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Sander AM, Pappadis MR, Bushnik T, Chiaravalloti ND, Driver S, Hanks R, Lercher K, Neumann D, Rabinowitz A, Seel RT, Weber E, Ralston RK, Corrigan J, Kroenke K, Hammond FM. An Umbrella Review of Self-Management Interventions for Health Conditions With Symptom Overlap With Traumatic Brain Injury. J Head Trauma Rehabil 2024; 39:140-151. [PMID: 37294622 DOI: 10.1097/htr.0000000000000863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To synthesize evidence for the effectiveness of self-management interventions for chronic health conditions that have symptom overlap with traumatic brain injury (TBI) in order to extract recommendations for self-management intervention in persons with TBI. DESIGN An umbrella review of existing systematic reviews and/or meta-analyses of randomized controlled trials or nonrandomized studies targeting self-management of chronic conditions and specific outcomes relevant to persons with TBI. METHOD A comprehensive literature search of 5 databases was conducted using PRISMA guidelines. Two independent reviewers conducted screening and data extraction using the Covidence web-based review platform. Quality assessment was conducted using criteria adapted from the Assessing the Methodological Quality of Systematic Reviews-2 (AMSTAR-2). RESULTS A total of 26 reviews met the inclusion criteria, covering a range of chronic conditions and a range of outcomes. Seven reviews were of moderate or high quality and focused on self-management in persons with stroke, chronic pain, and psychiatric disorders with psychotic features. Self-management interventions were found to have positive effects on quality of life, self-efficacy, hope, reduction of disability, pain, relapse and rehospitalization rates, psychiatric symptoms, and occupational and social functioning. CONCLUSIONS Findings are encouraging with regard to the effectiveness of self-management interventions in patients with symptoms similar to those of TBI. However, reviews did not address adaptation of self-management interventions for those with cognitive deficits or for populations with greater vulnerabilities, such as low education and older adults. Adaptations for TBI and its intersection with these special groups may be needed.
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Affiliation(s)
- Angelle M Sander
- Author Affiliations: H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine and Harris Health System, Houston, Texas (Dr Sander); Brain Injury Research Center, TIRR Memorial Herman, Houston, Texas (Drs Sander and Pappadis); Department of Population Health and Health Disparities, School of Public and Population Health, and Sealy Center on Aging, The University of Texas Medical Branch (UTMB) (Dr Pappadis); Rusk Rehabilitation and NYU Langone Health, New York City, New York (Dr Bushnik); Kessler Foundation, East Hanover, New Jersey (Drs Chiaravalloti, Weber, and Lercher); Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark (Drs Chiaravalloti, Weber, and Lercher); Department of Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas (Dr Driver); Baylor Scott and White Research Institute, Dallas, Texas (Dr Driver); Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, Michigan (Dr Hanks); Department of Physical Medicine and Rehabilitation (Drs Neumann and Hammond), Ruth Lilly Medical Library (Mr Ralston), and Department of Medicine (Dr Kroenke), Indiana University School of Medicine, Indianapolis; Rehabilitation Hospital of Indiana, Indianapolis (Drs Neumann and Hammond); Moss Rehabilitation Research Institute, Elkins, Pennsylvania (Dr Rabinowitz); Department of Physical Medicine and Rehabilitation, Thomas Jefferson University Philadelphia, Pennsylvania (Dr Rabinowitz); Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond (Dr Seel); Department of Physical Medicine & Rehabilitation, The Ohio State University, Columbus (Dr Corrigan); and Regenstrief Institute, Indianapolis, Indiana (Dr Kroenke)
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Watson J, Wilcockson J, Houston A, van Wyk A, Keyes S, Murphy D, Hare P, Wiersma E, Clarke C. 'I feel more part of the world': Participatory action research to develop post-diagnostic dementia support. DEMENTIA 2023; 22:1420-1439. [PMID: 37501339 PMCID: PMC10521152 DOI: 10.1177/14713012231190775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Many people living with dementia are 'on the margins', not accessing services and support, despite policy and care advancements. The COVID-19 pandemic exacerbated this, with the closure of face-to-face support during lockdowns in the UK and globally. The aim of the 'Beyond the Margins' project was to develop, implement, and evaluate a face-face programme of support with, by and for people with direct experience of dementia who are on the margins of existing services and support. In March 2020 the project was interrupted by the outbreak of the COVID-19 pandemic and it changed to an online format. The three-phase participatory action research project included 40 people living with dementia, 26 care partners and 31 health and social care practitioners. A seven-week online personal development programme called Getting On with Life (GO) was developed, delivered, and evaluated. This paper focuses on the participatory approaches used to develop and implement the GO programme, and the resulting aspects of its approach to facilitation and content. Key features include the GO Programme's principles of providing a safe and a respectful space, and the programme's values of: Everyone who comes already knows things, can learn things and can teach things; Doing things 'with' each other, rather than 'for' or 'to' each other; Personalised goals-led by the needs of participants rather than an imposed agenda. A key finding was the importance of developing post-diagnostic programmes as a 'sandwich', providing a safe space for learning that is preceded by understanding pathways to access the programme and followed by explicit consideration of the next steps in increasing social engagement.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Charlotte Clarke
- University of Edinburgh, Edinburgh, UK; Durham University, Durham, UK
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Collins K, Hanna M, Makarski J, Kastner M. Occupational Therapist Led Cognitive Stimulation Therapy: Feasibility of Implementation. Can J Occup Ther 2023; 90:68-78. [PMID: 35903935 DOI: 10.1177/00084174221115284] [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] [Indexed: 11/16/2022]
Abstract
Background. Despite local training opportunities for Cognitive Stimulation Therapy (CST) for occupational therapists, there has been limited evaluation of the feasibility of implementation in Canada. Purpose. This study explored the feasibility of CST delivery by an occupational therapist in an Ontario health care setting and the impact it may have on self-efficacy and hope measures of individuals with dementia. Methods. A mixed-methods experimental pre/post design was used. Survey measures included hope, self-efficacy, feasibility, satisfaction, and individual session evaluation. Semistructured focus groups were held for participants and facilitators. Findings. Quantitative findings are summarized descriptively for the 10 participants. Qualitative findings were grouped into themes: social connectedness, knowledge gained and shared, tailored implementation adjustments, and need for long-term programing. Implications. Occupational therapists are well-positioned to implement CST and should be a part of further research to test the intervention rigorously for applicability within a range of Canadian health care settings.
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Abstract
In health care, well-being is considered to be composed of multiple interacting dimensions and to regard the subjective (affective and cognitive) evaluation of these dimensions. These dimensions are often referred to as physical, psychological, and social domains of life. Although there are various disease-specific and group-specific conceptual approaches, starting from a universal perspective provides a more inclusive approach to well-being. Indeed, universal approaches to well-being have striking overlaps with dementia-specific approaches. Although many initiatives have been launched to promote person-centered care and attention for well-being in recent decades, the current COVID pandemic showed that the primary focus in (Dutch) long-term care was still on physical health. However, a well-being perspective can be a central base of care: it is a means to include positive aspects, and it can be applied when addressing problems such as challenging behavior in the sense that both are about needs. Furthermore, providing care from this perspective is not only about the well-being of frail people and their loved ones but also about the well-being and needs of the involved professionals. Increasingly, research shows the importance of the quality of the resident-carer relationship, the carer's behavior, and their well-being for improving the well-being of residents. Applying the care approaches 'attentiveness in care' and relationship-centered care can contribute to the well-being of all involved stakeholders as these uphold the reciprocity of care relationships and take the values and attitudes, but also the vulnerability of those involved, into account.
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Affiliation(s)
- Debby L Gerritsen
- Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Department of Primary and Community care, Radboud University Medical Center, Nijmegen, The Netherlands
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Ward R, Rummery K, Odzakovic E, Manji K, Kullberg A, Keady J, Clark A, Campbell S. Taking time: The temporal politics of dementia, care and support in the neighbourhood. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44:1427-1444. [PMID: 36062552 PMCID: PMC9825962 DOI: 10.1111/1467-9566.13524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
Dementia is a global health challenge and currently the focus of a coordinated international response articulated through the notion of 'dementia-friendly communities and initiatives' (DFCIs). Yet, while increasing research attention has been paid to the social and spatial dimensions to life with dementia in a neighbourhood setting, the temporalities of dementia have been largely overlooked. This article sets out different aspects of the lived experience of time for people with dementia and unpaid carers, before exploring the temporal politics of formal dementia care and support. The authors show that time is a site for material struggle and a marker of unequal relations of power. People with dementia and unpaid carers are disempowered through access to formal care, and this is illustrated in their loss of (temporal) autonomy and limited options for changing the conditions of the care received. The authors advocate for a time-space configured understanding of the relationship with neighbourhood and foreground a tempo-material understanding of dementia. Set against the backdrop of austerity policy in the UK, the findings reveal that ongoing budgetary restrictions have diminished the capacity for social care to mediate in questions of social justice and inequality, at times even compounding inequity.
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Affiliation(s)
- Richard Ward
- Faculty of Social SciencesUniversity of StirlingStirlingScotland
| | - Kirstein Rummery
- Faculty of Social SciencesUniversity of StirlingStirlingScotland
| | | | - Kainde Manji
- Independent Researcher (previously Faculty of Social Sciences University of Stirling)StirlingScotland
| | - Agneta Kullberg
- Faculty of Medicine and Health SciencesLinköping UniversityLinkopingSweden
| | - John Keady
- Division of NursingMidwifery and Social WorkUniversity of ManchesterManchesterUK
| | - Andrew Clark
- School of Health and SocietyUniversity of SalfordSalfordUK
| | - Sarah Campbell
- Department of Social Care and Social WorkManchester Metropolitan UniversityManchesterUK
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Jiao Y, Liu C, Chang J, Zhou S, Ji Y. Self-management preferences in patients with mild cognitive impairment: A qualitative study. Front Psychol 2022; 13:955960. [DOI: 10.3389/fpsyg.2022.955960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
PurposePatients with mild cognitive impairment (MCI) require self-management, yet current self-management compliance is low. Taking patients’ preferences into account can improve the self-management situation. The purpose of this study is to look into MCI patients’ preferences for self-management in China.MethodsA qualitative research was conducted using semi-structured in-depth interviews with 21 patients recently diagnosed with MCI who were chosen by purposive sampling. These interviews were analyzed through thematic analysis and identified emerging themes.ResultsFive themes of self-management preference were identified: (1) Preference for acquiring disease knowledge; (2) Preference for participating in drug therapy; (3) Preference for participating in exercise; (4) Preference for applying memory compensation strategy; (5) Preferences for emotional expression and response.ConclusionOur study identified the specific preferences of MCI patients in China for the main self-management items. The findings are valuable insights for knowing MCI patients’ self-management content and preferences and provide better guidance for health practitioners to improve self-management compliance.
