Department of Human Development and Family Studies, Penn State University, University Park, PA, USA.
Aging Ment Health. 2013;17(2):197-206. doi: 10.1080/13607863.2012.717252. Epub 2012 Sep 4.
There has been growing interest in providing tailored or adaptive interventions to family caregivers as a way of addressing their heterogeneity of risk factors and other needs. A particular challenge in an adaptive study is to implement the individualized intervention protocol as planned (program fidelity). This study explores the fidelity of implementation of an adaptive intervention for family caregivers of persons with dementia and its acceptability to caregivers.
Using a sample of 35 caregivers of person with dementia who participated in a program development study, we gathered information on acceptability and fidelity of the program from multiple sources, including caregiver and counselor reports and ratings of recordings of sessions.
Findings show that caregivers have high levels of acceptance of the intervention plan and high ratings of satisfaction with the program. Ratings of satisfaction and counselor competence were not associated with the amount of treatment provided. Ratings by counselors and independent raters found good fidelity for two of the three program domains.
The results demonstrate that trained counselors can follow a tailored intervention plan and that caregivers' experience of the program did not differ depending on how much intervention was provided. A next step is to determine how an adaptive protocol would affect caregiver outcomes.
为家庭照顾者提供量身定制或适应性干预措施的兴趣日益浓厚,这是解决他们的风险因素和其他需求异质性的一种方式。在适应性研究中,一个特殊的挑战是按照计划实施个性化干预方案(方案保真度)。本研究探讨了为痴呆症患者的家庭照顾者提供适应性干预措施的实施保真度及其对照顾者的可接受性。
使用 35 名参与方案开发研究的痴呆症患者照顾者的样本,我们从多个来源收集了有关方案可接受性和保真度的信息,包括照顾者和顾问的报告以及对会议录音的评分。
研究结果表明,照顾者对干预计划的接受程度很高,对方案的满意度评价也很高。满意度评分和顾问能力评分与提供的治疗量无关。顾问和独立评估者的评分发现,三个方案领域中的两个具有良好的保真度。
结果表明,经过培训的顾问可以遵循量身定制的干预计划,而且照顾者对方案的体验并不取决于提供多少干预。下一步是确定适应性方案如何影响照顾者的结果。