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Yang L, Ye J, Zhu H, Tang Y, Li X. Development and evaluation of a family-child reading picture book on reducing autism spectrum disorder caregivers' psychological stress: a mixed method study. Front Psychiatry 2024; 15:1390430. [PMID: 38863613 PMCID: PMC11165404 DOI: 10.3389/fpsyt.2024.1390430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/22/2024] [Indexed: 06/13/2024] Open
Abstract
Introduction The rapid increasing prevalence of ASD has become a significant global health issue. Caregivers of children with ASD are experiencing higher level of psychological stress and mental disorders. However, interventions to improve the psychological health of caregivers of children with ASD have largely been neglected. Methods Based on the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model, we initially did in-depth interviews with 8 caregivers, and conducted field observation in two rehabilitation centers to analyze the daily lives, the empowered components, the emotional moments of the children with autism and their caregivers. Then we designed the outline of the picture book, and developed it by a multi-disciplinary team by 4 rounds. After that, this picture book was sent out to 54 caregivers of children with ASD for family-child reading in one month. A quantitative questionnaire was administered before and after their reading to evaluate the efficacy of reducing their stress and affiliate stigma, and improving self-efficacy, resilience, empowerment capacity; and exit interviews were conducted after their initial reading to assess the acceptability, content appropriateness, perceived benefits and generalizability of this picture book. Quantitative data were analyzed by descriptive analysis and paired t-tests using IBM SPSS 26.0. Qualitative data were analyzed using template analysis. Results In total, 54 caregivers read the picture book with their child, with the total of 149 (an average of 2.76 per family) times reading in one month. Among them, 39 caregivers returned the following-up questionnaires. Although most of the outcome measures did not showed significant changes except the stress level decreased statistically significant (13.38 ± 3.864 to 11.79 ± 3.238, P=0.001), caregivers reported that the picture book echoed their daily lives and gave them a sense of warmth, inspiration, and hope, as well as some insight on family relationships and attitudes towards the disorder. They also expressed a willingness to disseminate the book to other families with children suffering ASD and the public. Conclusion This specially designed picture book has been proven to be an acceptable, content-appropriate, and effective family-centered psychological intervention, which could be easily scaled up.
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Affiliation(s)
- Lei Yang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jinlin Ye
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Hongrui Zhu
- School of International Nursing, Hainan Medical University, Haikou, Hainan, China
| | - Yao Tang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Xianhong Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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Wang S, Qin J, Cheung DSK, Tyrovolas S, Leung SHI, Leung AYM, Davidson PM. E-bibliotherapy for improving the psychological well-being of informal caregivers of people with dementia: a randomized controlled trial protocol. BMC Nurs 2024; 23:84. [PMID: 38303009 PMCID: PMC10832133 DOI: 10.1186/s12912-024-01706-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/03/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Providing informal care for individuals with dementia is frequently a challenging and demanding experience that can have detrimental effects on the psychological well-being of caregivers. Regrettably, community-based caregiver services often prove inadequate, highlighting the necessity for innovative approaches to support caregivers. AIM To test the efficacy of e-bibliotherapy in improving the psychological well-being of informal caregivers of people with dementia. METHOD The study is divided into two phases. In phase 1, the research team will co-design the e-bibliotherapy app with caregivers. In phase 2, a randomized controlled trial will be conducted among 192 informal caregivers of people with dementia in Hong Kong. Caregivers will be randomly assigned to either the e-bibliotherapy group or the control group using simple randomization. Outcome measures will encompass caregivers' psychological well-being, caregiving appraisal, mental health, saliva cortisol levels as an indicator of stress, and health-related quality of life for caregivers. Data will be collected at baseline, immediately post intervention, and 3 months and 6 months post intervention. General linear mixed model will be employed to analyze intervention effects. Qualitative interviews will be undertaken to explore caregiver experiences within this study and evaluate intervention acceptability using conventional content analysis methods. DISCUSSION This study represents a pioneering effort in utilizing e-bibliotherapy to enhance the psychological well-being of informal caregivers of individuals with dementia, addressing the existing gap in caregiver services and facilitating knowledge dissemination within the community. TRIAL REGISTRATION The trial has been registered on ClinicalTrial.gov (Ref: NCT05927805).