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Mountain G, Wright J, Cooper CL, Lee E, Sprange K, Beresford-Dent J, Young T, Walters S, Berry K, Dening T, Loban A, Turton E, Thomas BD, Young EL, Thompson BJ, Crawford B, Craig C, Bowie P, Moniz-Cook E, Foster A. An intervention to promote self-management, independence and self-efficacy in people with early-stage dementia: the Journeying through Dementia RCT. Health Technol Assess 2022; 26:1-152. [PMID: 35536231 DOI: 10.3310/khha0861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND There are few effective interventions for dementia. AIM To determine the clinical effectiveness and cost-effectiveness of an intervention to promote self-management, independence and self-efficacy in people with early-stage dementia. OBJECTIVES To undertake a randomised controlled trial of the Journeying through Dementia intervention compared with usual care, conduct an internal pilot testing feasibility, assess intervention delivery fidelity and undertake a qualitative exploration of participants' experiences. DESIGN A pragmatic two-arm individually randomised trial analysed by intention to treat. PARTICIPANTS A total of 480 people diagnosed with mild dementia, with capacity to make informed decisions, living in the community and not participating in other studies, and 350 supporters whom they identified, from 13 locations in England, took part. INTERVENTION Those randomised to the Journeying through Dementia intervention (n = 241) were invited to take part in 12 weekly facilitated groups and four one-to-one sessions delivered in the community by secondary care staff, in addition to their usual care. The control group (n = 239) received usual care. Usual care included drug treatment, needs assessment and referral to appropriate services. Usual care at each site was recorded. MAIN OUTCOME MEASURES The primary outcome was Dementia-Related Quality of Life score at 8 months post randomisation, with higher scores representing higher quality of life. Secondary outcomes included resource use, psychological well-being, self-management, instrumental activities of daily living and health-related quality of life. RANDOMISATION AND BLINDING Participants were randomised in a 1 : 1 ratio. Staff conducting outcome assessments were blinded. DATA SOURCES Outcome measures were administered in participants' homes at baseline and at 8 and 12 months post randomisation. Interviews were conducted with participants, participating carers and interventionalists. RESULTS The mean Dementia-Related Quality of Life score at 8 months was 93.3 (standard deviation 13.0) in the intervention arm (n = 191) and 91.9 (standard deviation 14.6) in the control arm (n = 197), with a difference in means of 0.9 (95% confidence interval -1.2 to 3.0; p = 0.380) after adjustment for covariates. This effect size (0.9) was less than the 4 points defined as clinically meaningful. For other outcomes, a difference was found only for Diener's Flourishing Scale (adjusted mean difference 1.2, 95% confidence interval 0.1 to 2.3), in favour of the intervention (i.e. in a positive direction). The Journeying through Dementia intervention cost £608 more than usual care (95% confidence interval £105 to £1179) and had negligible difference in quality-adjusted life-years (-0.003, 95% confidence interval -0.044 to 0.038). Therefore, the Journeying through Dementia intervention had a mean incremental cost per quality-adjusted life-year of -£202,857 (95% confidence interval -£534,733 to £483,739); however, there is considerable uncertainty around this. Assessed fidelity was good. Interviewed participants described receiving some benefit and a minority benefited greatly. However, negative aspects were also raised by a minority. Seventeen per cent of participants in the intervention arm and 15% of participants in the control arm experienced at least one serious adverse event. None of the serious adverse events were classified as related to the intervention. LIMITATIONS Study limitations include recruitment of an active population, delivery challenges and limitations of existing outcome measures. CONCLUSIONS The Journeying through Dementia programme is not clinically effective, is unlikely to be cost-effective and cannot be recommended in its existing format. FUTURE WORK Research should focus on the creation of new outcome measures to assess well-being in dementia and on using elements of the intervention, such as enabling enactment in the community. TRIAL REGISTRATION This trial is registered as ISRCTN17993825. FUNDING This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 24. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Gail Mountain
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Jessica Wright
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Cindy L Cooper
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Ellen Lee
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Kirsty Sprange
- Nottingham Clinical Trials Research Unit, University of Nottingham, Nottingham, UK
| | | | - Tracey Young
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Stephen Walters
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Katherine Berry
- Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Tom Dening
- Division of Psychiatry & Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Amanda Loban
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Emily Turton
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Benjamin D Thomas
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Emma L Young
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Benjamin J Thompson
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Bethany Crawford
- Division of Psychiatry & Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Claire Craig
- Art and Design Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Peter Bowie
- Sheffield Health and Social Care NHS Foundation Trust, Sheffield, UK
| | | | - Alexis Foster
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Powell C, Tomlinson J, Quinn C, Fylan B. Interventions for self-management of medicines for community-dwelling people with dementia and mild cognitive impairment and their family carers: a systematic review. Age Ageing 2022; 51:6593707. [PMID: 35639800 PMCID: PMC9154223 DOI: 10.1093/ageing/afac089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Indexed: 11/21/2022] Open
Abstract
Background people with dementia or mild cognitive impairment (MCI) and their family carers face challenges in managing medicines. How medicine self-management could be supported for this population is unclear. This review identifies interventions to improve medicine self-management for people with dementia and MCI and their family carers, and the core components of medicine self-management that they address. Methods a database search was conducted for studies with all research designs and ongoing citation search from inception to December 2021. The selection criteria included community-dwelling people with dementia and MCI and their family carers, and interventions with a minimum of one medicine self-management component. The exclusion criteria were wrong population, not focusing on medicine management, incorrect medicine self-management components, not in English and wrong study design. The results are presented and analysed through narrative synthesis. The review is registered [PROSPERO (CRD42020213302)]. Quality assessment was carried out independently applying the QATSDD quality assessment tool. Results 13 interventions were identified. Interventions primarily addressed adherence. A limited number focused on a wider range of medicine self-management components. Complex psychosocial interventions with frequent visits considered the person’s knowledge and understanding, supply management, monitoring effects and side effects and communicating with healthcare professionals, and addressed more resilience capabilities. However, these interventions were delivered to family carers alone. None of the interventions described patient and public involvement. Conclusion interventions, and measures to assess self-management, need to be developed which can address all components of medicine self-management to better meet the needs of people with dementia and MCI and their family carers.
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Affiliation(s)
- Catherine Powell
- School of Pharmacy and Medical Sciences , University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research , Bradford, UK
| | - Justine Tomlinson
- School of Pharmacy and Medical Sciences , University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research , Bradford, UK
- Medicines Management & Pharmacy Services , Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Catherine Quinn
- Centre for Applied Dementia Studies , University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research , Bradford, UK
| | - Beth Fylan
- School of Pharmacy and Medical Sciences , University of Bradford, Bradford, UK
- NIHR Yorkshire and Humber Patient Safety Translational Research Centre , Bradford Institute for Health Research, Bradford, UK
- Wolfson Centre for Applied Health Research , Bradford, UK
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Aurooj A, Mahmood Z. Subjective Experiences of Alzheimer's Disease in the Pakistani Cultural Context: An Exploratory Study. JOURNAL OF RELIGION AND HEALTH 2022; 61:125-138. [PMID: 34250570 DOI: 10.1007/s10943-021-01335-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/30/2021] [Indexed: 06/13/2023]
Abstract
Studying Alzheimer's disease with the fluctuating environmental, individual, and cultural factors in pertinence to the Diagnostic Statistical Manual (DSM-5) requires information, awareness, and understanding of the disease. Studies have calibrated sociocultural factors to be imperative in the expression of functional symptomology of Alzheimer's disease. Pakistan as a sociocentric, predominantly Muslim country, calls for such efforts. The current research was conducted to study the functional symptomology and experiences of Alzheimer's disease. A qualitative approach was adopted in which in-depth interviews of three dyads of patients with Alzheimer's disease and their caregivers (N = 6) were conducted. Interpretative Phenomenological Analysis was applied to acquire the thematic analysis of data. Results showed sociocentricism as a forefront factor. Cognition, behavior, and emotions were found to be functionally expressed by religion, unawareness, respect of older people, stigmatization, and isolation within family dynamics. The study could be an instigator for further culture-oriented assessment and management providing services.
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Affiliation(s)
- Amna Aurooj
- University of Management and Technology, Lahore, Pakistan.
| | - Zahid Mahmood
- University of Management and Technology, Lahore, Pakistan
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Estrada-Bellmann I, Meléndez-Flores JD, Cámara-Lemarroy CR, Castillo-Torres SA. Determinants of self-efficacy in patients with Parkinson's disease. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 79:686-691. [PMID: 34550188 DOI: 10.1590/0004-282x-anp-2020-0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 10/15/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Self-efficacy is the individual's assessment of his or hers ability to complete a specific task successfully and has been closely related to self-management and quality of life in several diseases. OBJECTIVE To investigate self-efficacy in a population of Parkinson's disease (PD) patients in Mexico and study the factors that are associated with this measure. METHODS We carried out a cross-sectional observational study involving patients with PD in an outpatient neurology clinic in Mexico, using the following instruments: Spanish version of the Chronic Disease Self-Efficacy Scale (CDSES), Quality of Life Questionnaire PDQ-8, Movement Disorders Society-Unified Parkinson's disease Rating Scale (MDS-UPDRS), Montreal Cognitive Assessment (MoCA), and Non-Motor Symptom Scale (NMSS). Clinical and demographic variables were also recorded. RESULTS We included 73 patients with a mean age of 65 years and most patients were male. Patients with lower CDSES scores (<7.75) had worse scores in MDS-UPDRS, NMSS, and PDQ-8 scales. CDSES scores were significantly correlated with MDS-UPDRS Part I (r=-0.497, p=<0.001), Part II (r= -0.271, p=0.020), Part III (r=-0.304, p=<0.001), PDQ-8 (r=-0.472, p=<0.001), and NMSS (r=-0.504, p=<0.001). Furthermore, when assessing the simultaneous effect of covariates associated with CDSES score, only Mood/Apathy domain of NMSS was significant (beta= -0.446, t= -3.807, p= 0.012). CONCLUSIONS PD patients with lower self-efficacy scores had worse motor and non-motor symptomatology and quality of life. Mood/Apathy disorders were negatively associated with self-efficacy and contributed significantly to this measure.
