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Gemito L, Alves E, Moreira J, Marques MF, Caldeira E, Ferreira R, Bico I, Pinho L, Fonseca C, Sousa L, Lopes M. Programmes Addressed to Informal Caregivers' Needs: A Systematic Literature Review. Geriatrics (Basel) 2024; 9:71. [PMID: 38920427 PMCID: PMC11202834 DOI: 10.3390/geriatrics9030071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/17/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Addressing informal caregivers' needs is essential for ensuring quality healthcare and promoting citizen-centred care. This systematic review assessed current knowledge about programmes aimed at meeting the needs of informal caregivers of adults who are dependent on others for daily life activities. METHODS Following the PRISMA guidelines, the electronic databases EBSCOhost Research Platform, MEDLINE, CINAHL, Scopus, Web of Science and The Virtual Health Library were searched for randomized experimental studies published between 2012 and 2022 that implemented programmes addressing informal caregivers' needs to improve their experiences, health, and well-being. Quality was assessed using the standardized critical evaluation tools from the Joanna Briggs Institute. Two independent investigators performed the eligibility assessment and data extraction. Quantitative data on the effectiveness of interventions were collected, and the content of each intervention was synthesized and aggregated into categories, through narrative synthesis. RESULTS The majority of the included studies (n = 16) were conducted in European countries and implemented a structured intervention programme compared to the provision of usual care. The studies were of fair to high methodological quality, with a higher risk of bias related to blinding. The results supported the achievement of favourable health outcomes among informal caregivers, namely improvements in mental health (n = 3) and quality of life (n = 3) and a decrease in psychological symptomatology (n = 5) and burden (n = 3). None of the interventions reported adverse outcomes; however, five studies did not describe significant differences in the outcomes assessed after the implementation of the programmes. Interventions focusing on training and educating caregivers (n = 14) and cognitive-behavioural strategies (n = 7) were the most common, while programmes focusing on emotional and psychological support as a resource to improve caregivers' psychological outcomes were scarce. CONCLUSIONS This systematic review adds to the growing body of evidence and insight showing that programmes that address informal caregivers' needs seem to contribute to better physical and psychological health outcomes through the promotion of caregivers' educational support and the implementation of cognitive-behavioural strategies. Future research should implement methodologically robust cross-country programmes tailored to informal caregivers' physical, emotional, psychosocial, societal, and educational needs throughout the care trajectory.
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Affiliation(s)
- Laurência Gemito
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Elisabete Alves
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - José Moreira
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Maria Fátima Marques
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Ermelinda Caldeira
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Rogério Ferreira
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
- School of Health of Beja, Polytechnic Institute of Beja, 7800-111 Beja, Portugal
| | - Isabel Bico
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Lara Pinho
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - César Fonseca
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Luís Sousa
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
- School of Health Atlântica (ESSATLA), Atlântica University, 2730-036 Barcarena, Portugal
| | - Manuel Lopes
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
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Baggaley J, Wolverson E, Clarke C. Self-report instruments measuring aspects of self for people living with dementia: A systematic literature review of psychosocial interventions. DEMENTIA 2024; 23:669-702. [PMID: 38545864 DOI: 10.1177/14713012241240906] [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: 05/01/2024]
Abstract
OBJECTIVE A positive sense of self may be a key domain of psychological well-being for people living with dementia and therefore a legitimate target for psychosocial interventions in dementia care. Determining the effectiveness of such interventions often requires valid self-report instruments. This review aimed to investigate what aspects of self have been measured using self-report instruments in evaluating psychosocial interventions for people living with dementia and to explore the effectiveness of these interventions in terms of positive outcomes related to aspects of self. METHOD A systematic search of the literature using five electronic databases and one register (CENTRAL) was conducted. A narrative synthesis and methodological quality assessment was completed for the included studies. RESULTS A total of 24 studies were included in the review. Seven aspects of self were measured using a range of self-report instruments, many of which have not been validated for dementia. Aspects of self were; self-esteem, self-efficacy, self-compassion, self-growth, self-acceptance, self-management, and self-identity. Studies included a variety of interventions; however, the effectiveness of these interventions for these aspects of self was mixed. CONCLUSION There is some evidence that psychosocial interventions improve specific aspects of self in dementia but further research to improve this evidence base is needed. Future research should also investigate and confirm the validity and reliability of existing self-report instruments that aim to measure aspects of self in dementia. Limitations and implications of the review are discussed.
