of information alone, we found that experimental interventions may result in a slight reduction in caregiver burden (nine studies, 650 participants; SMD -0.24, 95% CI -0.51 to 0.04); probably result in a slight improvement in depressive symptoms (11 studies, 1100 participants; SMD -0.25, 95% CI -0.43 to -0.06); may result in little or no difference in caregiver health-related quality of life (two studies, 257 participants; SMD -0.03, 95% CI -0.28 to 0.21); and probably result in an increase in dropouts for any reason (12 studies, 1266 participants; RR 1.51, 95% CI 1.04 to 2.20). AUTHORS' CONCLUSIONS Remotely delivered interventions including support, training or both, with or without information, may slightly reduce caregiver burden and improve caregiver depressive symptoms when compared with provision of information alone, but not when compared with usual treatment, waiting list or attention control. They seem to make little or no difference to health-related quality of life. Caregivers receiving training or support were more likely than those receiving information alone to drop out of the studies, which might limit applicability. The efficacy of these interventions may depend on the nature and availability of usual services in the study settings.
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Affiliation(s)
| | - Javier Ballesteros
- Department of Neuroscience, University of the Basque Country, CIBER Salud Mental (CIBERSAM), Leioa, Spain
| | - José-Ramón Rueda
- Department of Preventive Medicine and Public Health, University of the Basque Country, Leioa, Spain
| | - Borja Santos-Zorrozúa
- Scientific coordination Unit, Biocruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain
| | - Ivan Solà
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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16
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Christie HL, Schichel MCP, Tange HJ, Veenstra MY, Verhey FRJ, de Vugt ME. Perspectives From Municipality Officials on the Adoption, Dissemination, and Implementation of Electronic Health Interventions to Support Caregivers of People With Dementia: Inductive Thematic Analysis. JMIR Aging 2020; 3:e17255. [PMID: 32401217 PMCID: PMC7254285 DOI: 10.2196/17255] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 01/25/2023] Open
Abstract
Background Very few evidence-based electronic health (eHealth) interventions for caregivers of people with dementia are implemented into practice. As part of a cross-border collaboration focusing on dementia and depression in older people, two eHealth interventions for caregivers of people with dementia (“Myinlife” and “Partner in Balance”) were adopted by nine municipalities in the Euregion Meuse-Rhine. Objective This study aimed to (1) identify determinants for the implementation of eHealth interventions for caregivers of people with dementia in a municipality context and (2) formulate implementation strategies for these interventions. Methods Eight municipality officials were interviewed using open-ended, semistructured interviews about their background, thoughts on the implementation of the intervention, recommended strategies, and thoughts on eHealth in general. One additional municipality discontinued the implementation project and submitted answers to the interview questions via email. The interviews were transcribed and independently analyzed using inductive thematic analysis. Results The interviews provided information on the perspectives of municipality officials on implementing eHealth for caregivers of people with dementia in their local communities. Key findings from the inductive thematic analysis included the importance of face-to-face interviews in developing tailor-made implementation plans, the need for regular meetings, the enthusiasm of municipality officials to implement these interventions, the need for long-term sustainability planning through collecting data on the required resources and benefits, and the effect of name brand recognition in adoption. Conclusions The findings contribute toward filling the previously identified gap in the literature on the implementation context of eHealth interventions for caregivers of people with dementia. Municipality officials’ views indicated which implementation determinants they expected would influence the adoption, dissemination, and future implementation of eHealth interventions for caregivers of people with dementia in a municipal context. These insights were applied to tailored implementation strategies to facilitate the future implementation of interventions such as Myinlife and Partner in Balance.