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Affiliation(s)
- Ingrid Estrada-Bellmann
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José E. González", Servicio de Neurología, Monterrey, Nuevo León, México
| | - Jesús Daniel Meléndez-Flores
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José E. González", Servicio de Neurología, Monterrey, Nuevo León, México.,Universidad Autónoma de Nuevo León, Facultad de Medicina, Monterrey, Nuevo León, México
| | - Carlos Rodrigo Cámara-Lemarroy
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José E. González", Servicio de Neurología, Monterrey, Nuevo León, México.,University of Calgary, Department of Clinical Neurosciences, Cumming School of Medicine, Calgary, Canada.,University of Calgary, Hotchkiss Brain Institute, Cumming School of Medicine, Calgary, Canada
| | - Sergio Andrés Castillo-Torres
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José E. González", Servicio de Neurología, Monterrey, Nuevo León, México
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Skov SS, Nielsen MBD, Krølner RF, Øksnebjerg L, Rønbøl Lauridsen SM. A multicomponent psychosocial intervention among people with early-stage dementia involving physical exercise, cognitive stimulation therapy, psychoeducation and counselling: Results from a mixed-methods study. DEMENTIA 2021; 21:316-334. [PMID: 34416131 DOI: 10.1177/14713012211040683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND There is increasing awareness of the benefits of both physical and psychosocial interventions to empower and benefit people with dementia and their caregivers. However, the potential additional benefits of combining physical and psychosocial interventions have only been sparsely explored. The aim of this pilot study was to investigate the acceptability and potential impact of a multicomponent intervention comprising physical exercise, cognitive stimulation therapy (CST), psychoeducation and counselling for people with early-stage dementia. DESIGN A 15-week multicomponent group-based intervention was offered to people with early-stage dementia in Denmark (N = 44). A mixed-methods design combining interviews, observations, tests of cognitive and physical functioning and an interviewer-assisted questionnaire on quality of life was applied to (1) investigate acceptability of the intervention, including whether people with dementia and their caregivers found the intervention meaningful and (2) to explore and assess changes in participants' physical and cognitive functioning and quality of life. The study was conducted between June 2018 and August 2019. RESULTS The pilot study demonstrated that the multicomponent intervention was acceptable for people with early-stage dementia and their caregivers. Test results did not show significant changes in measures of participants' physical and cognitive functioning or quality of life. However, qualitative data revealed that participants perceived the intervention as meaningful and found that it had a positive influence on their physical and social well-being. In addition, interaction and support from peers and staff members was considered important and rewarding. CONCLUSION This multicomponent intervention constitutes a meaningful and beneficial activity for people with early-stage dementia and their caregivers. It provides an opportunity to engage in social interactions with peers and experience professional support. The study also underlines the importance of providing prolonged and sustainable interventions for people with dementia to maintain personal and social benefits.
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Shehadeh A, Hunter S, Jeong S. Self-Management of Dementia by Family Carers: A Scoping Review. Gerontol Geriatr Med 2021; 7:23337214211016694. [PMID: 34095351 PMCID: PMC8142234 DOI: 10.1177/23337214211016694] [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: 03/08/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 11/21/2022] Open
Abstract
Family carers increasingly take on the responsibility of self-management of
dementia as the condition progresses. However, research on this topic is scarce.
This scoping review aimed to identify the key characteristics related to
self-management of dementia by carers including its components,
theoretical/conceptual frameworks that underpinned these components and
measurements. A scoping review was conducted in 8 databases and 16 publications
met the inclusion criteria. Twenty-two components were identified and grouped
into two categories: activities and carer characteristics and skills. The
identified theoretical/conceptual frameworks were numerous and varied as were
the measures. There was a little consistency of the key characteristics of
self-management of dementia by carers. The findings assist carers and healthcare
providers to understand the components involved in self-managing dementia which
will guide the development and delivery of self-management support interventions
for carers. Further research is required to validate these findings and to
develop specialized conceptual frameworks and measures.
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Affiliation(s)
- Anas Shehadeh
- The University of Newcastle, Callaghan, NSW, Australia
| | - Sharyn Hunter
- The University of Newcastle, Callaghan, NSW, Australia
| | - Sarah Jeong
- The University of Newcastle, Callaghan, NSW, Australia
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Huang YC, Cuevas HE, Zuñiga JA, García AA. Predictors of Subjective Cognitive Decline Among People With Diabetes: Data From the Behavioral Risk Factor Surveillance System. Sci Diabetes Self Manag Care 2021; 47:207-215. [PMID: 34000913 DOI: 10.1177/26350106211001761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study was to examine the prevalence of subjective cognitive decline (SCD) and SCD-related functional limitations among people with diabetes and to identify socioeconomic and comorbidity risk factors associated with SCD. METHODS This study analyzed data from the 2017 Behavioral Risk Factor Surveillance System (BRFSS) with background variables (race, gender, education, and age), health-related factors (self-rated health, BMI, insurance, and comorbid conditions), and health behaviors (smoking, exercise, alcohol consumption) entered simultaneously to estimate logistic regression models of SCD. RESULTS Within the sample (n = 5263 adults with diabetes), 48% were age ≥65 years; 50% were male; 55% were non-Hispanic White; and of the 15% who reported having SCD, 57% had functional limitations. Increased odds of reporting SCD were observed among individuals who were Hispanic (odds ratio [OR] = 2.21, P < .001), male (OR = 1.47, P < .01), depressed (OR = 3.85, P < .001), or had arthritis (OR = 1.43, P < .03). Participants with better self-rated health had a reduced likelihood of SCD (OR = 0.51, P < .001). CONCLUSIONS Health care providers should assess high-risk patients for self-rated cognitive dysfunction and offer early interventions.
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Affiliation(s)
- Ya-Ching Huang
- St. David's School of Nursing, Texas State University, Round Rock, Texas
| | - Heather E Cuevas
- School of Nursing, The University of Texas at Austin, Austin, Texas
| | - Julie A Zuñiga
- School of Nursing, The University of Texas at Austin, Austin, Texas
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14
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Schmaderer M, Struwe L, Linton N, Zimmerman L. Self-management strategies differ by level of cognition in multimorbid patients. Appl Nurs Res 2021; 58:151407. [PMID: 33745560 DOI: 10.1016/j.apnr.2021.151407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 07/17/2020] [Accepted: 02/08/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Myra Schmaderer
- University of Nebraska Medical Center, College of Nursing, 550 N 19th St, P.O. Box 880220, Lincoln, NE 68588-0220, United States.
| | - Leeza Struwe
- University of Nebraska Medical Center, College of Nursing, 550 N 19th St, P.O. Box 880220, Lincoln, NE 68588-0220, United States.
| | - Nicole Linton
- University of Nebraska Medical Center, College of Nursing, 550 N 19th St, P.O. Box 880220, Lincoln, NE 68588-0220, United States.
| | - Lani Zimmerman
- University of Nebraska Medical Center, College of Nursing, 550 N 19th St, P.O. Box 880220, Lincoln, NE 68588-0220, United States.
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15
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Xu D, Simpson VL. Subjective Well-Being, Depression, and Delays in Care Among Older Adults: Dual-Eligible Versus Medicare-Only Beneficiaries. J Appl Gerontol 2021; 41:158-166. [PMID: 33736521 DOI: 10.1177/07334648211000920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We aimed to (a) determine the role of subjective well-being and depression in care delays among Medicare beneficiaries and (b) examine whether subjective well-being and depression play a differential role among Medicare-only and dual-eligible beneficiaries. A nationally representative sample of 1,696 older adults participated in the study. Roughly, 22% of participants reported often or sometimes experiencing care delays, with more delays among dual eligibles. We found that higher levels of subjective well-being were significantly related to less frequent care delays. In contrast, higher levels of depression were significantly related to more frequent care delays. Moreover, as depression increased, the predicted probability of delays increased to a greater extent among dual eligibles than Medicare-only beneficiaries. These findings signify the importance of identifying and implementing strategies to enhance subjective well-being and reduce depression in older adults, particularly dual eligibles, to improve access to timely care.
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16
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Sprange K, Beresford-Dent J, Mountain G, Thomas B, Wright J, Mason C, Cooper CL. Journeying through Dementia Randomised Controlled Trial of a Psychosocial Intervention for People Living with Early Dementia: Embedded Qualitative Study with Participants, Carers and Interventionists. Clin Interv Aging 2021; 16:231-244. [PMID: 33574660 PMCID: PMC7872215 DOI: 10.2147/cia.s293921] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 01/09/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To identify the barriers and facilitators to the implementation of a complex psychosocial intervention though a study exploring the experiences of participants, carers and interventionists during a trial. METHODS Individual semi-structured interviews were conducted with participants, their carers, and interventionists from a sample of recruiting sites that took part in the Journeying through Dementia randomized controlled trial (RCT). Interview data were transcribed and analysed using framework analysis. Co-researcher data analysis workshops were also conducted to explore researcher interpretations of the data through the lens of those with lived experience of dementia. Triangulation enabled comparison of findings from the interviews with findings from the co-researcher workshops. RESULTS Three main themes emerged from the interview data: being prepared; intervention engagement; and participation and outcomes from engagement. From these themes, a number of factors that can moderate delivery and receipt of the intervention as intended were identified. These were context and environment; readiness, training, skills and competencies of the workforce; identifying meaningful participation and relationships. CONCLUSION This study highlighted that the observed benefit of the intervention was nuanced for each individual. Mechanisms of change were influenced by a range of individual, social and contextual factors. Future research should therefore consider how best to identify and measure the multifaceted interplay of mechanisms of change in complex interventions. TRIAL REGISTRATION ISRCTN17993825.