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Affiliation(s)
| | - Emma Wolverson
- School of Psychology and Social Work, University of Hull, UK
- Research and Publications Team, Dementia, UK
| | - Chris Clarke
- Tees, Esk and Wear Valley NHS Foundation Trust, UK
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Spiers G, Tan MMC, Astbury JL, Hall A, Ahmed N, Lanyi K, Williams O, Beyer F, Craig D, Hanratty B. What works to support carers of older people and older carers? an international evidence map of interventions and outcomes. BMC Geriatr 2024; 24:301. [PMID: 38553679 PMCID: PMC10979610 DOI: 10.1186/s12877-024-04897-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/15/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Unpaid carers of older people, and older unpaid carers, experience a range of adverse outcomes. Supporting carers should therefore be a public health priority. Our understanding of what works to support carers could be enhanced if future evaluations prioritise under-researched interventions and outcomes. To support this, we aimed to: map evidence about interventions to support carers, and the outcomes evaluated; and identify key gaps in current evidence. METHODS Evidence gap map review methods were used. Searches were carried out in three bibliographic databases for quantitative evaluations of carer interventions published in OECD high-income countries between 2013 and 2023. Interventions were eligible if they supported older carers (50 + years) of any aged recipient, or any aged carers of older people (50 + years). FINDINGS 205 studies reported across 208 publications were included in the evidence map. The majority evaluated the impact of therapeutic and educational interventions on carer burden and carers' mental health. Some studies reported evidence about physical exercise interventions and befriending and peer support for carers, but these considered a limited range of outcomes. Few studies evaluated interventions that focused on delivering financial information and advice, pain management, and physical skills training for carers. Evaluations rarely considered the impact of interventions on carers' physical health, quality of life, and social and financial wellbeing. Very few studies considered whether interventions delivered equitable outcomes. CONCLUSION Evidence on what works best to support carers is extensive but limited in scope. A disproportionate focus on mental health and burden outcomes neglects other important areas where carers may need support. Given the impact of caring on carers' physical health, financial and social wellbeing, future research could evaluate interventions that aim to support these outcomes. Appraisal of whether interventions deliver equitable outcomes across diverse carer populations is critical.
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Affiliation(s)
- Gemma Spiers
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
| | - Michelle M C Tan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Jayne L Astbury
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Alex Hall
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Nisar Ahmed
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Kate Lanyi
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Oleta Williams
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona Beyer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Dawn Craig
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Barbara Hanratty
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Bauernschmidt D, Wittmann J, Hirt J, Meyer G, Bieber A. The Implementation Success of Technology-Based Counseling in Dementia Care: Scoping Review. JMIR Aging 2024; 7:e51544. [PMID: 38271050 PMCID: PMC10853855 DOI: 10.2196/51544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/07/2023] [Accepted: 11/21/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Implementing technology-based counseling as a complex intervention in dementia care poses challenges such as adaptation to stakeholders' needs and limited resources. While studies have examined the effectiveness of technology-based counseling, its successful implementation remains largely unexplored. OBJECTIVE We aimed to review the knowledge about the implementation success of technology-based counseling interventions for people with dementia and their informal caregivers. METHODS We conducted a scoping review and systematically searched CINAHL, the Cochrane Library including the Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, and Web of Science Core Collection databases (April 2021) in combination with citation searching and web searching (November 2021). Studies reporting on technology-based counseling interventions for people with dementia or their informal caregivers were included, irrespective of the design. We used the conceptual framework for implementation outcomes to operationalize implementation success and applied the outcomes acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability as categories to inform data extraction. We identified dimensions within the categories and synthesized results narratively and graphically. RESULTS We included 52 publications reporting on 27 technology-based counseling interventions. The studies were conducted in 9 countries and published between 1993 and 2021. As the design of the included studies varied, the number of participants and the type of data reported varied as well. The intervention programs were heterogeneous and ranged from single counseling interventions (such as helpline services) to counseling as part of a multicomponent program. Telephone, email, videoconferencing, social media (respectively chats), and web-based platforms were used for delivering counseling. We found data on appropriateness for all interventions and data on acceptability for most interventions, describing aspects such as consumer-perceived usefulness and helpfulness of services, as well as satisfaction. Information on the other categories of adoption, feasibility, fidelity, implementation cost, penetration, and sustainability was fragmented. CONCLUSIONS The scope and depth of information on conceptual categories of the implementation success of technology-based counseling for people with dementia and informal caregivers varied. The data only partially covered the concept of implementation success, which highlights the need for a systematic evaluation accompanying the implementation. The application of theoretical approaches for implementation and adherence to the framework for developing and evaluating complex interventions are required to promote the implementation of complex interventions and to comprehensively assess implementation success. TRIAL REGISTRATION PROSPERO CRD42021245473; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=245473.
