Gaugler Joseph E, Reese Mark, Tanler Richard
Center on Aging, School of Nursing, University of Minnesota, Minneapolis.
Families and LTC Projects, School of Nursing, University of Minnesota, Minneapolis.
Gerontologist. 2016 Dec;56(6):1161-1174. doi: 10.1093/geront/gnv150. Epub 2015 Nov 23.
Even with the advent of evidence-based interventions, an ongoing concern in clinical practice is how to help dementia caregivers determine what type of support is best for them absent a laborious process of trial and error. To help address this practice gap, the present study developed and tested the feasibility of "Care to Plan" (CtP), an online resource for dementia caregivers (e.g., relatives or unpaid nonrelatives) that generates tailored support recommendations.
Care to Plan was developed using an iterative prototype and testing process with the assistance of a 29-member Community Advisory Board. A parallel-convergent mixed methods design (quan + QUAL) was used that included a post-CtP survey and a brief semistructured interview to capture in-depth information on the utility and feasibility of CtP. The sample included 30 caregivers of persons with dementia.
The integrated qualitative and quantitative data indicated that CtP was simple and easy to understand, the streamlined visual layout facilitated utility, and the individualized recommendations could meet the needs of users. Key barriers to use included the need for additional features (e.g., video introductions of caregiver support types) to further guide dementia caregivers' potential use of tailored support.
The multiple data sources underscore the high feasibility and utility of CtP. By describing, identifying, and prioritizing support, CtP could help to improve the care planning process for dementia caregivers. Future dissemination efforts should aim to demonstrate how CtP can be implemented seamlessly within current family caregiver support systems.
即使循证干预措施已经出现,但临床实践中一直存在的一个问题是,如何在不经过繁琐的反复试验过程的情况下,帮助痴呆症患者的照料者确定哪种类型的支持最适合他们。为了填补这一实践空白,本研究开发并测试了“Care to Plan”(CtP)的可行性,这是一个为痴呆症患者照料者(如亲属或无报酬的非亲属)提供的在线资源,可生成量身定制的支持建议。
在一个由29名成员组成的社区咨询委员会的协助下,通过迭代原型和测试过程开发了Care to Plan。采用了平行收敛混合方法设计(quan + QUAL),包括CtP使用后的调查和一次简短的半结构化访谈,以获取关于CtP的实用性和可行性的深入信息。样本包括30名痴呆症患者的照料者。
综合定性和定量数据表明,CtP简单易懂,简化的视觉布局便于使用,个性化建议能够满足用户需求。使用的主要障碍包括需要额外的功能(如照料者支持类型的视频介绍),以进一步指导痴呆症患者照料者对量身定制支持的潜在使用。
多个数据源强调了CtP的高度可行性和实用性。通过描述、识别支持并确定其优先级,CtP有助于改善痴呆症患者照料者的护理计划过程。未来的推广工作应旨在展示如何在当前的家庭照料者支持系统中无缝实施CtP。