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Affiliation(s)
- Kirsty Sprange
- Nottingham Clinical Trials Unit, Faculty of Medicine, University of Nottingham, Nottingham, NG7 2RD, UK
| | | | - Gail Mountain
- University of Bradford, Bradford West Yorkshire, BD7 1DP, UK
| | - Ben Thomas
- Clinical Trials Research Unit, ScHARR, University of Sheffield, Sheffield, S1 4DP, UK
| | - Jessica Wright
- Clinical Trials Research Unit, ScHARR, University of Sheffield, Sheffield, S1 4DP, UK
| | - Clare Mason
- University of Bradford, Bradford West Yorkshire, BD7 1DP, UK
| | - Cindy L Cooper
- Clinical Trials Research Unit, ScHARR, University of Sheffield, Sheffield, S1 4DP, UK
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17
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Testad I, Kajander M, Gjestsen MT, Dalen I. Health promotion intervention for people with early-stage dementia: A quasi-experimental study. Brain Behav 2020; 10:e01888. [PMID: 33064358 PMCID: PMC7749592 DOI: 10.1002/brb3.1888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/21/2020] [Accepted: 09/26/2020] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION With the limited advancements in medical treatment, there is a growing need for supporting people with early-stage dementia adjust to their diagnosis and improve their quality of life. This study aimed to investigate the effects of a 12-week health promotion course for people with early-stage dementia. METHODS Quasi-experimental, single group, pretest-posttest design. A total of 108 persons with dementia participated in this study, and for each participant, a carer was interviewed. The 12-week health promotion intervention consisted of 2-hr sessions at weekly intervals. Outcome measures were cognition, measured by Mini-Mental State Examination, personal, and instrumental activities of daily living (P-ADL and I-ADL), measured by Lawton and Brody's Physical Self-Maintenance Scale and Instrumental Activities of Daily Living Scale, self-rated health, measured by the European Quality of life Visual Analogue Scale, depressive symptoms, measured by the Cornell Scale for Depression in Dementia, and neuropsychiatric symptoms, measured by The Neuropsychiatric Inventory. Assessments were conducted at baseline and at follow-up 1-2 months postintervention. RESULTS The results demonstrate a small but statistically significant improvement in depressive symptoms (p = .015) and in self-rated health (p = .031). The results also demonstrated a small statistically significant decline in the participants' I-ADL (p = .007). The participants' cognitive function, P-ADL, and neuropsychiatric symptoms were stable during the 4-month follow-up. CONCLUSION This study demonstrates promising results with regard to the benefit of attending a 12-week health promotion intervention in promoting health and well-being in people with early-stage dementia. With the majority of participants with early-stage dementia living at home without any healthcare services in a vulnerable stage of the condition, this study makes an important contribution to highlighting the need for, and benefit of, educational approaches for this population.
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Affiliation(s)
- Ingelin Testad
- Centre for Age-related Medicine - SESAM, Stavanger University Hospital, Stavanger, Norway.,College of Medicine and Health, University of Exeter, Exeter, UK.,Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, UK
| | - Martine Kajander
- Centre for Age-related Medicine - SESAM, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Martha T Gjestsen
- Centre for Age-related Medicine - SESAM, Stavanger University Hospital, Stavanger, Norway
| | - Ingvild Dalen
- Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway
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18
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Øksnebjerg L, Woods B, Vilsen CR, Ruth K, Gustafsson M, Ringkøbing SP, Waldemar G. Self-management and cognitive rehabilitation in early stage dementia - merging methods to promote coping and adoption of assistive technology. A pilot study. Aging Ment Health 2020; 24:1894-1903. [PMID: 31429315 DOI: 10.1080/13607863.2019.1625302] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: It is essential to develop interventions that meet individual needs for coping and self-management of people with dementia. This study explored the feasibility and applicability of an intervention merging methods of cognitive rehabilitation and self-management groups for people with early stage dementia. The potential of this intervention to promote adoption of assistive technology was also explored.Method: People with early stage Alzheimer's disease (N = 19) participated in the programme comprising both individual and group sessions. Caregivers were involved in the individual session and a separate group meeting. The intervention both addressed individual goals and more general self-management approaches. In addition, both participants and caregivers were introduced to the ReACT app, a holistic solution tailormade to meet self-management needs of people with early stage dementia.Results: There was significant improvement in the participants' attainment of individual goals and satisfaction with goal attainment from pre- to post-intervention. Participants and caregivers generally reported a positive attitude towards the intervention, attendance rate was high, and all participants completed the intervention. Qualitative results also indicated that the intervention promoted awareness, acceptance and coping among participants. The specific benefits of using the ReACT app for self-management were also emphasised. Forty-two percent of the participants adopted the app and continued using it after completing the intervention.Conclusion: Results from this pilot study indicated that the intervention is both feasible and applicable and can be an effective method to promote coping and adoption of assistive technology among people with early stage dementia.
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Affiliation(s)
- Laila Øksnebjerg
- Danish Dementia Reseach Centre, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
| | - Bob Woods
- Dementia Services Development Centre Wales, Bangor University, Bangor, United Kingdom
| | | | - Kathrine Ruth
- Bispebjerg and Frederiksberg Hospital, Department of Geriatric Medicine and Palliative Care, Frederiksberg Hospital, Frederiksberg, Denmark
| | - Moa Gustafsson
- Department of Neurology, Zealand University Hospital, Roskilde, Denmark
| | - Signe Pertou Ringkøbing
- Copenhagen Memory Clinic and Danish Dementia Research Centre, Section 6911, Department of Neurology, The Neuroscience Centre, Rigshospitalet, Copenhagen, Denmark
| | - Gunhild Waldemar
- Danish Dementia Reseach Centre, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
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19
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Testad I, Clare L, Anstey K, Selbæk G, Bjørkløf GH, Henderson C, Dalen I, Gjestsen MT, Rhodes S, Røsvik J, Bollen J, Amos J, Kajander MM, Quinn L, Knapp M. Self-management and HeAlth Promotion in Early-stage dementia with e-learning for carers (SHAPE): study protocol for a multi-centre randomised controlled trial. BMC Public Health 2020; 20:1508. [PMID: 33036591 PMCID: PMC7545375 DOI: 10.1186/s12889-020-09590-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/22/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND With an increasing number of people with dementia worldwide and limited advancement in medical treatments, the call for new and cost-effective approaches is crucial. The utility of self-management has been proven in certain chronic conditions. However, very little work has been undertaken regarding self-management in people with dementia. METHODS The SHAPE trial will include 372 people with mild to moderate dementia to evaluate the effectiveness and cost-effectiveness of an educational programme combining approaches of self-management, health promotion, and e-learning for care partners. The study is a multi-site, single-randomised, controlled, single-blinded trial with parallel arms. The intervention arm is compared with treatment as usual. The intervention comprises a 10-week course delivered as group sessions for the participants with dementia. The sessions are designed to develop self-management skills and to provide information on the nature of the condition and the development of healthy behaviours in a supportive learning environment. An e-learning course will be provided for care partners which covers similar and complementary material to that discussed in the group sessions for the participant with dementia. DISCUSSION This trial will explore the effect of the SHAPE group intervention on people with mild to moderate dementia in terms of self-efficacy and improvement in key health and mental health outcomes and cost-effectiveness, along with carer stress and knowledge of dementia. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04286139, registered prospectively February 26, 2020, https://clinicaltrials.gov/ct2/show/NCT04286139.
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Affiliation(s)
- Ingelin Testad
- Centre for Age-related Medicine - SESAM, Stavanger University Hospital, Stavanger, Norway.
- University of Exeter, College of Medicine and Health, University of Exeter, Exeter, UK.
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, UK.
| | - Linda Clare
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter, St Luke's Campus, Exeter, UK
| | - Kaarin Anstey
- UNSW Ageing Futures Institute, University of New South Wales, Randwick, Australia
- Neuroscience Research Australia, Randwick, Australia
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Guro Hanevold Bjørkløf
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Catherine Henderson
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Ingvild Dalen
- Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway
| | | | - Shelley Rhodes
- University of Exeter, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Janne Røsvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Jessica Bollen
- University of Exeter, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Jessica Amos
- UNSW Ageing Futures Institute, University of New South Wales, Randwick, Australia
| | - Martine Marie Kajander
- Centre for Age-related Medicine - SESAM, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Lynne Quinn
- University of Exeter, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Martin Knapp
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
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20
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Schoon Y, Bongers KTJ, Olde Rikkert MGM. Feasibility study by a single-blind randomized controlled trial of self-management of mobility with a gait-speed feedback device by older persons at risk for falling. Assist Technol 2020; 32:222-228. [PMID: 30373502 DOI: 10.1080/10400435.2018.1529004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
This single-blind randomized pilot study explored feasibility and safety of a self-management fall prevention program, hypothesizing that older persons can comply with this program, while it does not result in more (injurious) falls, or a decrease in mental wellbeing as an adverse effect of being focused on falls prevention. Eighty-six persons, community-dwelling or home for the aged (mean age 80.3 years [SD: 6.3], 56 women (65.1%)) participated. The intervention group measured their gait speed by using the Mobility Feedback Device (MFD) weekly for 6 months. The control group was monitored for the outcomes without an intervention. Change scores involving health perception and mental wellbeing (Medical Outcomes Study 20-item short form (MOS-20)) were compared between groups. Feasibility was assessed by drop-out rate and compliance to measure gait speed. Safety was assessed by fall incidence during follow-up. MOS-20 decreased significantly in the control group (p = 0.024) but remained stable in the intervention group. Drop-out rate was low (9.3%), and compliance was good. Fall incidence was the same for both groups (p = 0.155). The self-management fall prevention program is feasible and safe in a community-dwelling and home for the aged population, making it worthwhile to further explore self-management fall-prevention studies.