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Affiliation(s)
- Dorothee Bauernschmidt
- Institute of Health and Nursing Science, University Medicine Halle, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Janina Wittmann
- Institute of Health and Nursing Science, University Medicine Halle, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Julian Hirt
- Center for Dementia Care, Institute of Nursing Science, Department of Health, Eastern Switzerland University of Applied Sciences, St Gallen, Switzerland
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Gabriele Meyer
- Institute of Health and Nursing Science, University Medicine Halle, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anja Bieber
- Institute of Health and Nursing Science, University Medicine Halle, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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de Dios-Rodríguez E, Patino-Alonso C, González-Sánchez S, Tamayo-Morales O, Ripoll J, Mora-Simón S, Unzueta-Arce J, Gómez-Marcos MA, García-Ortiz L, Rodríguez-Sánchez E. Promoting Physical Activity in a Primary Care Practice in People Living with Dementia and Their Family Caregivers. Healthcare (Basel) 2023; 11:healthcare11091255. [PMID: 37174797 PMCID: PMC10178700 DOI: 10.3390/healthcare11091255] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
People living with dementia (PLWD) and their family caregivers report higher rates of having a sedentary lifestyle than their non-disabled peers do. This study analyzed the effectiveness of an intervention designed to increase physical activity among PLWD and their family caregivers in primary health care settings. A cluster-randomized multicenter clinical trial was conducted. Participants from four health centers were randomly assigned to the intervention group (IG) or the control group (CG) in a 1:1 ratio using Epidat software. After a seven-day period with a digital pedometer (Omron Hj-321 lay-UPS), participants were asked to complete the International Physical Activity Questionnaire Short Form (IPAQ-SF). PLWD and caregivers allocated to the IG were given brief advice, educational materials and an additional 15 min appointment to prescribe an individualized physical activity plan. Seventy PLWD and 80 caregivers were assigned to the CG and 70 PLWD and 96 caregivers were assigned to the IG. Results of the pedometer assessment show that in PLWD, the IG's activity increased by 52.89 aerobic steps at 6 months and the CG's activity decreased by 615.93 aerobic steps, showing a net increase in the IG of 668.82 (95% CI: -444.27 to 1781.91; p = 0.227). For caregivers in the IG, activity increased by 356.91 aerobic steps and in the CG it decreased by 12.95 aerobic steps, showing a net increase in favor of the IG of 369.86 (95%CI: -659.33 to 1399.05; p = 0.476). The effectiveness of interventions to increase physical activity in this group of people with dementia and their caregivers did not achieved positive results overall but may have provided suggestions for family physicians and physical therapists to improve physical activity among people with dementia and their families.