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Affiliation(s)
- Hannah Liane Christie
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, Netherlands
| | | | - Huibert Johannes Tange
- Department of Family Practice, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Marja Yvonne Veenstra
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, Netherlands.,Burgerkracht Limburg, Sittard, Netherlands
| | - Frans Rochus Josef Verhey
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, Netherlands
| | - Marjolein Elizabeth de Vugt
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, Netherlands
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17
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Evans S, Evans S, Brooker D, Henderson C, Szcześniak D, Atkinson T, Bray J, Amritpal R, Saibene FL, d'Arma A, Scorolli C, Chattat R, Farina E, Urbańska K, Rymaszewska J, Meiland F, Dröes RM. The impact of the implementation of the Dutch combined Meeting Centres Support Programme for family caregivers of people with dementia in Italy, Poland and UK. Aging Ment Health 2020; 24:280-290. [PMID: 30520312 DOI: 10.1080/13607863.2018.1544207] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: The MEETINGDEM research project aimed to implement the combined Dutch Meeting Centre Support Programme (MCSP) for community-dwelling people with dementia and caregivers within Italy, Poland and UK and to assess whether comparable benefits were found in these countries as in the Netherlands.Method: Nine pilot Meeting Centres (MCs) participated (Italy-5, Poland-2, UK-2). Effectiveness of MCSP was compared to usual care (UC) on caregiver outcomes measuring competence (SSCQ), mental health (GHQ-12), emotional distress (NPI-Q) and loneliness (UCLA) analysed by ANCOVAs in a 6-month pre-test/post-test controlled trial. Interviews using standardised measures were completed with caregivers.Results: Pre/post data were collected for 93 caregivers receiving MCSP and 74 receiving UC. No statistically significant differences on the outcome measures were found overall. At a country level MC caregivers in Italy showed significant better general mental health (p = 0.04, d = 0.55) and less caregiver distress (p = 0.02, d = 0.62) at post-test than the UC group. Caregiver satisfaction was rated on a sample at 3 months (n = 81) and 6 months (n = 84). The majority of caregivers reported feeling less burdened and more supported by participating in MCSP.Conclusion: The moderate positive effect on sense of competence and the greater mental health benefit for lonely caregivers using the MCSP compared to UC as found in the original Dutch studies were not replicated. However, subject to study limitations, caregivers in Italy using MCSP benefitted more regarding their mental health and emotional distress than caregivers using UC. Further evaluation of the benefits of MCSP within these countries in larger study samples is recommended.
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Affiliation(s)
- Shirley Evans
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Simon Evans
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Dawn Brooker
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Cate Henderson
- London School of Economics, United Kingdom London School of Economics and Political Science, London, UK
| | - Dorota Szcześniak
- Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Teresa Atkinson
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Jennifer Bray
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Rehill Amritpal
- London School of Economics and Political Science, London, UK
| | | | | | | | - Rabih Chattat
- Department of Philosophy and Communication Studies, University of Bologna, Bologna, Italy
| | | | | | - Joanna Rymaszewska
- Department of Psychology, University of Bologna, Bologna, Italy.,Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Franka Meiland
- Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands
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18
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Alves GS, Casali ME, Veras AB, Carrilho CG, Bruno Costa E, Rodrigues VM, Dourado MCN. A Systematic Review of Home-Setting Psychoeducation Interventions for Behavioral Changes in Dementia: Some Lessons for the COVID-19 Pandemic and Post-Pandemic Assistance. Front Psychiatry 2020; 11:577871. [PMID: 33132937 PMCID: PMC7550734 DOI: 10.3389/fpsyt.2020.577871] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/07/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Impacts of social isolation measures imposed by COVID-19 Pandemic on mental health and quality of life of older adults living with dementia and their caregivers remain unexplored. Studies have shown that psychoeducational and psychosocial interventions can manage behavioral and psychological symptoms in dementia (BPSD) and reduce the emotional burden on family members when applied in home-setting scenarios. METHOD a comprehensive systematic review of useful interventions for easing the BPSD burden in patients with dementia (PwD) and their caregivers in the context of COVID-19 quarantine was performed from January 2010 to March 2020. RESULTS From a total of 187 articles retrieved from electronic databases (MEDLINE, LILACS, Cochrane and SCOPUS), 43 studies were eligible for this review. Most of the psychosocial and psychoeducational interventions described were person-centered strategies based on the cognitive-behavioral approach or informational tools to enhance care providers' knowledge of dementia. Most studies achieved successful results in handling BPSD and mood-anxiety symptoms of care providers, contributing to an overall improvement in dyad life quality. CONCLUSION Evidence from the last few years suggest that low-cost techniques, tailored to the dyad well-being, with increasing use of technology through friendly online platforms and application robots, can be an alternative to conventional assistance during COVID-19 Pandemic. Nevertheless, the world's current experience regarding the duration of the COVID-19 Pandemic and its effects on the cognition, behavior, and life quality of PwD will demand research on preventive and protective factors of dementia and the pursue of efficient interventions in different scenarios.
