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Sun Y, Leng M, Lu W, Li B, Lv F, Zhang W, Wang Z. A knowledge graph-based recommender system for dementia care: Design and evaluation study. Int J Med Inform 2024; 191:105554. [PMID: 39079317 DOI: 10.1016/j.ijmedinf.2024.105554] [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: 07/20/2023] [Revised: 04/25/2024] [Accepted: 07/14/2024] [Indexed: 09/07/2024]
Abstract
BACKGROUND Caring for people with dementia is perceived as one of the most challenging caring roles, so effective and practical support is essential. One such innovative approach to internet-based tailored health intervention is the use of recommender system. OBJECTIVE This study develops a dementia care intelligent recommender system (DCIRS) that can provide personalized and timely care recommendations for caregivers when they encounter difficult various care problems in people with dementia. METHODS The development process was divided into 3 stages. In stage 1, we complete the construction of the domain knowledge graph of dementia care. In stage 2, the established domain knowledge graph of dementia care was introduced into the recommendation model by the way of graph embedding to form a recommendation model composed of graph embedding module and recommendation module. In stage 3, on the basis of the application of knowledge graph and recommendation mode, DCIRS was developed, for practical use. In addition, DCIRS has been validated for accuracy for assessing the correctness of the profiling and recommendation, by enrolling 56 caregivers. RESULTS The proposed DCIRS has functions of knowledge graph management and dementia care decision support. Experiments on 56 caregivers in single class recommendation task; the value of accuracy is equals to 98.92% and indicates the high capability of DCIRS. CONCLUSIONS This study was a pioneering research to develop a more comprehensive DCIRS for caregivers of people with dementia. According to the evaluation results, our DCIRS showing high specificity and accuracy. This system can provide a novel perspective for patient-centered and needs-based support of caregivers of people with dementia.
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Affiliation(s)
- Yue Sun
- School of Nursing, Peking University, Beijing, China; Peking University Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Affiliated Group, Beijing, China
| | - Minmin Leng
- Department of Nursing, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Weihua Lu
- China Electronics Engineering Design Institute Co., Ltd, China
| | - Baihe Li
- China Electronics Engineering Design Institute Co., Ltd, China
| | - Feifei Lv
- China Electronics Engineering Design Institute Co., Ltd, China
| | - Wenmin Zhang
- School of Nursing, Peking University, Beijing, China; Peking University Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Affiliated Group, Beijing, China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, China; Peking University Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Affiliated Group, Beijing, China.
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2
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Brown P, Burton A, Ayden J, Harrison Dening K, Hoe J, Cooper C. Specialist dementia nursing models and impacts: a systematic review. Curr Opin Psychiatry 2023; 36:376-390. [PMID: 37191653 DOI: 10.1097/yco.0000000000000874] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE OF REVIEW Dementia policy priorities recommend that people who are living with dementia and their family should have access to support and interventions delivered by dementia specialists, including specialist nurses. However, specialist dementia nursing models and role-related competencies are not clearly defined. We systematically review the current evidence regarding specialist dementia nursing models and their impacts. RECENT FINDINGS Thirty-one studies from across three databases, and grey literature were included in the review. One framework defining specific specialist dementia nursing competencies was found. We did not find convincing evidence of the effectiveness of specialist nursing dementia services, relative to standard models of care from the current, limited evidence base, although families living with dementia valued it. No Randomised Controlled Trial (RCT) has compared the impact of specialist nursing on client and carer outcomes relative to less specialist care, although one nonrandomised study reported that specialist dementia nursing reduces emergency and inpatient service use compared with a usual care group. SUMMARY Current models of specialist dementia nursing are numerous and heterogeneous. Further exploration of the specialist nursing skills and the impact of specialist nursing interventions is needed to usefully inform workforce development strategies and clinical practice.