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Affiliation(s)
- Elena de Dios-Rodríguez
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
| | - Carmen Patino-Alonso
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
- Departamento de Estadística, Universidad de Salamanca, Calle Alfonso X el Sabio s/n, 37007 Salamanca, Spain
| | - Susana González-Sánchez
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
| | - Olaya Tamayo-Morales
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
| | - Joana Ripoll
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
- Primary Care Research Unit of Mallorca, Baleares Health Services-IbSalut, Palma, Carrer de l'Escola Graduada, 3, 07002 Palma, Spain
- Balearic Islands Health Research Institute (IdISBa), Carrer de l'Escola Graduada, 3, 07002 Palma, Spain
| | - Sara Mora-Simón
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
- Departamento de Psicología Básica, Psicobiología y Metodología de las Ciencias del Comportamiento, Campus Ciudad Jardín, Universidad de Salamanca, 37005 Salamanca, Spain
| | - Jaime Unzueta-Arce
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
- Departamento de Psicología Básica, Psicobiología y Metodología de las Ciencias del Comportamiento, Campus Ciudad Jardín, Universidad de Salamanca, 37005 Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
- Departamento de Medicina, Universidad de Salamanca, Calle Alfonso X el Sabio s/n, 37007 Salamanca, Spain
| | - Luis García-Ortiz
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
- Departamento de Ciencias Biomédicas y del Diagnóstico, Universidad de Salamanca, Calle Alfonso X el Sabio s/n, 37007 Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
- Departamento de Estadística, Universidad de Salamanca, Calle Alfonso X el Sabio s/n, 37007 Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, Calle Alfonso X el Sabio s/n, 37007 Salamanca, Spain
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Cho E, Shin J, Seok JW, Lee H, Lee KH, Jang J, Heo SJ, Kang B. The effectiveness of non-pharmacological interventions using information and communication technologies for behavioral and psychological symptoms of dementia: A systematic review and meta-analysis. Int J Nurs Stud 2023; 138:104392. [PMID: 36434931 DOI: 10.1016/j.ijnurstu.2022.104392] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 11/01/2022] [Accepted: 11/05/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Although behavioral and psychological symptoms of dementia are a global public health challenge, non-pharmacological interventions using information and communication technologies can be an affordable, cost-effective, and innovative solution. OBJECTIVES This study aimed to examine the effectiveness of non-pharmacological interventions using information and communication technologies on the behavioral and psychological symptoms of dementia and identify potential moderators of intervention effects. DESIGN Systematic review and meta-analysis of randomized controlled trials. METHODS A systematic literature review was conducted using PubMed, CINAHL, PsycINFO, Embase, and the Cochrane Library from May 2022. Randomized controlled trials that examined the effects of non-pharmacological interventions using information and communication technologies on the behavioral and psychological symptoms of dementia were included. A meta-analysis using a random-effects model was performed to calculate the pooled standardized mean differences between overall symptoms and each type of symptom. For moderator analyses, subgroup and meta-regression analyses were performed. RESULTS Sixteen trials (15 articles) met the eligibility criteria. The interventions were grouped into activity engagement interventions using digital health that provided music and reminiscence therapy, physical exercise, social interaction interventions using social robots, and telehealth-based care aid interventions that provided coaching or counseling programs. Pooled evidence demonstrated that non-pharmacological interventions using information and communication technologies exerted a large effect on depression (SMD = -1.088, 95% CI -1.983 to -0.193, p = 0.017), a moderate effect on overall behavioral and psychological symptoms of dementia (SMD = -0.664, 95% CI -0.990 to -0.338, p < 0.001), and agitation (SMD = -0.586, 95% CI -1.130 to -0.042, p = 0.035). No effects on neuropsychiatric symptoms (SMD = -0.251, 95% CI -0.579 to 0.077, p = 0.133), anxiety (SMD = -0.541, 95% CI -1.270 to 0.188, p = 0.146), and apathy (SMD = -0.830, 95% CI -1.835 to 0.176, p = 0.106) were reported. Moderator analyses identified the mean age of the participants as a potential moderator of intervention effects. CONCLUSIONS Evidence from this systematic review and meta-analysis suggests that non-pharmacological interventions, using information and communication technologies, were an applicable approach to managing behavioral and psychological symptoms among older adults with dementia, with moderate to large effect sizes. However, evidence on anxiety and apathy is inconclusive due to the limited number of existing randomized controlled trials. Future studies with subgroup analyses are warranted to conclude the most effective types of intervention using information and communication technologies for each type of symptom. REGISTRATION CRD42021258498.
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Affiliation(s)
- Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea; Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea.
| | - Jinhee Shin
- College of Nursing, Woosuk University, Jeollabuk-do, Republic of Korea.
| | - Jo Woon Seok
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea.
| | - Hyangkyu Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea; Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea.
| | - Kyung Hee Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea; Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea.
| | - Jiyoon Jang
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea.
| | - Seok-Jae Heo
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Bada Kang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea; Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea.