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Affiliation(s)
- Yvonne Schoon
- Department of Geriatric Medicine (925), Radboud University Medical Center , Nijmegen, The Netherlands
| | - Kim T J Bongers
- Department of Geriatric Medicine (925), Radboud University Medical Center , Nijmegen, The Netherlands
| | - Marcel G M Olde Rikkert
- Department of Geriatric Medicine (925), Radboud University Medical Center , Nijmegen, The Netherlands
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21
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Ellis JL, Altenburger P, Lu Y. Change in Depression, Confidence, and Physical Function Among Older Adults With Mild Cognitive Impairment. J Geriatr Phys Ther 2020; 42:E108-E115. [PMID: 29059120 DOI: 10.1519/jpt.0000000000000143] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Nearly a quarter of those in the United States older than 71 years experience mild cognitive impairment. Persons with mild cognitive impairment battle depression and progressive disengagement from daily activities, which contribute to participation restriction and activity limitation. Daily engagement in meaningful activity (DEMA) is a tailored intervention designed to benefit persons with mild cognitive impairment and their caregivers through preserved engagement and supported adjustment to cognitive changes. This secondary analysis was guided by the International Classification of Functioning, Disability and Health (ICF) model. Aims were to (i) explore the extent to which change in self-rated activity performance and physical function can predict change in depressive symptoms, (ii) evaluate for difference in confidence and depressive symptoms at ICF levels of activity and participation, and (iii) quantify the impact of daily engagement at the ICF level of participation on physical function. METHODS A secondary analysis was conducted using data from the parent study, which was a 2-group randomized trial involving persons with mild cognitive impairment and their informal caregivers participating in the Indiana Alzheimer Disease Center DEMA program. Quantitative analysis (dyads: DEMA N = 20, Information Support N = 20) examined outcomes at posttest and follow-up. Analysis employed linear regression to model the relationship between explanatory and dependent variables and independent t test to examine for difference in confidence, depression, and physical function. RESULTS AND DISCUSSION At posttest, change in self-rated performance predicted change in depressive symptoms. Those in the DEMA group who engaged in activity at the ICF level of participation demonstrated a significant increase in confidence and physical function. Although not significant, the control group posttest results showed a mean decrease in confidence. CONCLUSIONS Results demonstrate a positive impact of DEMA on depressive symptoms, confidence, and physical function. Change in occupational performance predicted change in depressive symptoms. Confidence significantly improved among those who engaged at the ICF participation level. A larger, randomized controlled longitudinal trial is needed to better assess the impact of DEMA on physical function, activity, participation restriction, and quality of life.
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Affiliation(s)
- Jennifer L Ellis
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University-Purdue University Indianapolis
| | - Peter Altenburger
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University-Purdue University Indianapolis
| | - Yvonne Lu
- Department of Science of Nursing Care, School of Nursing, Indiana University-Purdue University Indianapolis
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22
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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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23
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Kim MS, Gang M, Lee J, Park E. The Effects of Self-Care Intervention Programs for Elderly with Mild Cognitive Impairment. Issues Ment Health Nurs 2019; 40:973-980. [PMID: 31322472 DOI: 10.1080/01612840.2019.1619202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study examined the effects of a self-care intervention program on self-efficacy, dementia-preventive behavior, cognitive function, depression, and quality of life in elderly with mild cognitive impairment. The study employed a quasi-experimental study design using a nonequivalent control group pre-post. Data were analyzed using the chi-square test, independent t-test, and repeated-measures ANOVA. The results of the study showed that the program reduced dementia risk and strengthened self-care ability in older adults with MCI.
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Affiliation(s)
- Myung-Suk Kim
- Department of Nursing Science, Howon University , Gunsan , Jeonbuk , South Korea
| | - Moonhee Gang
- College of Nursing, Chungnam National University , Daejeon , South Korea
| | - Jihye Lee
- Department of Nursing Science, Ulsan College , Ulsan , South Korea
| | - Eunyoung Park
- College of Nursing, Chungnam National University , Daejeon , South Korea
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24
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Stiekema APM, van Heugten CM, de Vugt ME. Joining forces to improve psychosocial care for people with cognitive deficits across diagnoses: social health as a common framework. Aging Ment Health 2019; 23:1275-1281. [PMID: 30450949 DOI: 10.1080/13607863.2018.1498446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Cognitive deficits such as memory problems have a major impact on independence in daily life and participation in society in several populations, such as people with dementia, brain injury (i.e. stroke) or a severe mental illness such as schizophrenia. Similarities in the impact on participation and well-being have resulted in the development of comparable psychosocial interventions across populations, aiming to support people to adapt to cognitive deficits or by adapting the environment. These interventions are developed separately, without using the expertise in other fields. We argue that each of the fields and the field of psychosocial care in general would benefit from closer collaboration on development and evaluation of innovative psychosocial interventions. Collaboration has been complicated by the use of different care models and theoretical frameworks, each with their own terminology. The concept of social health - the ability to participate in work or other meaningful activities and to feel healthy despite a condition - translates to the leading care models within the fields of dementia, brain injury and severe mental illness. The concept of social health provides a common language and framework. In this paper, we elaborate on strategies for collaboration using examples of interventions to improve social health.
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Affiliation(s)
- Annemarie P M Stiekema
- a School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center , Maastricht , The Netherlands
| | - Caroline M van Heugten
- a School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center , Maastricht , The Netherlands.,b School for Mental Health and Neuroscience, Faculty of Psychology and Neuroscience, Department of Neuropsychology and Psychopharmacology, Maastricht University , Maastricht , The Netherlands
| | - Marjolein E de Vugt
- a School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center , Maastricht , The Netherlands
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25
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Rees J, Tuijt R, Burton A, Walters K, Cooper C. Supporting self-care of long-term conditions in people with dementia: A systematic review. Int J Nurs Stud 2019; 116:103432. [PMID: 32197788 DOI: 10.1016/j.ijnurstu.2019.103432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/09/2019] [Accepted: 09/13/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Long-term conditions are common in people living with dementia; their self-management is an important determinant of wellbeing. Family carers often support or substitute self-care activities, and act as proxies for self-management, as dementia progresses. OBJECTIVES To conduct the first systematic review of how management of long-term conditions in people with dementia is best enabled and supported, including factors that facilitate or inhibit self-management and management by a proxy. DESIGN Systematic review. DATA SOURCES We systematically searched MEDLINE, PsychINFO, Embase and Allied and Complementary Medicine databases up to November 2018. REVIEW METHODS We identified the long-term conditions most prevalent in people with dementia that require an element of self-management. We then developed our inclusion criteria to identify qualitative and quantitative studies describing the self-management (or self-management assisted by family carers) of long-term conditions in people with dementia. Two authors independently rated study validity using a standardised checklist. We synthesised qualitative and quantitative findings using a data driven convergent synthesis approach. RESULTS We included 12 articles meeting predetermined inclusion criteria: seven qualitative, two case studies, two quantitative and one mixed methods study. We identified four main themes across these studies: (1) dementia symptoms impeding treatment regimens (forgetfulness, decreased understanding, ability to communicate symptoms and behavioural and psychological symptoms); (2) adapting routines to be simpler, (using memory aids and accommodating physical limitations); (3) negotiating self-management support (carer availability and knowledge; balancing needs for safety and empowerment); and (4) interface with professionals, (Routine simplification, condition specific education, and acknowledging carer role). CONCLUSIONS People living with dementia can be supported to manage their own health for as long as possible, through simplifying routines and reminding, but where this can no longer be negotiated, carers take over responsibility for self-management, often due to safety concerns. Empowerment of people with dementia to remain involved in their care reduces the loss experienced by this transition. Communication and partnership between clinicians and carers is critical when supporting people living with a long-term condition and dementia. Care planning for people living with dementia and a long-term condition should include explicit discussion of how these partnerships will work and guidance on strategies carers can use to support people to self-manage long-term conditions.
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Affiliation(s)
- Jessica Rees
- Division of Psychiatry, University College London, London, UK.
| | - Remco Tuijt
- Division of Psychiatry, University College London, London, UK
| | | | - Kate Walters
- Division of Psychiatry, University College London, London, UK
| | - Claudia Cooper
- Division of Psychiatry, University College London, London, UK
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Wright J, Foster A, Cooper C, Sprange K, Walters S, Berry K, Moniz-Cook E, Loban A, Young TA, Craig C, Dening T, Lee E, Beresford-Dent J, Thompson BJ, Young E, Thomas BD, Mountain G. Study protocol for a randomised controlled trial assessing the clinical and cost-effectiveness of the Journeying through Dementia (JtD) intervention compared to usual care. BMJ Open 2019; 9:e029207. [PMID: 31519673 PMCID: PMC6747651 DOI: 10.1136/bmjopen-2019-029207] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Services are being encouraged to provide postdiagnostic treatment to those with dementia but the availability of evidence-based interventions following diagnosis has not kept pace with increase in demand. To address this need, the Journeying through Dementia (JtD) intervention was created. A randomised controlled trial (RCT), based on a pilot study, is in progress. METHODS AND ANALYSIS The RCT is a pragmatic, two-arm, parallel group trial designed to test the clinical and cost-effectiveness of JtD compared with usual care. Recruitment will be through NHS services, third sector organisations and Join Dementia Research. The sample size is 486 randomised (243 to usual care and 243 to the intervention usual care). Participants can choose to ask a friend or relative (supporter) to become involved in the study. The primary outcome measure for participants is Dementia-Related Quality of Life (DEMQOL), collected at baseline and at 8 months' postrandomisation. Secondary outcome measures will be collected from participants and supporters at those visits. Participants will also be followed up at 12 months' postrandomisation with a reduced set of measures. A process evaluation will be conducted through qualitative and fidelity substudies. Analyses will compare the two arms of the trial on an intention to treat as allocated basis. The primary analyses will compare the mean DEMQOL scores of the participants at 8 months between the two study arms. A cost-effectiveness analysis will consider the incremental cost per Quality Adjusted Life Years of the intervention compared with usual care. Qualitative and fidelity substudies will be analysed through framework analysis and fidelity assessment tools respectively. ETHICS AND DISSEMINATION REC and HRA approval were obtained. A Data Monitoring and Ethics Committee has been constituted. Dissemination will be via publications, conferences and social media. Intervention materials will be made open access. TRIAL REGISTRATION NUMBER ISRCTN17993825.