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Affiliation(s)
- Gilberto Sousa Alves
- Translational Psychiatry Research Group, Federal University of Maranhão, São Luís, Brazil.,Post Graduation in Psychiatry and Mental Health (PROPSAM), Institute of Psychiatry, UFRJ, Rio de Janeiro, Brazil
| | | | | | | | - Eriko Bruno Costa
- Translational Psychiatry Research Group, Federal University of Maranhão, São Luís, Brazil
| | - Valeska Marinho Rodrigues
- Post Graduation in Psychiatry and Mental Health (PROPSAM), Institute of Psychiatry, UFRJ, Rio de Janeiro, Brazil.,Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Marcia Cristina Nascimento Dourado
- Post Graduation in Psychiatry and Mental Health (PROPSAM), Institute of Psychiatry, UFRJ, Rio de Janeiro, Brazil.,Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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19
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Narasimha S, Wilson M, Dixon E, Davis N, Madathil KC. An Investigation of the Interaction Patterns of Peer Patrons on an Online Peer-Support Portal for Informal Caregivers of Alzheimer’s Patients. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2019. [DOI: 10.1080/15398285.2019.1682757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Mackenzie Wilson
- Department of Industrial Engineering, Clemson University, Clemson, SC, USA
| | - Emma Dixon
- College of Information Studies, University of Maryland, College Park, MD, USA
| | - Nicole Davis
- School of Health Research, Clemson University, Clemson, SC, USA
| | - Kapil Chalil Madathil
- Departments of Industrial and Civil Engineering, Clemson University, Clemson, SC, USA
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20
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Pinto-Bruno ÁC, Pot AM, Kleiboer A, Droes RM, van Straten A. An Online Minimally Guided Intervention to Support Family and Other Unpaid Carers of People With Dementia: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e14106. [PMID: 31603433 PMCID: PMC6819009 DOI: 10.2196/14106] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/26/2019] [Accepted: 07/28/2019] [Indexed: 01/29/2023] Open
Abstract
Background About three-quarters of people with dementia live in their own homes, with help from family members and/or other unpaid carers, such as friends or neighbors. Often, unpaid carers themselves experience negative consequences, such as stress, burden, and symptoms of depression or anxiety. Research has shown that these consequences can be alleviated by psychosocial and psychological interventions. Moreover, there are indications that those interventions can be effective when offered online. Objective This paper describes the protocol of a randomized controlled trial (RCT) that will take place in the Netherlands to evaluate the effectiveness of iSupport, a minimally guided, internet-based intervention to improve carers’ mental health and coping resources. Methods A superiority two-arm RCT comparing the effects of the online support program with a waiting list control condition will be carried out in the Netherlands. The iSupport intervention was developed by the World Health Organization and is based on cognitive behavioral therapy principles. It has five main themes divided into 23 lessons. Carers can pick and choose which lessons they want to complete. We aim to recruit 200 unpaid carers. The experimental group (n=100) will be provided with access to the intervention for 3 months following randomization; those in the waiting list control group (n=100) will be granted access to the intervention after 3 months. Assessments will be conducted at baseline (T0), 3 months after baseline (post intervention, T1), and 6 months after baseline (follow-up, T2). The primary outcome is perceived stress, measured by the Perceived Stress Scale. Secondary outcomes are symptoms of depression and anxiety, caregiver burden, sense of competence, self-efficacy, mastery, and carers’ attitudes toward dementia and their person-centered approach (ie, to what extent carers tailor the provided care to the interest, needs, and history of the person with dementia). Results Recruitment for the trial started in January 2019. As of July 2019, we have enrolled 120 participants.