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Felstead C, Perkins L, Stott J, Hui EK, Spector A. A systematic literature review of group-based training interventions for informal carers: impact on the behavioural and psychological symptoms of dementia (BPSD). Aging Ment Health 2022:1-10. [PMID: 36369837 DOI: 10.1080/13607863.2022.2141193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES Caring for a relative with dementia can be extremely challenging especially when someone presents with behavioural and psychological symptoms of dementia (BPSD). The training provided to informal carers is varied and inconsistent. Group-based training programmes are often prescribed but their impact on care-recipient wellbeing and symptomology is yet to be well established. This review synthesises the literature on consensus, themes and effectiveness of informal-carer, group-based educational training programmes on BPSD symptoms. METHODS Ten papers were included of which very few considered BPSD outcomes as their primary aim of investigation. RESULTS Methodological and theoretical approaches across the empirical papers varied considerably. Generally, studies of higher quality and with some positive results on BPSD outcomes tended to incorporate teaching on structured problem-solving skills. Studies measuring for longer term changes also tended to conclude more beneficial outcomes. The length and duration of groups and the group-sizes appeared inconsequential to BPSD outcomes. CONCLUSION The empirical evidence is weak for carer group interventions in the management of BPSD. Practice reasons for this are discussed. Future studies designed to measure BPSD as a primary outcome would be a welcome addition to the literature.
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Affiliation(s)
- Cerne Felstead
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Luke Perkins
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Josh Stott
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Esther K Hui
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Aimee Spector
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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8
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Ghosh M, Dunham M, O'Connell B. Systematic review of dyadic psychoeducational programs for persons with dementia and their family caregivers. J Clin Nurs 2022. [DOI: 10.1111/jocn.16570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/02/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Manonita Ghosh
- School of Nursing and Midwifery Edith Cowan University Joondalup Western Australia Australia
| | - Melissa Dunham
- School of Nursing and Midwifery Edith Cowan University Joondalup Western Australia Australia
| | - Beverly O'Connell
- School of Nursing and Midwifery Edith Cowan University Joondalup Western Australia Australia
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9
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Saragih ID, Tonapa SI, Porta CM, Lee BO. Effects of telehealth intervention for people with dementia and their carers: A systematic review and meta-analysis of randomized controlled studies. J Nurs Scholarsh 2022; 54:704-719. [PMID: 35769007 DOI: 10.1111/jnu.12797] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 05/25/2022] [Accepted: 06/11/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Interventions delivered using telehealth modalities are becoming standard practice with patient populations around the world, partly because of innovation necessitated by the COVID-19 pandemic and partly due to improved infrastructure and comfort of providers, patients, and families, through technology. Though increasingly utilized, the effectiveness of telehealth interventions with families with dementia remains unclear. This gives rise to the need for investigation to develop telehealth interventions that are evidence based and not merely convenient tools. This current study is designed to systematically examine the impact and effectiveness of telehealth-delivered psychoeducational and behavioral interventions among persons with dementia and their caregivers. DESIGN The design combines systematic review and meta-analysis. METHODS A total of eight databases were electronically accessed and searched as of November 16, 2021. Experimental studies identifying the results of telehealth interventions for persons with dementia and associated caregivers published in English have been reviewed in this study. Standardized mean differences (SMD) offering 95% confidence intervals (CI) were developed to pool the effect size using a random effects model (in this case, Stata 16.0). The Revised Cochrane Risk-of-Bias Tool for Randomized Trials (RoB-2) was used to analyze the study's methodological soundness. FINDINGS Nineteen cases met the eligibility criteria (including 1379 persons with dementia and 1339 caregivers). Overall, telehealth interventions demonstrated effects in the expected directions on depression (SMD -0.63; 95% degree of confidence intervals (CI) -0.88 to -0.38, p < 0.001); and caregivers' perceived competency (SMD 0.27; 95% CI -0.05 to 0.50, p = 0.02). There were, however, no statistically significant effects observed on cognitive function or multiple aspects of quality of life for subjects. CONCLUSIONS Telehealth interventions appear to effect a reduction in depression among persons diagnosed with dementia while improving the perceived competency of caregivers. CLINICAL RELEVANCE The study's results could be used as evidence of the effectiveness of using telehealth for persons with dementia and their caregivers, including contextualizing where they are used (i.e., long-term care facilities, private homes, etc.), understanding the mechanisms in play (including intervention delivery and systems), and isolating and identifying mediating influences.