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Affiliation(s)
- Pat Brown
- Division of Psychiatry, University college London, and Dementia UK
| | | | - Jordan Ayden
- Division of Psychiatry, University College London
| | - Karen Harrison Dening
- Faculty of Health and Life Sciences, De Montfort University, Leicester, and Dementia UK
| | - Juanita Hoe
- Geller Institute of Ageing and Memory (GIAM), University of West London
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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3
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Wyman DL, Butler L, Bright P, Morgan‐Trimmer S, Budgett J, Cooper C. A systematic review of process evaluations for psychosocial interventions designed to improve the wellbeing and quality of life of community-dwelling people with dementia and their carers. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5828. [PMID: 36317287 PMCID: PMC9827886 DOI: 10.1002/gps.5828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 10/16/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Psychosocial interventions improve the wellbeing and quality of life of People Living with Dementia (PLWD) and their family carers; but due to their complexity it can be challenging to identify mechanisms of action. We reviewed process evaluations that have sought to elucidate how these interventions work, to inform their implementation. METHOD We systematically reviewed process evaluations of studies evaluating psychosocial interventions for PLWD in their own home and/or their family carers. We rated study quality using the Mixed Methods Appraisal Tool. We described, with reference to Medical Research Council (2015) process evaluation guidance, how implementation, mechanisms of impact and contextual factors were investigated; and describe commonalities in the mechanisms of action identified across studies. RESULTS Twenty four included studies evaluated the processes of 22 interventions. These studies collectively applied five frameworks; almost all frameworks' advised evaluations were theory-based and used mixed-methods analyses, but only 5/24 evaluation designs were informed by the intervention theory and 8/24 used mixed methods. 8/24 evaluations considered contextual factors in their design, though 20/24 cited contextual factors in findings. Interventions were more successful where PLWD were motivated and aware of potential benefits, and when carers could support engagement and were themselves supported by the intervention. How the intervention aligned with participants' current needs and stage of dementia were key influencing factors. CONCLUSION Knowing how interventions can influence change for community-dwelling people with dementia and their family carer's will improve translation of trial findings into practice. Robust, theory-driven process evaluations can enable this.
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Yuan S, Zhang W, Yao Q, Lü W, Yu W, Zhong F, Wang Y, Xing D, Wang X, Song J, Huang H, Chen C, Liu J, Yu W, Lü Y. The Neuropsychiatric Changes After COVID-19 Quarantine in Patients With Cognitive Impairment and Their Caregivers in Chongqing, China: A Cohort Study. Front Aging Neurosci 2022; 13:762907. [PMID: 35221981 PMCID: PMC8868570 DOI: 10.3389/fnagi.2021.762907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/29/2021] [Indexed: 12/14/2022] Open
Abstract
BackgroundThe follow-up study on neuropsychiatric changes after the lifting of coronavirus disease 2019 (COVID-19) quarantine in patients with cognitive impairment and their caregivers is still lacking, and relative information is needed to formulate more comprehensive healthcare prevention measures worldwide.AimsTo provide data on the changes in neuropsychiatric performance after the lifting of COVID-19 quarantine in patients with cognitive disorders and their caregivers.MethodsTwo surveys in Chongqing, China were conducted via telephonic interview with 531 patients and their caregivers. The baseline survey was performed from February 11 to 23, 2020, and the follow-up was from October 24 to November 9, 2020. The data of neuropsychiatric symptoms (NPSs), sleep, nutrition, and chronic diseases of patients, as well as the burden of care, anxiety, and depression of caregivers were evaluated.ResultsSignificant alleviation of NPSs after the lifting of COVID-19 quarantine was observed in patients with mild cognitive impairment (MCI) and dementia (both P < 0.05). Compared with baseline, the prevalence for NPSs of all participants dropped from 57.94 to 38.82%. Among NPS subdomains, apathy displayed the biggest decline at follow-up by 10.72%, followed by nighttime behavior by 8.65%. Mixed effect generalized estimation equation analysis showed significant amelioration in hallucination, depression, apathy, irritability, aberrant motor behavior, and nighttime behavior (all P < 0.05), with the most prominent changes in nighttime behavior and apathy. Among the patients with unsatisfactory control of chronic disease, the medication adherence rate dropped by approximately 30% after the lifting of quarantine. More importantly, around 13% increase of care burden was observed among the caregivers at follow-up, with both depression and anxiety rising by nearly 4%.ConclusionThe prolonged quarantine may exacerbate NPS in patients with memory disorders, while the care burden and mental stability of the caregivers after the pandemic should also be concerned.