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Affiliation(s)
- Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Jing Qin
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | - Stefanos Tyrovolas
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, USA
| | - Sze Him Isaac Leung
- Department of Statistics, The Chinese University of Hong Kong, Hong Kong SAR, China
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Yin Y, Tam HL, Quint J, Chen M, Ding R, Zhang X. Epidemiology of Dementia in China in 2010-2020: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2024; 12:334. [PMID: 38338219 PMCID: PMC10855047 DOI: 10.3390/healthcare12030334] [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: 12/12/2023] [Revised: 01/19/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Dementia has become one of the leading causes of death across the world. AIMS The aim of this study was to investigate the incidence, prevalence, and mortality of dementia in China between 2010 and 2020, and to investigate any geographical, age, and sex differences in the prevalence and incidence of dementia. METHODS Five databases were searched. The Joanna Briggs Institute (JBI) critical appraisal tool was used to assess the quality of the included studies. A random-effects meta-analysis was performed to estimate the pooled prevalence of dementia. Subgroup analysis was based on the type of dementia. The incidence and mortality of dementia were synthesized qualitatively. RESULTS A total of 19 studies were included. The meta-analysis showed that the prevalence of dementia was 6% (95%CI 5%, 8%), the prevalence of Alzheimer's disease (AD) was 5% (95%CI 4%, 6%), and the prevalence of vascular dementia (VaD) was 1% (95%CI 0%, 2%). The subgroup analysis showed that the prevalence rates of dementia in rural (6%, 95%CI 4%, 8%) and urban areas were similar (6%, 95%CI 4%, 8%). Deaths due to dementia increased over time. CONCLUSION The prevalence, incidence, and mortality of dementia increased with age and over time. Applying consistent criteria to the diagnosis of cognitive impairment and dementia is necessary to help with disease monitoring. Promoting dementia knowledge and awareness at the community level is necessary.
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Affiliation(s)
- Yueheng Yin
- School of Nursing, Nanjing Medical University, Nanjing 210029, China;
| | - Hon Lon Tam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China;
| | - Jennifer Quint
- School of Public Health, National Heart and Lung Institute, Imperial College London, London W12 7RQ, UK; (J.Q.); (R.D.)
| | - Mengyun Chen
- School of Nursing, Lanzhou University, Lanzhou 730000, China;
| | - Rong Ding
- School of Public Health, National Heart and Lung Institute, Imperial College London, London W12 7RQ, UK; (J.Q.); (R.D.)
| | - Xiubin Zhang
- School of Public Health, National Heart and Lung Institute, Imperial College London, London W12 7RQ, UK; (J.Q.); (R.D.)
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Smrokowska-Reichmann A, Janus E, Tamplin J, Odell-Miller H, Stensæth K, Wenborn J, Viken RM, Wosch T, Bukowska AA, Sousa TV, Baker FA. The HOMESIDE Study-A Research Project to Support People Living With Dementia and Their Family Caregivers: Preliminary Report on Reading Intervention. Gerontol Geriatr Med 2024; 10:23337214241239174. [PMID: 38510059 PMCID: PMC10953035 DOI: 10.1177/23337214241239174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/21/2024] [Accepted: 02/27/2024] [Indexed: 03/22/2024] Open
Abstract
The behavioral and psychological symptoms of dementia (BPSD) can be challenging for family caregivers to cope with, leading to distress and fatigue. It is therefore important to offer effective strategies to reduce the impact of BPSD. The HOMESIDE randomized controlled trial (RCT) was testing purposefully developed interventions to improve the quality of life and wellbeing of dyads of people with dementia and family caregivers as a result of reduction of BPSD. HOMESIDE RCT was conducted in Australia, Germany, Norway, Poland and the United Kingdom between 2019 and 2022. The study design was a three-arm parallel-group single-blinded, pragmatic RCT with a sample size of 432 dyads. Dyads were randomly allocated to one of three treatment conditions: Music Intervention plus Standard Care; or Reading Intervention plus Standard Care; or Standard Care only. The Reading Intervention (RI) within the HOMESIDE RCT aimed to evoke shared discussion, reminiscence, meaningful shared experiences and consequently enrich everyday life, interaction and the emotional connection between the caregiver (CG) and carereceiver (CR); as well as to enhance activities of daily living and to promote relaxation or stimulation as appropriate. This paper describes the underlying conceptual framework, the content, and delivery of the Reading Intervention within the HOMESIDE RCT.