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Affiliation(s)
- Jessica Wright
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Alexis Foster
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Cindy Cooper
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Kirsty Sprange
- Nottingham Clinical Trials Research Unit, The University of Nottingham, Nottingham, UK
| | - Stephen Walters
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Katherine Berry
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - Esme Moniz-Cook
- Faculty of Health Sciences, Department of Psychological Heath and Well Being, The University of Hull, Hull, UK
| | - Amanda Loban
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Tracey Anne Young
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Claire Craig
- Art & Design Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Tom Dening
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Ellen Lee
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Julie Beresford-Dent
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Benjamin John Thompson
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Emma Young
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Benjamin David Thomas
- Sheffield Clinical Trials Research Unit, School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Gail Mountain
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford, UK
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Yates L, Csipke E, Moniz-Cook E, Leung P, Walton H, Charlesworth G, Spector A, Hogervorst E, Mountain G, Orrell M. The development of the Promoting Independence in Dementia (PRIDE) intervention to enhance independence in dementia. Clin Interv Aging 2019; 14:1615-1630. [PMID: 31571842 PMCID: PMC6748161 DOI: 10.2147/cia.s214367] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 07/07/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Support after a diagnosis of dementia may facilitate better adjustment and ongoing management of symptoms. The aim of the Promoting Independence in Dementia (PRIDE) study was to develop a postdiagnostic social intervention to help people live as well and as independently as possible. The intervention facilitates engagement in evidence-based stimulating cognitive, physical and social activities. METHODS Theories to promote adjustment to a dementia diagnosis, including theories of social learning and self-efficacy, were reviewed alongside self-management and the selective optimization model, to form the basis of the intervention. Analyses of two longitudinal databases of older adults, and qualitative analyses of interviews of older people, people with dementia, and their carers about their experiences of dementia, informed the content and focus of the intervention. Consensus expert review involving stakeholders was conducted to synthesize key components. Participants were sourced from the British NHS, voluntary services, and patient and public involvement groups. A tailored manual-based intervention was developed with the aim for this to be delivered by an intervention provider. RESULTS Evidence-based stimulating cognitive, physical, and social activities that have been shown to benefit people were key components of the proposed PRIDE intervention. Thirty-two participants including people with dementia (n=4), carers (n=11), dementia advisers (n=14), and older people (n=3) provided feedback on the drafts of the intervention and manual. Seven topics for activities were included (eg, "making decisions" and "getting your message across"). The manual outlines delivery of the intervention over three sessions where personalized profiles and plans for up to three activities are developed, implemented, and reviewed. CONCLUSION A manualized intervention was constructed based on robust methodology and found to be acceptable to participants. Consultations with stakeholders played a key role in shaping the manualized PRIDE intervention and its delivery. Unlike most social interventions for dementia, the target audience for our intervention is the people with dementia themselves.
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Affiliation(s)
- Lauren Yates
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Emese Csipke
- Division of Psychiatry, University College London, London, UK
| | - Esme Moniz-Cook
- Department of Psychological Health and Well-Being, Faculty of Health Sciences, School of Health and Social Work, University of Hull, Hull, UK
| | - Phuong Leung
- Division of Psychiatry, University College London, London, UK
| | - Holly Walton
- Department of Applied Health Research, University College London, London, UK
| | - Georgina Charlesworth
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Aimee Spector
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Eef Hogervorst
- National Centre for Sports and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Gail Mountain
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Martin Orrell
- Institute of Mental Health, University of Nottingham, Nottingham, UK
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Self-management and social participation in community-dwelling people with mild dementia: a review of measuring instruments. Int Psychogeriatr 2019; 31:1267-1285. [PMID: 30724149 DOI: 10.1017/s1041610218001709] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND In order to evaluate interventions promoting social health in people with dementia it is essential to have reliable and valid measures. The present review aims to provide an overview of available instruments for the assessment of two domains of social health in community-dwelling people with mild dementia, i.e., the ability to manage life with some degree of independence (self-management) and participation in social activities. METHODS An electronic search was conducted in the following databases: PubMed, CINAHL, and PsycINFO. Characteristics of the instruments, feasibility and psychometric properties of the instruments included are reported on. RESULTS We identified eight instruments measuring aspects of self-management and three instruments measuring social participation. Validity and reliability of self-management instruments varied between moderate and good. Little information was found on the psychometric properties of the instruments for social participation. In general, feasibility and responsiveness data regarding application in community-dwelling people with dementia were scarce for both types of instruments. CONCLUSIONS Future research into assessment tools for social health should focus on the development of instruments for self-management that also cover the areas of coping with and adapting to the emotional consequences of the disease; instruments for social participation covering the involvement in social interactions that are experienced as meaningful by the person; and on the psychometric properties and responsiveness of instruments. More attention should also be given to the feasibility (ease of use) of these instruments for people with mild dementia, professionals, and researchers.
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Niemann-Mirmehdi M, Häusler A, Gellert P, Nordheim J. Perceived Overprotection and Its Association With Quality of Life in Dementia. GEROPSYCH 2019. [DOI: 10.1024/1662-9647/a000207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. To date, few studies have focused on perceived overprotection from the perspective of people with dementia (PwD). In the present examination, the association of perceived overprotection in PwD is examined as an autonomy-restricting factor and thus negative for their mental well-being. Cross-sectional data from the prospective DYADEM study of 82 patient/partner dyads (mean age = 74.26) were used to investigate the association between overprotection, perceived stress, depression, and quality of life (QoL). The analyses show that an overprotective contact style with PwD has a significant positive association with stress and depression, and has a negative association with QoL. The results emphasize the importance of avoiding an overprotective care style and supporting patient autonomy.
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Affiliation(s)
- Mechthild Niemann-Mirmehdi
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité – Universitätsmedizin Berlin, Germany
| | - Andreas Häusler
- Department of Social and Preventive Medicine, University of Potsdam, Germany
| | - Paul Gellert
- Institute of Medical Sociology and Rehabilitation Science, Charité – Universitätsmedizin Berlin, Germany
| | - Johanna Nordheim
- Institute of Medical Sociology and Rehabilitation Science, Charité – Universitätsmedizin Berlin, Germany
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Hertzog C, Lustig E, Pearman A, Waris A. Behaviors and Strategies Supporting Everyday Memory in Older Adults. Gerontology 2019; 65:419-429. [PMID: 30739118 DOI: 10.1159/000495910] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 12/01/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Little is known about the means by which older adults achieve memory-demanding goals in everyday life or alternatively about why they fail to do so. OBJECTIVES We conducted qualitative interviews to evaluate what older people do to support everyday memory functioning. A principal focus was on understanding the ways in which individuals use internal memory strategies and external memory aids. METHODS We interviewed 25 community-dwelling older adults (mean age 70 years) in a semi-structured interview. The transcribed results were coded by extracting segments of the interviews and classifying the responses into emergent categories. All coded interview segments were reviewed by category. Memos were created and relevant themes identified. RESULTS The older adults reported everyday memory failures (such as forgetting names), often without nominating explicit methods for avoiding these problems. They also reported using a number of external memory aids such as calendars and lists. Our interviews indicated this use was typically a part of complex routines and habits of living that often seemed vulnerable to errors. For instance, people would report filling medication organizers or completing to-do lists without mentioning plans for how to effectively use these aids later. Furthermore, they often reported reliance on spontaneous encoding and retrieval - for example, stating that they would routinely remember to perform important actions in the future. CONCLUSIONS Older adults' reported everyday memory failures were linked to suboptimal use of external memory aids and to a reliance on incidental learning and remembering. There is potential value for interventions that improve procedures for managing everyday life goals that rely on memory.
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Affiliation(s)
- Christopher Hertzog
- School of Psychology, Georgia Institute of Technology, Atlanta, Georgia, USA,
| | - Emily Lustig
- School of Psychology, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Ann Pearman
- School of Psychology, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Aiman Waris
- School of Psychology, Georgia Institute of Technology, Atlanta, Georgia, USA
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Matthews ML, Wells Y, Pike KE, Kinsella GJ. Long-term effects of a memory group intervention reported by older adults. Neuropsychol Rehabil 2018; 30:1044-1058. [DOI: 10.1080/09602011.2018.1544570] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Milanda L. Matthews
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Yvonne Wells
- School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
| | - Kerryn E. Pike
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Glynda J. Kinsella
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Department of Psychology, Caulfield Hospital, Caulfield, Australia
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Stockwell‐Smith G, Moyle W, Kellett U. The impact of early‐stage dementia on community‐dwelling care recipient/carer dyads’ capacity to self‐manage. J Clin Nurs 2018; 28:629-640. [DOI: 10.1111/jocn.14657] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/14/2018] [Accepted: 08/29/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Gillian Stockwell‐Smith
- School of Nursing and Midwifery Griffith University Brisbane Queensland Australia
- Menzies Health Institute Queensland Griffith University Brisbane Queensland Australia
| | - Wendy Moyle
- School of Nursing and Midwifery Griffith University Brisbane Queensland Australia
- Menzies Health Institute Queensland Griffith University Brisbane Queensland Australia
| | - Ursula Kellett
- School of Nursing and Midwifery Griffith University Brisbane Queensland Australia
- Menzies Health Institute Queensland Griffith University Brisbane Queensland Australia
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Bielsten T, Lasrado R, Keady J, Kullberg A, Hellström I. Living Life and Doing Things Together: Collaborative Research With Couples Where One Partner Has a Diagnosis of Dementia. QUALITATIVE HEALTH RESEARCH 2018; 28:1719-1734. [PMID: 30033851 DOI: 10.1177/1049732318786944] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The aim of this study is to identify relevant content for a self-management guide by using the outcomes of previous research in combination with knowledge and experiences from couples where one partner has a diagnosis of dementia. The study was carried out in three phases: (a) literature search of previous research related to well-being and couplehood in dementia; (b) interviews with couples with dementia based on the findings of the literature search; and (c) further authentication of the findings within expert groups of people with dementia and carers. For analysis of data, we used a hybrid approach of thematic analysis with combined deductive and inductive approaches. The findings of this study indicated that the four main themes "Home and Neighborhood," "Meaningful Activities and Relationships," "Approach and Empowerment," and "Couplehood" with related subthemes could be appropriate targets for a self-management guide for couples where one partner has a diagnosis of dementia.
