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Xiao L, Ullah S, Hu R, Wang J, Wang H, Chang CC, Kwok T, Zhu M, Ratcliffe J, Brodaty H, Brijnath B, Chang HCR, Wong B, Zhou Y, He J, Xia M, Hong JY, Che S, Milte R. The effects of a facilitator-enabled online multicomponent iSupport for dementia programme: A multicentre randomised controlled trial. Int J Nurs Stud 2024; 159:104868. [PMID: 39163682 DOI: 10.1016/j.ijnurstu.2024.104868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/30/2024] [Accepted: 07/30/2024] [Indexed: 08/22/2024]
Abstract
BACKGROUND Multicomponent interventions with carers of people with dementia demonstrate positive effects on the health and quality of life for carers and care recipients. The World Health Organization's iSupport for Dementia is an evidence-based online psychoeducation programme for carers. However, the programme was mainly implemented as a self-learning tool which might have limited its positive effects on carers and care recipients. Evidence for online multicomponent interventions with carers that incorporates the iSupport programme remains unknown. OBJECTIVES This study aimed to partner with health and social care organisations to evaluate the effects of a facilitator-enabled online multicomponent Chinese iSupport programme, which included psychoeducation using the iSupport programme, facilitator-enabled carer support groups and access to care services. DESIGN A multicentre randomised controlled trial. SETTINGS AND PARTICIPANTS Participants were family carers in Australia and greater China. We recruited participants to the study from 1st November 2021 to 30th June 2022. METHODS The intervention group received the Chinese iSupport programme delivered online. The intervention lasted for 6 months. Our primary outcome was carers' quality of life. Our secondary outcomes were carers' self-efficacy, social support, distress reactions to changed behaviours, care recipients' frequency of changed behaviours, quality of life, unplanned hospital admissions, emergency department presentations and permanent admissions to nursing homes. The outcomes were measured at baseline (T0), 6 months (T1) and 9 months (T2). We applied a multivariate mixed effect linear regression model to capture the group effect, time effect and their interaction. RESULTS In total, 266 eligible family carers agreed to participate and were randomly assigned to an intervention group (n = 131) or a usual care group (n = 135). Most carers were women with a mean age of 53 years. The intervention group showed a statistically significant higher score of mental-health-related quality of life (mean difference = 4.1, 95 % CI: 1.5, 6.8, p = 0.002), self-efficacy in controlling upsetting thoughts (mean difference = 7.1, 95 % CI: 2.2, 12.0, p = 0.005) and lower score of distress reactions to changed behaviours (mean difference = -0.1, 95 % CI: -0.3, -0.03, p = 0.012) than the usual care group at T1. CONCLUSION The facilitator-enabled online multicomponent Chinese iSupport programme demonstrated positive effects for carers on mental health-related quality of life, controlling upsetting thoughts and distress reactions to changed behaviours of people with dementia. TRIAL REGISTRATION This study is registered in the Australia New Zealand Clinical Trials Registry on 12th March 2021 (ACTRN12621000276853). TWEETABLE ABSTRACT The facilitator-enabled online multicomponent Chinese iSupport programme improved family carers' mental health-related quality of life, control of upsetting thoughts and distress reactions to changed behaviours of people with dementia.
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Affiliation(s)
- Lily Xiao
- College of Nursing and Health Sciences, Flinders University, Australia.
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Australia
| | - Rujun Hu
- Department of Nursing, Affiliated Hospital of Zunyi and School of Nursing, Zunyi Medical University, China
| | - Jing Wang
- College of Nursing and Health Sciences, Flinders University, Australia; Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, China
| | - Huali Wang
- Dementia Care and Research Center, Institute of Mental Health, Peking University, Sixth Hospital (Institute of Mental Health), Beijing Key Lab for Translational Research for Dementia Diagnosis and Treatment, Beijing, China
| | - Chia-Chi Chang
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taiwan, China; College of Interdisciplinary Studies, Taipei Medical University, Taiwan, China
| | - Timothy Kwok
- Jockey Club Centre for Positive Ageing, Hong Kong, China; Department of Medicine & Therapeutics and School of Public Health, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Mingxia Zhu
- Kiang Wu Nursing College of Macau, Macau, China
| | - Julie Ratcliffe
- College of Nursing and Health Sciences, Flinders University, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Bianca Brijnath
- National Ageing Research Institute (NARI), Australia; Melbourne School of Population and Global Health, University of Melbourne, Australia; School of Social Sciences, University of Western Australia, Australia
| | | | - Bel Wong
- Jockey Club Centre for Positive Ageing, Hong Kong, China
| | - Yunrui Zhou
- College of Nursing and Health Sciences, Flinders University, Australia
| | - Jinjie He
- School of Economics and Management, Xi'an University, China
| | - Mengmeng Xia
- Dementia Care and Research Center, Peking University, Institute of Mental Health, Beijing, China
| | - Jhih-Yang Hong
- School of Gerontology and Long-Term Care, Taipei Medical University, Taiwan, China
| | - Shirley Che
- Nursing and Health Education Research Centre, Kiang Wu Nursing College of Macau, Macau, China
| | - Rachel Milte
- College of Nursing and Health Sciences, Flinders University, Australia
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Rodero E, Mas L, Larrea O, Rodríguez-de-Dios I, de-la-Mota C. The Relevance of Communication Between Alzheimer's Patients and Their Caregivers. Effective Prosody Strategies to Improve Communication. HEALTH COMMUNICATION 2023:1-14. [PMID: 38124466 DOI: 10.1080/10410236.2023.2292830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
One of the most critical factors in Alzheimer's disease (AD) is communication between patients and caregivers. A relevant part of the way of speaking is what is known as prosody, or the variations a speaker makes when talking. To our knowledge, no research has analyzed the relevance of communication for caregivers when speaking with AD patients or what they consider the most effective strategies to communicate with them. Therefore, this pilot study aims are twofold: to know the relevance caregivers (professionals and family) give to communication with AD patients; and to determine what prosody strategies they consider most effective. Two hundred fifty-two caregivers of AD patients (professional and family) participated in two online surveys, answering different questions about the relevance of communication and the best prosody strategies. They also performed an auditory perceptual assessment. The results showed that caregivers give communication a significant role in the patient's treatment behavior. They consider Alzheimer's (AD) patients should be spoken to with authority but with affection and positiveness. The most valued prosodic strategies were marked intonation, speaking affectionately, emphasizing essential words, a medium/low pitch, and a slow speed. This study highlights the value of communication in interacting with AD patients to improve their cognitive and emotional responses.
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Affiliation(s)
- Emma Rodero
- Media Psychology Lab, Department of Communication, Pompeu Fabra University, UPF-Barcelona School of Management, Barcelona, Spain
| | - Lluís Mas
- Department of Communication, Pompeu Fabra University, UPF-Barcelona School of Management, Barcelona, Spain
| | - Olatz Larrea
- Department of Philology and Communication, University of Barcelona, Barcelona, Spain
| | | | - Carme de-la-Mota
- Department of Spanish Philology, Autonomous University of Barcelona, Barcelona, Spain
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