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Affiliation(s)
| | - Santo Imanuel Tonapa
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,School of Nursing, Sam Ratulangi University, Manado, Indonesia
| | - Carolyn M Porta
- School of Nursing, University of Minnesota, Minneapolis, USA
| | - Bih-O Lee
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
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10
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Nkodo JA, Gana W, Debacq C, Aidoud A, Poupin P, Camus V, Fougère B. The Role of Telemedicine in the Management of the Behavioral and Psychological Symptoms of Dementia: A Systematic Review. Am J Geriatr Psychiatry 2022; 30:1135-1150. [PMID: 35241355 DOI: 10.1016/j.jagp.2022.01.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 01/25/2023]
Abstract
The first-line management of behavioral and psychological symptoms of dementia (BPSD) is based on nonpharmacologic interventions such as the provision of guidance and medical support to caregivers. However, accessibility to specialized care and medical resources is often scarce. The ongoing COVID-19 pandemic has compromised the delivery of outpatient care (notably in order to minimize the risk of disease transmission), thus making it essential to provide other means of accessing care for these patient populations. The use of telemedicine (TM) may be a means of increasing access to specialist care for patients with disabilities and poor access to health services, such as those with BPSD. The aim of this study is to provide a review of the literature on the use of TM for treatment and follow-up of patients with BPSD and their caregivers. We searched the PUBMED, EMBASE and CINAHL for articles published between January 1st, 2000, and December 31st, 2020, on the applicability of TM support for people with BPSD and their caregivers. We included open-label studies, qualitative studies, and randomized controlled trials . We did not include studies on the use of TM during the COVID-19 pandemic. A total of 22 publications were included and reviewed. TM was found to 1) be acceptable and feasible for both patients and caregivers, 2) decrease the frequency and intensity of BPSD, and 3) improve the caregiver's perceived wellbeing and mental health. Videoconferencing was effective for patient-centered interventions in nursing homes. Telephone-based interventions were more relevant when they were targeted at caregivers. The published studies are lacking in scope and high-quality studies are now needed to confirm these findings and assess TM's cost-effectiveness and ability to improve the management of patients with BPSD. In view of the ongoing COVID-19 pandemic, remote solutions for assessing and monitoring individuals with BPSD are urgently needed - particularly those living in rural areas and so-called "medical deserts."
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Affiliation(s)
- Jacques-Alexis Nkodo
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France; Service de Psychiatrie Universitaire (JAN, VC), CHRU Tours, Tours, France.
| | - Wassim Gana
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France
| | - Camille Debacq
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France
| | - Amal Aidoud
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France
| | - Pierre Poupin
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France
| | - Vincent Camus
- Service de Psychiatrie Universitaire (JAN, VC), CHRU Tours, Tours, France; UMR INSERM U1253 & Université de Tours (VC), Tours, France
| | - Bertrand Fougère
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France; Education, Ethics, Health (EA 7505) (BF), Tours University, Tours, France
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11
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Huang SS. Depression among caregivers of patients with dementia: Associative factors and management approaches. World J Psychiatry 2022; 12:59-76. [PMID: 35111579 PMCID: PMC8783169 DOI: 10.5498/wjp.v12.i1.59] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/29/2021] [Accepted: 11/30/2021] [Indexed: 02/06/2023] Open
Abstract
As elderly people increasingly come to represent a higher proportion of the world’s population, various forms of dementia are becoming a significant chronic disease burden. The World Health Organization emphasizes dementia care as a public health priority and calls for more support for family caregivers who commonly play a significant, central role in dementia care. Taking care of someone with dementia is a long-term responsibility that can be stressful and may lead to depression among family caregivers. Depression and related behavioral and cognitive changes among caregivers could in turn affect the status and prognosis of the dementia patient. This review article explores depression in dementia caregivers and summarizes proposed mechanisms, associated factors, management and research findings, and proposes future research directions.