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Affiliation(s)
- Shiyun Yuan
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenbo Zhang
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiang Yao
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
| | - Wenqi Lü
- Department of Psychiatry, West China Hospital, Sichuan University, Sichuan, China
| | - Wuhan Yu
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fuxin Zhong
- Institutes of Neuroscience, Chongqing Medical University, Chongqing, China
| | - Yan Wang
- Foreign Language College, Chongqing Medical University, Chongqing, China
| | - Dianxia Xing
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoqin Wang
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiaqi Song
- Institutes of Neuroscience, Chongqing Medical University, Chongqing, China
| | - Hong Huang
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chenxi Chen
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Junjin Liu
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Weihua Yu
- Institutes of Neuroscience, Chongqing Medical University, Chongqing, China
| | - Yang Lü
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Yang Lü,
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Sun Y, Ji M, Leng M, Li X, Zhang X, Wang Z. Comparative efficacy of 11 non-pharmacological interventions on depression, anxiety, quality of life, and caregiver burden for informal caregivers of people with dementia: A systematic review and network meta-analysis. Int J Nurs Stud 2022; 129:104204. [DOI: 10.1016/j.ijnurstu.2022.104204] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 12/21/2022]
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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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Leng M, Zhao Y, Xiao H, Li C, Wang Z. Internet-Based Supportive Interventions for Family Caregivers of People With Dementia: Systematic Review and Meta-Analysis. J Med Internet Res 2020; 22:e19468. [PMID: 32902388 PMCID: PMC7511858 DOI: 10.2196/19468] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 06/25/2020] [Accepted: 07/26/2020] [Indexed: 12/14/2022] Open
Abstract
Background Caring for people with dementia is perceived as one of the most stressful and difficult forms of caring. Family caregivers always experience high levels of psychological burden and physical strain, so effective and practical support is essential. Internet-based supportive interventions can provide convenient and efficient support and education to potentially reduce the physical and psychological burden associated with providing care. Objective This review aimed to (1) assess the efficacy of internet-based supportive interventions in ameliorating health outcomes for family caregivers of people with dementia, and (2) evaluate the potential effects of internet-based supportive intervention access by caregivers on their care recipients. Methods An electronic literature search of the PubMed, EMBASE, Web of Science, CINAHL, Cochrane Library, and PsycINFO databases was conducted up to January 2020. Two reviewers (ML and YZ) worked independently to identify randomized controlled trials (RCTs) that met the inclusion criteria and independently extracted data. The quality of the included RCTs was evaluated using the approach recommended by the Cochrane Handbook for Systematic Reviews of Interventions. Standardized mean differences (SMDs) with 95% CIs were applied to calculate the pooled effect sizes. Results In total, 17 RCTs met the eligibility criteria and were included in this systematic review. The meta-analysis showed that internet-based supportive interventions significantly ameliorated depressive symptoms (SMD=–0.21; 95% CI –0.31 to –0.10; P<.001), perceived stress (SMD=–0.40; 95% CI –0.55 to –0.24; P<.001), anxiety (SMD=–0.33; 95% CI –0.51 to –0.16; P<.001), and self-efficacy (SMD=0.19; 95% CI 0.05-0.33; P=.007) in dementia caregivers. No significant improvements were found in caregiver burden, coping competence, caregiver reactions to behavioral symptoms, or quality of life. Six studies assessed the unintended effects of internet-based supportive intervention access by caregivers on their care recipients. The results showed that internet-based supportive interventions had potential benefits on the quality of life and neuropsychiatric symptoms in care recipients. Conclusions Internet-based supportive interventions are generally effective at ameliorating depressive symptoms, perceived stress, anxiety, and self-efficacy in dementia caregivers and have potential benefits on care recipients. Future studies are encouraged to adopt personalized internet-based supportive interventions to improve the health of family caregivers and their care recipients. Trial Registration PROSPERO CRD42020162434; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=162434
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Affiliation(s)
- Minmin Leng
- School of Nursing, Peking University, Beijing, China.,Peking University Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Affiliated Group, Beijing, China
| | - Yajie Zhao
- School of Nursing, Peking University, Beijing, China.,Peking University Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Affiliated Group, Beijing, China