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Affiliation(s)
| | - Reena Lasrado
- 2 University of Manchester, Manchester, United Kingdom
| | - John Keady
- 2 University of Manchester, Manchester, United Kingdom
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Bunn F, Goodman C, Jones PR, Russell B, Trivedi D, Sinclair A, Bayer A, Rait G, Rycroft-Malone J, Burton C. Managing diabetes in people with dementia: a realist review. Health Technol Assess 2018; 21:1-140. [PMID: 29235986 DOI: 10.3310/hta21750] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Dementia and diabetes mellitus are common long-term conditions that coexist in a large number of older people. People living with dementia and diabetes may be at increased risk of complications such as hypoglycaemic episodes because they are less able to manage their diabetes. OBJECTIVES To identify the key features or mechanisms of programmes that aim to improve the management of diabetes in people with dementia and to identify areas needing further research. DESIGN Realist review, using an iterative, stakeholder-driven, four-stage approach. This involved scoping the literature and conducting stakeholder interviews to develop initial programme theories, systematic searches of the evidence to test and develop the theories, and the validation of programme theories with a purposive sample of stakeholders. PARTICIPANTS Twenty-six stakeholders (user/patient representatives, dementia care providers, clinicians specialising in dementia or diabetes and researchers) took part in interviews and 24 participated in a consensus conference. DATA SOURCES The following databases were searched from 1990 to March 2016: MEDLINE (PubMed), Cumulative Index to Nursing and Allied Health Literature, Scopus, The Cochrane Library (including the Cochrane Database of Systematic Reviews), Database of Abstracts of Reviews of Effects, the Health Technology Assessment (HTA) database, NHS Economic Evaluation Database, AgeInfo (Centre for Policy on Ageing - UK), Social Care Online, the National Institute for Health Research (NIHR) portfolio database, NHS Evidence, Google (Google Inc., Mountain View, CA, USA) and Google Scholar (Google Inc., Mountain View, CA, USA). RESULTS We included 89 papers. Ten papers focused directly on people living with dementia and diabetes, and the rest related to people with dementia or diabetes or other long-term conditions. We identified six context-mechanism-outcome (CMO) configurations that provide an explanatory account of how interventions might work to improve the management of diabetes in people living with dementia. This includes embedding positive attitudes towards people living with dementia, person-centred approaches to care planning, developing skills to provide tailored and flexible care, regular contact, family engagement and usability of assistive devices. A general metamechanism that emerges concerns the synergy between an intervention strategy, the dementia trajectory and social and environmental factors, especially family involvement. A flexible service model for people with dementia and diabetes would enable this synergy in a way that would lead to the improved management of diabetes in people living with dementia. LIMITATIONS There is little evidence relating to the management of diabetes in people living with dementia, although including a wider literature provided opportunities for transferable learning. The outcomes in our CMOs are largely experiential rather than clinical. This reflects the evidence available. Outcomes such as increased engagement in self-management are potential surrogates for better clinical management of diabetes, but this is not proven. CONCLUSIONS This review suggests that there is a need to prioritise quality of life, independence and patient and carer priorities over a more biomedical, target-driven approach. Much current research, particularly that specific to people living with dementia and diabetes, identifies deficiencies in, and problems with, current systems. Although we have highlighted the need for personalised care, continuity and family-centred approaches, there is much evidence to suggest that this is not currently happening. Future research on the management of diabetes in older people with complex health needs, including those with dementia, needs to look at how organisational structures and workforce development can be better aligned to the needs of people living with dementia and diabetes. STUDY REGISTRATION This study is registered as PROSPERO CRD42015020625. FUNDING The NIHR HTA programme.
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Affiliation(s)
- Frances Bunn
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Claire Goodman
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | | | - Bridget Russell
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Daksha Trivedi
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Alan Sinclair
- Foundation for Diabetes Research in Older People, Diabetes Frail Ltd, Luton, UK
| | - Antony Bayer
- Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK
| | - Greta Rait
- Research Department of Primary Care and Population Health, University College London Medical School, London, UK
| | | | - Chris Burton
- School of Healthcare Sciences, Bangor University, Bangor, UK
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Dams-O’Connor K, Landau A, Hoffman J, St De Lore J. Patient perspectives on quality and access to healthcare after brain injury. Brain Inj 2018; 32:431-441. [DOI: 10.1080/02699052.2018.1429024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kristen Dams-O’Connor
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexandra Landau
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jeanne Hoffman
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Jef St De Lore
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
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Abstract
PURPOSE OF REVIEW To provide an overview of a selection of largely neglected psychological risk factors for nonadherence, and to offer new approaches to improve medication adherence. RECENT FINDINGS Current adherence research and intervention programs focus on a few risk factors for nonadherence, such as complexity of the drug regimen. In addition, other important risk factors of nonadherence are neglected or insufficiently addressed. There is good evidence for the significant role of the quality of the patient-healthcare provider relationship. Other risk factors like the individual history of nonadherence, the lack of acceptance of having a treatable disorder, fear of side-effects, comorbid depression, and cognitive impairment have been broadly neglected in adherence programs, although they offer a powerful key to improve adherence-oriented interventions. SUMMARY Current research on determinants of nonadherence has focused on a few risk factors, while neglecting crucial psychological predictors of nonadherence. The personalized consideration of a multiplicity of risk factors offers a new basis for the development and evaluation of interventions to better promote adherence.
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Bunn F, Goodman C, Reece Jones P, Russell B, Trivedi D, Sinclair A, Bayer A, Rait G, Rycroft-Malone J, Burton C. What works for whom in the management of diabetes in people living with dementia: a realist review. BMC Med 2017; 15:141. [PMID: 28750628 PMCID: PMC5532771 DOI: 10.1186/s12916-017-0909-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 07/04/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Dementia and diabetes mellitus are common long-term conditions and co-exist in a large number of older people. People living with dementia (PLWD) may be less able to manage their diabetes, putting them at increased risk of complications such as hypoglycaemia. The aim of this review was to identify key mechanisms within different interventions that are likely to improve diabetes outcomes in PLWD. METHODS This is a realist review involving scoping of the literature and stakeholder interviews to develop theoretical explanations of how interventions might work, systematic searches of the evidence to test and develop the theories and their validation with a purposive sample of stakeholders. Twenty-six stakeholders - user/patient representatives, dementia care providers, clinicians specialising in diabetes or dementia and researchers - took part in interviews, and 24 participated in a consensus conference. RESULTS We included 89 papers. Ten focused on PLWD and diabetes, and the remainder related to people with either dementia, diabetes or other long-term conditions. We identified six context-mechanism-outcome configurations which provide an explanatory account of how interventions might work to improve the management of diabetes in PLWD. This includes embedding positive attitudes towards PLWD, person-centred approaches to care planning, developing skills to provide tailored and flexible care, regular contact, family engagement and usability of assistive devices. An overarching contingency emerged concerning the synergy between an intervention strategy, the dementia trajectory and social and environmental factors, especially family involvement. CONCLUSIONS Evidence highlighted the need for personalised care, continuity and family-centred approaches, although there was limited evidence that this happens routinely. This review suggests there is a need for a flexible service model that prioritises quality of life, independence and patient and carer priorities. Future research on the management of diabetes in older people with complex health needs, including those with dementia, needs to look at how organisational structures and workforce development can be better aligned to their needs. TRIAL REGISTRATION PROSPERO, CRD42015020625. Registered on 18 May 2015.
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Affiliation(s)
- Frances Bunn
- Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK.
| | - Claire Goodman
- Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK
| | | | - Bridget Russell
- Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK
| | - Daksha Trivedi
- Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK
| | - Alan Sinclair
- Foundation for Diabetes Research in Older People, Diabetes Frail Ltd, Luton, LU1 3UA, UK
| | - Antony Bayer
- Division of Population Medicine, Cardiff University, Cardiff, Wales, CF10 3AT, LL57 2EF, UK
| | - Greta Rait
- Research Department of Primary Care and Population Health, UCL Medical School (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK
| | | | - Christopher Burton
- Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK
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Poulos CJ, Bayer A, Beaupre L, Clare L, Poulos RG, Wang RH, Zuidema S, McGilton KS. A comprehensive approach to reablement in dementia. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2017; 3:450-458. [PMID: 29067351 PMCID: PMC5654482 DOI: 10.1016/j.trci.2017.06.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
As society grapples with an aging population and increasing prevalence of disability, “reablement” as a means of maximizing functional ability in older people is emerging as a potential strategy to help promote independence. Reablement offers an approach to mitigate the impact of dementia on function and independence. This article presents a comprehensive reablement approach across seven domains for the person living with mild-to-moderate dementia. Domains include assessment and medical management, cognitive disability, physical function, acute injury or illness, assistive technology, supportive care, and caregiver support. In the absence of a cure or ability to significantly modify the course of the disease, the message for policy makers, practitioners, families, and persons with dementia needs to be “living well with dementia”, with a focus on maintaining function for as long as possible, regaining lost function when there is the potential to do so, and adapting to lost function that cannot be regained. Service delivery and care of persons with dementia must be reoriented such that evidence-based reablement approaches are integrated into routine care across all sectors. We present a comprehensive reablement approach in dementia. The reablement approach is described across seven domains. Reablement aims to maintain or regain function, or adapt to lost function. Evidence-based reablement should be integrated into routine care across all sectors.
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Affiliation(s)
- Christopher J Poulos
- HammondCare, Centre for Positive Ageing, Sydney, Australia.,School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia
| | - Antony Bayer
- Division of Population Medicine, Cardiff University, Penarth, Wales, UK
| | - Lauren Beaupre
- Departments of Physical Therapy and Surgery (Division of Orthopaedic Surgery), University of Alberta, Edmonton, Canada
| | - Linda Clare
- REACH, School of Psychology, University of Exeter, Exeter, UK
| | - Roslyn G Poulos
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia
| | - Rosalie H Wang
- Intelligent Assistive Technology and Systems Lab, Deptarment of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Sytse Zuidema
- Department of General Practice and Elderly Care Medicine, University Medical Center, University of Groningen, Groningen, Netherlands
| | - Katherine S McGilton
- Faculty of Nursing, Toronto Rehabilitation Institute-UHN, Toronto, Ontario, Canada
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Gleason KT, Gitlin LN, Szanton SL. The Association of Socioeconomic Conditions and Readiness to Learn New Ways of Performing Daily Activities in Older Adults With Functional Difficulties. J Appl Gerontol 2017; 38:849-865. [PMID: 28715932 DOI: 10.1177/0733464817721110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Behavioral interventions for older adults can reduce difficulties in performing daily activities, hospitalizations, and mortality risk. The success of behavior change interventions, however, can be affected by a participant's readiness to adopt changes. This study evaluates whether socioeconomic conditions, particularly financial strain affording food, are associated with readiness to change. We conducted a cross-sectional, descriptive study of baseline data from disabled older adults ( N = 147) participating in an intervention to reduce physical disability. Readiness to change score was rated at the start of the intervention by interventionists as either pre-action (precontemplation = 1, contemplation = 2, preparation = 3) or action (=4). Participants reporting high financial strain affording food were more likely to have high readiness at the start of intervention; the association of this specific socioeconomic condition with readiness may be an important consideration in implementing interventions to reduce disability.