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Affiliation(s)
- Si-Sheng Huang
- Division of Geriatric Psychiatry, Department of Psychiatry, Changhua Christian Hospital, Changhua 500, Taiwan
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12
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Tan JRO, Boersma P, Ettema TP, Aëgerter L, Gobbens R, Stek ML, Dröes RM. Known in the nursing home: development and evaluation of a digital person-centered artistic photo-activity intervention to promote social interaction between residents with dementia, and their formal and informal carers. BMC Geriatr 2022; 22:25. [PMID: 34991472 PMCID: PMC8733433 DOI: 10.1186/s12877-021-02632-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/15/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND To address the lack of social interaction and meaningful activities for persons with dementia (PWD) in nursing homes an artistic Photo-Activity was designed. The present study aims to develop a digital version of the Photo-Activity and to investigate its implementation and impact on nursing home residents with advanced dementia, and their (in)formal carers. METHODS First, within a user-participatory design, a digital-app version of the Photo-Activity will be developed and pilot-tested, in co-creation with (in)formal carers and PWD. Next, the feasibility and effectiveness of the Photo-Activity versus a control activity will be explored in a randomized controlled trial with nursing home residents (N=90), and their (in)formal carers. Residents will be offered the Photo-Activity or the control activity by (in)formal carers during one month. Measurements will be conducted by independent assessors at baseline (T0), after one month (T1) and at follow up, two weeks after T1 (T2). Qualitative and quantitative methods will be used to investigate the effects of the intervention on mood, social interaction and quality of life of the PWD, sense of competence of informal carers, empathy and personal attitude of the formal carers, and quality of the relationship between the PWD, and their (in)formal carers. In addition, a process evaluation will be carried out by means of semi-structured interviews with the participating residents and (in)formal carers. Finally, an implementation package based on the process evaluation will be developed, allowing the scaling up of the intervention to other care institutions. DISCUSSION Results of the trial will be available for dissemination by Spring 2023. The digital Photo-Activity is expected to promote meaningful connections between the resident with dementia, and their (in)formal carers through the facilitation of person-centered conversations. TRIAL REGISTRATION Netherlands Trial Register: NL9219 ; registered (21 January 2021); NTR (trialregister.nl).
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Affiliation(s)
- Josephine Rose Orejana Tan
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc /Amsterdam Public Health Research institute, Amsterdam, The Netherlands.
| | - Petra Boersma
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, The Netherlands
| | - Teake P Ettema
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc /Amsterdam Public Health Research institute, Amsterdam, The Netherlands
| | | | - Robbert Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, The Netherlands.,Zonnehuisgroep Amstelland, Amstelveen, The Netherlands.,Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Max L Stek
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc /Amsterdam Public Health Research institute, Amsterdam, The Netherlands.,Department of Old Age Psychiatry, Regional Mental Health organization GGZ inGeest, Amsterdam, Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc /Amsterdam Public Health Research institute, Amsterdam, The Netherlands
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13
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Hill TG, Langley JE, Kervin EK, Pesut B, Duggleby W, Warner G. An Integrative Review on the Feasibility and Acceptability of Delivering an Online Training and Mentoring Module to Volunteers Working in Community Organizations. Front Digit Health 2021; 3:688982. [PMID: 34723241 PMCID: PMC8551809 DOI: 10.3389/fdgth.2021.688982] [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: 05/18/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Volunteer programs that support older persons can assist them in accessing healthcare in an efficient and effective manner. Community-based initiatives that train volunteers to support patients with advancing illness is an important advance for public health. As part of implementing an effective community-based volunteer-based program, volunteers need to be sufficiently trained. Online training could be an effective and safe way to provide education for volunteers in both initial training and/or continuing education throughout their involvement as a volunteer. Method: We conducted an integrative review that synthesized literature on online training programs for volunteers who support older adults. The review included both a search of existing research literature in six databases, and an online search of online training programs currently being delivered in Canada. The purpose of this review was to examine the feasibility and acceptability of community-based organizations adopting an online training format for their volunteers. Results: The database search identified 13,626 records, these went through abstract and full text screen resulting in a final 15 records. This was supplemented by 2 records identified from hand searching the references, for a total of 17 articles. In addition to identifying Volunteers Roles and Responsibilities; Elements of Training; and Evaluation of Feasibility and Acceptability; a thematic analysis of the 17 records identified the categories: (1) Feasibility Promoting Factors; (2) Barriers to Feasibility; (3) Acceptability Promoting Factors; and (4) Barriers to Acceptability. Six programs were also identified in the online search of online training programs. These programs informed our understanding of delivery of existing online volunteer training programs. Discussion: Findings suggested that feasibility and acceptability of online training were promoted by (a) topic relevant training for volunteers; (b) high engagement of volunteers to prevent attrition; (c) mentorship or leadership component. Challenges to online training included a high workload; time elapsed between training and its application; and client attitude toward volunteers. Future research on online volunteer training should consider how online delivery can be most effectively paced to support volunteers in completing training and the technical skills needed to complete the training and whether teaching these skills can be integrated into programs.
