狂想曲——为早发性痴呆患者的照顾者提供基于互联网的支持:一项试点研究的项目设计与方法
RHAPSODY - Internet-based support for caregivers of people with young onset dementia: program design and methods of a pilot study.
作者信息
Kurz Alexander, Bakker Christian, Böhm Markus, Diehl-Schmid Janine, Dubois Bruno, Ferreira Catarina, Gage Heather, Graff Caroline, Hergueta Thierry, Jansen Sabine, Jones Bridget, Komar Alexander, de Mendonça Alexandre, Metcalfe Anna, Milecka Katrina, Millenaar Joany, Orrung Wallin Anneli, Oyebode Jan, Schneider-Schelte Helga, Saxl Susanna, de Vugt Marjolein
机构信息
Department of Psychiatry and Psychotherapy,Klinikum rechts der Isar,Technische Universität München,Munich,Germany.
School for Mental Health and Neuroscience,Alzheimer Center Limburg,Maastricht University Medical Center,Maastricht,the Netherlands.
出版信息
Int Psychogeriatr. 2016 Dec;28(12):2091-2099. doi: 10.1017/S1041610216001186. Epub 2016 Aug 30.
BACKGROUND
Young Onset Dementia (YOD), defined by first symptoms of cognitive or behavioral decline occurring before the age of 65 years, is relatively rare compared to dementia of later onset, but it is associated with diagnostic difficulty and heavy burden on affected individuals and their informal carers. Existing health and social care structures rarely meet the needs of YOD patients. Internet-based interventions are a novel format of delivering health-related education, counseling, and support to this vulnerable yet underserved group.
METHODS
The RHAPSODY (Research to Assess Policies and Strategies for Dementia in the Young) project is a European initiative to improve care for people with YOD by providing an internet-based information and skill-building program for family carers. The e-learning program focuses on managing problem behaviors, dealing with role change, obtaining support, and looking after oneself. It will be evaluated in a pilot study in three countries using a randomized unblinded design with a wait-list control group. Participants will be informal carers of people with dementia in Alzheimer's disease or behavioral-variant Frontotemporal degeneration with an onset before the age of 65 years. The primary outcome will be caregiving self-efficacy after 6 weeks of program use. As secondary outcomes, caregivers' stress and burden, carer health-related quality of life, caring-related knowledge, patient problem behaviors, and user satisfaction will be assessed. Program utilization will be monitored and a health-economic evaluation will also be performed.
CONCLUSIONS
The RHAPSODY project will add to the evidence on the potential and limitations of a conveniently accessible, user-friendly, and comprehensive internet-based intervention as an alternative for traditional forms of counseling and support in healthcare, aiming to optimize care and support for people with YOD and their informal caregivers.
背景
早发性痴呆(YOD)定义为65岁之前出现认知或行为衰退的首发症状,与晚发性痴呆相比相对少见,但它与诊断困难以及对患者及其非正式护理人员造成的沉重负担相关。现有的卫生和社会护理结构很少能满足YOD患者的需求。基于互联网的干预措施是一种新颖的形式,可为这个脆弱但未得到充分服务的群体提供与健康相关的教育、咨询和支持。
方法
RHAPSODY(评估青年痴呆症政策和策略的研究)项目是一项欧洲倡议,旨在通过为家庭护理人员提供基于互联网的信息和技能培养计划,改善对YOD患者的护理。该电子学习计划侧重于管理问题行为、应对角色变化、获得支持以及自我照顾。将在三个国家进行一项试点研究,采用随机非盲设计和等待名单对照组对其进行评估。参与者将是65岁之前发病的阿尔茨海默病或行为变异型额颞叶痴呆患者的非正式护理人员。主要结局将是使用该计划6周后的护理自我效能感。作为次要结局,将评估护理人员的压力和负担、与护理人员健康相关的生活质量、护理相关知识、患者的问题行为以及用户满意度。将监测计划的使用情况,并进行卫生经济评估。
结论
RHAPSODY项目将为以下方面的证据添砖加瓦:一种方便获取、用户友好且全面的基于互联网的干预措施作为医疗保健中传统咨询和支持形式的替代方案的潜力和局限性,旨在优化对YOD患者及其非正式护理人员的护理和支持。