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Affiliation(s)
| | - Edyta Janus
- University of Physical Education in Kraków, Poland
| | | | | | | | | | | | - Thomas Wosch
- Hochschule für angewandte Wissenschaften Würzburg-Schweinfurt, Germany
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Wang J, Chen H, Yang L, Yu X, Zhang D, Zhao Q, Xiao M. Effectiveness of the Stress Process Model-Based Program in Dementia Caregiving (DeCare-SPM) for Family Caregivers: A Study Protocol for a Randomized Controlled Trial. J Multidiscip Healthc 2023; 16:3507-3519. [PMID: 38024118 PMCID: PMC10658953 DOI: 10.2147/jmdh.s438342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
This paper aims to describe a randomized controlled trial protocol evaluating the effectiveness, cost, and process of a stress process model-based program in dementia caregiving (DeCare-SPM) for family caregivers. Family caregivers of individuals with dementia will be recruited from memory clinics and community settings and randomly assigned to either DeCare-SPM or usual care. DeCare-SPM comprises three face-to-face sessions (ie, problem-based coping, emotion-based coping, meaning-based coping), and a fourth session (ie, social support) including weekly telephone-based consultation for four weeks and then monthly face-to-face boosters. Outcomes will be measured at baseline (T0), and at one (T1), three (T2), and six months (T3). The primary outcome is positive aspects of caregiving and secondary outcomes are caregiving (ie, sense of competence, caregiver burden, social support, anxiety, depression, and quality of life), dementia-related (ie, care dependency, neuropsychiatric symptoms, and quality of life), and stress-related biomarkers of blood and saliva. In addition, process and economic evaluations will be performed. Mixed-effects models will be used to assess intervention effects. Content analysis will be performed on the qualitative data. This paper described the protocol for comprehensive evaluation of the effectiveness, cost, and process of the theory-driven DeCare-SPM to inform how and why interventions work. It highlights the need to reduce challenges and enhance the positive aspects of dementia care. The DeCare-SPM will provide evidence-based insights into how to support and empower family caregivers in their important roles, thereby, leading to improved dementia care.
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Affiliation(s)
- Jun Wang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Hongmei Chen
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Lin Yang
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xiuli Yu
- Qinggang Senior Care Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Dandan Zhang
- Qinggang Senior Care Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
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Wang S, Cheung DSK, Bressington D, Li Y, Leung AYM. The Development of an Evidence-Based Telephone-Coached Bibliotherapy Protocol for Improving Dementia Caregiving Appraisal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148731. [PMID: 35886582 PMCID: PMC9317862 DOI: 10.3390/ijerph19148731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 02/06/2023]
Abstract
Caregiving appraisal is the caregivers’ cognitive evaluation of caregiving stressors. It determines the caregiving outcomes and caregiver health. Dementia caregivers have shown relatively negative caregiving appraisals. However, there is a lack of interventions to improve caregiving appraisal. This study describes the multi-phase process of developing and validating an evidence-based bibliotherapy protocol for improving the caregiving appraisal of informal caregivers of people with dementia. Two phases were included in the development: In Phase 1, a series of reviews of theory and evidence were conducted to identify the theoretical underpinnings, the core components, the dosage, and the mode of delivery of evidence-based bibliotherapy. In Phase 2, focus groups consisting of an expert panel of 16 clinicians and academics were used to validate the intervention protocol. Evidence synthesis was used in Phase 1 to formulate a draft intervention protocol. Content analysis was used in Phase 2 to work out the principles to revise the intervention protocol. The validated evidence-based bibliotherapy protocol included eight weekly sessions, and each session targeted improving one aspect of the essential factors that influence caregiving appraisal. This study provided a culturally sensitive and contextually appropriate evidence-based bibliotherapy protocol ready to be tested in a clinical trial.
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Affiliation(s)
- Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China; (S.W.); (Y.L.)
- WHO Collaborating Center for Community Health Services, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
- School of Nursing and Health, Zhengzhou University, #101 Science Avenue, Zhengzhou 450001, China
| | - Daphne Sze Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China; (S.W.); (Y.L.)
- Correspondence: (D.S.K.C.); (A.Y.M.L.); Tel.: +852-2766-4534 (D.S.K.C.); +852-2766-5587 (A.Y.M.L.)
| | - Daniel Bressington
- College of Nursing and Midwifery, Charles Darwin University, Casuarina 0815, Australia;
| | - Yan Li
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China; (S.W.); (Y.L.)
| | - Angela Yee Man Leung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China; (S.W.); (Y.L.)
- WHO Collaborating Center for Community Health Services, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
- Correspondence: (D.S.K.C.); (A.Y.M.L.); Tel.: +852-2766-4534 (D.S.K.C.); +852-2766-5587 (A.Y.M.L.)
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