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Affiliation(s)
- Taylor G Hill
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Jodi E Langley
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Emily K Kervin
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Barbara Pesut
- Nursing, University of British Columbia, Okanagan, BC, Canada
| | | | - Grace Warner
- School of Occupational Therapy, Dalhousie University, Halifax, NS, Canada
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14
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Effects of e-Health Training and Social Support Interventions for Informal Caregivers of People with Dementia-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157728. [PMID: 34360020 PMCID: PMC8345641 DOI: 10.3390/ijerph18157728] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 01/11/2023]
Abstract
Along with the burden commonly experienced by informal caregivers (ICs) of people with dementia (PwD), associated with the progressive decline that accompanies dementia, the lockdown due to the public health crisis has had a great negative impact on the emotional wellbeing, physical health, and social relationships of ICs. Support interventions through telemedicine represent an opportunity for ICs to learn the skills required for the care and maintenance of social networks. In this work, a narrative review of the effects of e-health training and social support interventions was carried out. A literature search was conducted using the ProQuest, Ovid, and Scopus databases. Information regarding social support (SS), psychological interventions, and training for the management of medications and behavioral changes was extracted. One hundred and nine studies were included in this review. Forums and training platforms were the main tools for ICs. The most effective platforms to improve SS include the participation of both ICs and health professionals. However, no significant improvements in objective caring skills were identified. Platforms developed specifically for ICs should be based in tools that ICs are familiar with, because many ICs have not yet incorporated Information and Communication Technologies in many activities of their daily lives. Education in the digitalization to ICs of PwD should be one of the priority objectives in telehealth interventions.
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15
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Neal DP, Kerkhof YJF, Ettema TP, Muller M, Bosmans J, Finnema E, Graff M, Dijkstra K, Stek ML, Dröes RM. Evaluation of FindMyApps: protocol for a randomized controlled trial of the effectiveness and cost-effectiveness of a tablet-based intervention to improve self-management and social participation of community-dwelling people with mild dementia, compared to usual tablet use. BMC Geriatr 2021; 21:138. [PMID: 33627069 PMCID: PMC7903400 DOI: 10.1186/s12877-021-02038-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 01/19/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND For the rising number of people living with dementia, cost-effective community-based interventions to support psychosocial care are needed. The FindMyApps intervention has been developed with and for people with dementia and their caregivers, to help them use tablets to facilitate self-management and engagement in meaningful social activities. A feasibility study and exploratory pilot trial evaluating FindMyApps have been carried out. This definitive trial further evaluates the effectiveness of the intervention and, for the first time, the cost-effectiveness. METHODS A randomized controlled non-blinded single-center two-arm superiority trial will be conducted. Community-dwelling people with Mild Cognitive Impairment (MCI), or dementia with a Mini Mental-State Examination (MMSE) of > 17 and < 26, or Global Deterioration Scale 3 or 4, with an informal caregiver and access to a wireless internet connection will be included. In total, 150 patient-caregiver dyads will be randomly allocated to receive either usual care (control arm - tablet computer; n = 75 dyads) or usual care and the FindMyApps intervention (experimental arm - tablet computer and FindMyApps; n = 75 dyads). The primary outcomes are: for people with dementia, self-management and social participation; for caregivers, sense of competence. In addition to a main effect analysis, a cost-effectiveness analysis will be performed. In line with MRC guidance for evaluation of complex interventions a process evaluation will also be undertaken. DISCUSSION Results of the trial are expected to be available in 2023 and will be submitted for publication in international peer-reviewed scientific journals, in addition to conference presentations and reporting via the EU Marie Sklodowska-Curie DISTINCT ITN network. By providing evidence for or against the effectiveness and cost-effectiveness of the FindMyApps intervention, the results of the trial will influence national implementation of FindMyApps. We hope that the results of the trial will further stimulate research and development at the intersection of technology and psycho-social care in dementia. We hope to further demonstrate that the randomized controlled trial is a valuable and feasible means of evaluating new digital technologies, to stimulate further high-quality research in this growing field. TRIAL REGISTRATION NUMBER Netherlands Trial Register: NL8157 ; registered 15th November 2019.
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Affiliation(s)
- David Peter Neal
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc, Amsterdam, Netherlands
| | | | - Teake P Ettema
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc, Amsterdam, Netherlands
| | - Majon Muller
- Department of Internal Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Judith Bosmans
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Evelyn Finnema
- University Medical Centre Groningen, Groningen, Netherlands
| | - Maud Graff
- Radboud University Medical Centre, Nijmegen, Netherlands
| | - Karin Dijkstra
- Saxion University of Applied Sciences, Deventer, Netherlands
| | - Max L Stek
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc, Amsterdam, Netherlands
- Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc, Amsterdam, Netherlands.
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