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Affiliation(s)
- Kelly T Gleason
- 1 School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Laura N Gitlin
- 1 School of Nursing, Johns Hopkins University, Baltimore, MD, USA.,2 School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Sarah L Szanton
- 1 School of Nursing, Johns Hopkins University, Baltimore, MD, USA.,3 School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Rivas Costa C, Fernández Iglesias MJ, Anido Rifón LE, Gómez Carballa M, Valladares Rodríguez S. The acceptability of TV-based game platforms as an instrument to support the cognitive evaluation of senior adults at home. PeerJ 2017; 5:e2845. [PMID: 28070464 PMCID: PMC5214704 DOI: 10.7717/peerj.2845] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 11/29/2016] [Indexed: 11/20/2022] Open
Abstract
Introduction The computing capabilities of state-of-the-art television sets and media centres may facilitate the introduction of computer-assisted evaluation at home. This approach would help to overcome the drawbacks of traditional pen-and-paper evaluations administered in clinical facilities, as they could be performed in a more comfortable environment, the subject’s home, and they would be more flexible for designing complex environments for the evaluation of neuropsychological constructs that are difficult to assess through traditional testing. The objective of this work was to obtain some initial evidence about the technical acceptance by senior adults of serious games played at home on the TV set and therefore about the convenience of further investigating such an approach to cognitive assesment. Materials and Methods We developed a collection of games to be deployed on a TV environment. These games were tried by a group of senior adults at their homes. The Technology Acceptance Model (TAM) was used to validate this approach. Surveys were performed to study the perceived usefulness and perceived ease of use of such technical setting as an instrument for their cognitive evaluation; that is, its technical acceptance. Subjective information collected from participants was correlated with actual interaction data captured. An additional survey was performed 36 months after pilot testing to have an indication about the long-term perceptions about usefulness and ease of use. Results More than 90% of participating subjects perceived cognitive games on TV as useful or very useful. The majority of participants selected the TV set as their preferred option to interact with serious games at home, when compared to other devices such as smartphones, tablets or PCs. This result correlates with the number of participants perceiving them as easily usable or very easy to use, and also with automatically captured interaction data. Three out of four seniors expressed their interest in keeping the system at home after the pilot. Besides, these perceptions are fairly stable in time as shown by the survey performed 36 months after pilot testing. Limitations Although participating users are a representative sample of the Galician population, which in turn is comparable to the population of most rural areas in Europe, a larger and more diverse user sample would be needed to obtain significant results for a wider population profile. Conclusion The study confirmed the technical acceptance, that is, the perceived usefulness and perceived ease of use, of the TV-based home technical setting introduced as a means of cognitive evaluation. This study provides initial evidence on the viability of a TV-based serious games approach for cognitive longitudinal screening at home with little intervention of clinical professionals, thus contributing to the early detection of cognitive impairments in the senior population.
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Dröes RM, Chattat R, Diaz A, Gove D, Graff M, Murphy K, Verbeek H, Vernooij-Dassen M, Clare L, Johannessen A, Roes M, Verhey F, Charras K. Social health and dementia: a European consensus on the operationalization of the concept and directions for research and practice. Aging Ment Health 2017; 21:4-17. [PMID: 27869503 DOI: 10.1080/13607863.2016.1254596] [Citation(s) in RCA: 118] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Because the pattern of illnesses changes in an aging population and many people manage to live well with chronic diseases, a group of health care professionals recently proposed reformulating the static WHO definition of health towards a dynamic one based on the ability to physically, mentally and socially adapt and self-manage. This paper is the result of a collaborative action of the INTERDEM Social Health Taskforce to operationalize this new health concept for people with dementia, more specifically the social domain, and to formulate directions for research and practice to promote social health in dementia. METHOD Based on the expertise of the Social Health Taskforce members (N = 54) three groups were formed that worked on operationalizing the three social health dimensions described by Huber et al.: (1) capacity to fulfil potential and obligations; (2) ability to manage life with some degree of independence; (3) participation in social activities. For each dimension also influencing factors, effective interventions and knowledge gaps were inventoried. After a consensus meeting, the operationalizations of the dimensions were reviewed by the European Working Group of People with Dementia (EWGPWD). RESULTS The social health dimensions could be well operationalized for people with dementia and are assessed as very relevant according to the Social Health Taskforce and EWGPWD. Personal (e.g. sense of coherence, competencies), disease-related (e.g. severity of cognitive impairments, comorbidity), social (support from network, stigma) and environmental factors (e.g. enabling design, accessibility) that can influence the person with dementia's social health and many interventions promoting social health were identified. CONCLUSION A consensus-based operationalization of social health in dementia is proposed, and factors that can influence, and interventions that improve, social health in dementia identified. Recommendations are made for research and practice.
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Affiliation(s)
- R M Dröes
- a Department of Psychiatry, Alzheimer Centre , EMGO Institute for Health and Care Research, VU University Medical Centre , Amsterdam , The Netherlands
| | - R Chattat
- b Department of Psychology , University of Bologna , Bologna , Italy
| | - A Diaz
- c Alzheimer Europe , Luxembourg , Luxembourg
| | - D Gove
- c Alzheimer Europe , Luxembourg , Luxembourg
| | - M Graff
- d Radboud University Medical Centre, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Radboud Alzheimer Centre , Nijmegen , The Netherlands
| | - K Murphy
- e School of Nursing and Midwifery, Aras Loyola, National University of Irelands , Galway , Ireland
| | - H Verbeek
- f Research School CAPHRI, Department of Health Services Research , Maastricht University , Maastricht , The Netherlands
| | - M Vernooij-Dassen
- d Radboud University Medical Centre, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Radboud Alzheimer Centre , Nijmegen , The Netherlands
| | - L Clare
- g Centre for Research in Ageing and Cognitive Health (REACH) , School of Psychology, University of Exeter, and PenCLAHRC, University of Exeter Medical School , Exeter , United Kingdom
| | - A Johannessen
- h Norwegian National Advisory Unit on Ageing and Health , VID Specialized University , Oslo , Norway
| | - M Roes
- i German Center for Neurodegenerative Diseases, Department of Nursing Science, Faculty of Health , University of Witten/Herdecke , Witten , Germany
| | - F Verhey
- j Department of Psychiatry and Neuropsychology , Maastricht University , Maastricht , The Netherlands
| | - K Charras
- k Fondation Médéric Alzheimer , Psychosocial Interventions Department , Paris , France
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Enhancing and Maintaining Memory in Older Adulthood. J Appl Gerontol 2016; 35:1127-1129. [DOI: 10.1177/0733464816664158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Cavallo M, Angilletta C. A Case Study of the Long-Lasting Effects of Cognitive Training on Similar Tasks in Alzheimer's Disease. J Appl Gerontol 2016; 37:1215-1224. [PMID: 27538579 DOI: 10.1177/0733464816662964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Cognitive training allows patients with Alzheimer's disease (AD) to reinforce their cognitive abilities. Here, we investigated the generalizability of trained skills to novel tasks, and their stability over time. METHOD One patient underwent a structured cognitive training using the GEO (Geographical Exercise for cognitive Optimization) task, whereas 10 patients underwent a control intervention. Participants' performances on the GEO task, on a similar untrained task, and on a different untrained task were recorded before and after the intervention, and at the 24-month follow-up. RESULTS On both the trained and the similar untrained tasks, patient's and controls' performance significantly differed from one another, with trained patient showing a significant acquirement of procedural skills that were maintained over time. CONCLUSION Our preliminary evidence showed that a cognitive training could allow patients to acquire and maintain new skills not only on performing a trained task but surprisingly also on a similar untrained task.
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Affiliation(s)
- Marco Cavallo
- 1 eCampus University, Novedrate, Italy.,2 Azienda Sanitaria Locale Torino 3, Collegno, Italy.,3 Assisted Health Residence "Ville Roddolo," Moncalieri, Italy
| | - Chiara Angilletta
- 3 Assisted Health Residence "Ville Roddolo," Moncalieri, Italy.,4 Assisted Health Residence "Eremo dei Camaldolesi," Pecetto Torinese, Italy
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Huis In Het Veld J, Verkaik R, van Meijel B, Verkade PJ, Werkman W, Hertogh C, Francke A. Self-management by family caregivers to manage changes in the behavior and mood of their relative with dementia: an online focus group study. BMC Geriatr 2016; 16:95. [PMID: 27142664 PMCID: PMC4855870 DOI: 10.1186/s12877-016-0268-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 04/26/2016] [Indexed: 11/18/2022] Open
Abstract
Background Self-management is important for family caregivers of people with dementia, especially when they face changes in their relative’s behavior and mood, such as depression, apathy, anxiety, agitation and aggression. The aim of this study is to give insight into why these changes in behavior and mood are stressful for family caregivers, what self-management strategies family caregivers use when managing these changes and the stress they experience. Methods A qualitative study was conducted using four online focus groups with 32 family caregivers of people with dementia living in the Netherlands. Transcripts of the focus group discussions were analyzed using principles of thematic analysis. Results Managing changes in the behavior and mood of their relative with dementia is stressful for family caregivers because of constantly having to switch, continuously having to keep the person with dementia occupied and distracted, the fact that others see a different side to the relative, and the fact that caregivers know what to do, but are often not able to put this into practice. Caregivers use calming down and stimulation as self-management strategies for influencing the changes in the behavior and mood of their relative. Furthermore, caregivers describe three self-management strategies that let them manage their own stress and keep up the care for their loved ones: looking for distractions, getting rest, and discussing their feelings and experiences. Conclusions Behavior and mood changes of a person with dementia are stressful for family caregivers. They use several self-management strategies to positively affect the mood and behavior changes, and also to manage their own stress. Electronic supplementary material The online version of this article (doi:10.1186/s12877-016-0268-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Judith Huis In Het Veld
- Department of Public and Occupational Health, EMGO Institute for Health and Care, Research, VU University Medical Center, Amsterdam, Netherlands
| | - Renate Verkaik
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Berno van Meijel
- Inholland University of Applied Sciences, Amsterdam, The Netherlands.,Parnassia Psychiatric Institute, The Hague, The Netherlands.,Department of Psychiatry, EMGO Institute for Health and Care Research, VU University, Medical Center, Amsterdam, The Netherlands
| | | | - Wendy Werkman
- Dutch Alzheimer's society, Amersfoort, The Netherlands
| | - Cees Hertogh
- Department of General Practice and Elderly Care Medicine, EMGO+ Institute for Health and Care Research, VU Medical Center, Amsterdam, The Netherlands
| | - Anneke Francke
- Department of Public and Occupational Health, EMGO Institute for Health and Care, Research, VU University Medical Center, Amsterdam, Netherlands. .,Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
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