Data collection is expected to be completed by March 2020. Once all the data have been collected, we will conduct the data analyses between April and May 2020. We aim to publish our results in a manuscript by June 2020. Conclusions Online interventions have shown promising results in improving the mental health of carers of people with dementia. Additionally, online interventions may overcome accessibility barriers. If successful, this intervention will have important potential for implementation as a public health intervention, since costs and support by trained staff are minimal. Trial Registration Netherlands Trial Register (NTL) NL6417; https://www.trialregister.nl/trial/6417 International Registered Report Identifier (IRRID) DERR1-10.2196/14106
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Affiliation(s)
- Ángel C Pinto-Bruno
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Anne Margriet Pot
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,School of Psychology, University of Queensland, Brisbane, Australia.,Optentia Research Focus Area, North-West University, Vanderbijlpark, Gauteng, South Africa
| | - Annet Kleiboer
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Rose-Marie Droes
- Department of Psychiatry, Amsterdam University Medical Centers (at VUmc), Amsterdam Public Health Institute, Amsterdam, Netherlands
| | - Annemieke van Straten
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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21
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Dam AE, Christie HL, Smeets CM, van Boxtel MP, Verhey FR, de Vugt ME. Process evaluation of a social support platform 'Inlife' for caregivers of people with dementia. Internet Interv 2018; 15:18-27. [PMID: 30510911 PMCID: PMC6257912 DOI: 10.1016/j.invent.2018.09.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/07/2018] [Accepted: 09/09/2018] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Informal caregivers of persons with dementia have an increased risk of facing social isolation. Online social media interventions might offer a new opportunity to increase access to social support. An online social support platform, 'Inlife', was developed and launched in the Netherlands to enhance social support, positive interactions and information sharing in informal support networks. OBJECTIVE A process evaluation was performed to evaluate the internal and external validity of the Inlife intervention. METHODS Implementation, sampling and intervention quality were evaluated by both qualitative and quantitative methods. Analyses were performed using descriptive statistics and inductive content analysis. Analyses were conducted following participants' completion of the intervention after 16 weeks. RESULTS The overall participation rate in the study was 27% (96/351). The Inlife intervention was generally well-received by the primary caregivers. Inlife facilitated empowerment, openness, involvement, and efficient care organization. Still, adherence was not optimal for all Inlife users. Determinants for Inlife use were identified on the level of the Inlife innovation, the users, and the socio-political context. CONCLUSIONS Inlife was evaluated as a useful instrument for efficient central care coordination and mutual involvement. This study emphasizes that the personal attitudes of the Inlife users to seek and provide support warrant attention, next to the characteristics of the actual Inlife innovation for optimal intervention uptake. Online and offline support might be integrated to raise awareness of caregiver social support needs and attitudes and provide insight into caregivers' available social capital. TRIAL REGISTRATION Dutch trial register NTR6131, Registered on 20 October 2016.
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Affiliation(s)
- Alieske E.H. Dam
- Corresponding author at: Department of Psychiatry and Neuropsychology/School for Mental Health and Neuroscience/Alzheimer Centre Limburg, Dr. Tanslaan 12 (level 3
- room 3G3.058), P.O. Box 616, 6200 MD Maastricht, the Netherlands.
| | - Hannah L. Christie
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Claudia M.J. Smeets
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Martin P.J. van Boxtel
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Frans R.J. Verhey
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Marjolein E. de Vugt
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
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22
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Rakhshan M, Ganjalivand S, Zarshenas L, Majdinasab N. The Effect of Collaborative Care Model-Based Intervention on Hope in Caregivers and Patients with Multiple Sclerosis: A Randomized Controlled Clinical Trial. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2018; 6:218-226. [PMID: 30035138 PMCID: PMC6048004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Multiple Sclerosis can affect the patients' and their families' life. In this regard, the collaborative care model could be useful. This study aimed to investigate the effect of the collaborative care model on hope in patients with Multiple Sclerosis (MS) and their family caregivers. METHODS This randomized controlled clinical trial was conducted in May to September 2015 on 60 patients with MS referring to the MS Society of Khuzestan province and 60 family caregivers. After block randomization, the intervention groups (patients and caregivers) received 8 intervention sessions based on collaborative care model over 12 weeks. The data were collected using Snyder's adult hope scale and a demographic questionnaire at baseline and 12 weeks after the beginning of the intervention. Data analysis was conducted through SPSS, version 19, using frequency, mean, Chi-square, independent, paired t-tests and Fisher's exact test (P˂0.05). RESULTS The results of independent t-test before the intervention showed no significant differences between the patients in the intervention (42.76±8.75) and control groups (43.13±7.20) (P=0.86) and caregivers in the intervention (50.26±5.79) and control groups (49.23±6.71) (P=0.52), regarding the score of hope. However, a significant difference was found in this regard 12 weeks after the beginning of the intervention, between the patients in the control (43.63±6.97) and intervention groups (47.96±8.72) (P=0.03), and caregivers in the control (50.66±5.79) and intervention groups (53.80±4.71) (P=0.02). CONCLUSION The collaborative care model promoted hope in patients with MS and their family caregivers. Hence, this model can be used by healthcare personnel for promoting hope among patients and caregivers. Trial Registration Number: IRCT2015051121474N2.
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Affiliation(s)
- Mahnaz Rakhshan
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Somayeh Ganjalivand
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ladan Zarshenas
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nastran Majdinasab
- Department of Neurology, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran
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