| | - Hongmei Xiao
- School of Nursing, Peking University, Beijing, China.,Peking University Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Affiliated Group, Beijing, China
| | - Ce Li
- School of Nursing, Peking University, Beijing, China.,Peking University Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Affiliated Group, Beijing, China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, China.,Peking University Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Affiliated Group, Beijing, China
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8
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Huis In Het Veld JG, Willemse BM, van Asch IF, Groot Zwaaftink RB, Verkade PJ, Twisk JW, Verkaik R, Blom MM, van Meijel B, Francke AL. Online Self-Management Support for Family Caregivers Dealing With Behavior Changes in Relatives With Dementia (Part 2): Randomized Controlled Trial. J Med Internet Res 2020; 22:e13001. [PMID: 32130142 PMCID: PMC7064946 DOI: 10.2196/13001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 07/19/2019] [Accepted: 09/26/2019] [Indexed: 01/19/2023] Open
Abstract
Background Online contacts with a health professional have the potential to support family caregivers of people with dementia. Objective The goal of the research was to study the effects of an online self-management support intervention in helping family caregivers deal with behavior changes of a relative with dementia. The intervention—involving among others personal email contacts with a dementia nurse—was compared with online interventions without these email contacts. Methods A randomized controlled trial was conducted with 81 family caregivers of people with dementia who live at home. Participants were randomly assigned to a (1) major self-management support intervention consisting of personal email contacts with a specialist dementia nurse, online videos, and e-bulletins; (2) medium intervention consisting only of online videos and e-bulletins; or (3) minor intervention consisting of only the e-bulletins. The primary outcome was family caregivers’ self-efficacy in dealing with behavior changes of the relative with dementia. Secondary outcomes were family caregivers’ reports of behavior problems in the people with dementia and the quality of the relationship between the family caregiver and the person with dementia. Measurements were performed at the baseline and at 6 (T1) and 12 weeks (T2) after the baseline. A mixed-model analysis was conducted to compare the outcomes of the 3 intervention arms. Results Family caregivers participating in the major intervention involving email contacts showed no statistically significant differences in self-efficacy after the intervention compared with the minor intervention involving only e-bulletins (difference –0.02, P=.99). In the adjusted analysis, the medium intervention (involving videos and e-bulletins) showed a negative trend over time (difference –4.21, P=.09) and at T1 (difference –4.71, P=.07) compared with the minor intervention involving only e-bulletins. No statistical differences were found between the intervention arms in terms of the reported behavior problems and the quality of the relationship between the family caregiver and the person with dementia. Conclusions The expectation that an online self-management support intervention involving email contacts would lead to positive effects and be more effective than online interventions without personal email contacts was not borne out. One explanation might be related to the fact that not all family caregivers who were assigned to that intervention actually made use of the opportunity for personal email contact. The online videos were also not always viewed. To obtain more definite conclusions, future research involving extra efforts to reach higher use rates is required. Trial Registration Netherlands Trial Registry NTR6237; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6237 (Archived by WebCite at http://www.webcitation.org/6v0S4fxTC) International Registered Report Identifier (IRRID) RR2-10.2196/resprot.8365
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Affiliation(s)
- Judith G Huis In Het Veld
- Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Bernadette M Willemse
- Netherlands Institute of Mental Health and Addiction, Trimbos Institute, Utrecht, Netherlands
| | - Iris Fm van Asch
- Netherlands Institute of Mental Health and Addiction, Trimbos Institute, Utrecht, Netherlands
| | | | | | - Jos Wr Twisk
- Department of Clinical Epidemiology and Biostatistics, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Renate Verkaik
- Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Marco M Blom
- Dutch Alzheimer's Society, Amersfoort, Netherlands
| | - Berno van Meijel
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Inholland University of Applied Sciences, Amsterdam, Netherlands.,Parnassia Psychiatric Institute, The Hague, Netherlands.,Academy for Masters in Advanced Nursing Science, Utrecht, Netherlands
| | - Anneke L Francke
- Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Netherlands Institute for Health Services Research, Utrecht, Netherlands
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