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为早期痴呆症患者及其非正式照料者创建在线生活故事书的效果:一项随机对照试验方案

The effectiveness of creating an online life story book on persons with early dementia and their informal caregivers: a protocol of a randomized controlled trial.

作者信息

Elfrink Teuntje R, Zuidema Sytse U, Kunz Miriam, Westerhof Gerben J

机构信息

Department of Psychology, Health and Technology, University of Twente, P.O. Box 217, 7500, AE, Enschede, The Netherlands.

Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700, RB, Groningen, The Netherlands.

出版信息

BMC Geriatr. 2017 Apr 21;17(1):95. doi: 10.1186/s12877-017-0471-y.

Abstract

BACKGROUND

Dementia has a high burden for patients, informal caregivers and society. Given changes in care systems, more persons with dementia will live longer at home. However, living at home (with dementia) with a good quality of life is not easy to achieve. Dementia is often accompanied by neuropsychiatric symptoms like apathy, agitation, depression, and anxiety, which have a negative impact on quality of life. Whereas cognitive deterioration can hardly be influenced, it is possible to reduce neuropsychiatric symptoms. As autobiographical memories remain intact for a relatively long time in dementia, reminiscence interventions can promote feelings of pleasure and trust. The Online Life Story Book (OLSB) allows to digitally share memories (stories, pictures, video or audio fragments). The main objective is to study the effects of the OLSB on neuropsychiatric symptoms. The study has four secondary objectives: 1) to study the effectiveness of the intervention on the burden and quality of life of the primary informal caregiver; 2) to provide a preliminary health-economic evaluation; 3) to study the (time to) nursing home admittance as a longer term effect; 4) to provide a process evaluation.

METHODS AND DESIGN

A randomized controlled trial with individual randomization to one of two conditions is conducted: 1) intervention "Online Life Story Book"; 2) control condition (care as usual). Participants are persons with early dementia and their primary caregivers. In the intervention OLSB, a trained volunteer guides the participants through the process of putting together a timeline of their lives during 5 meetings within a period of 8-10 weeks. To assess the effects of the intervention on the primary outcome, neuropsychiatric symptoms, the Neuropsychiatric Inventory (NPI) will be assessed at three time points: before the intervention (baseline, T0), 3 months (T1) and 6 months (T2) post baseline.

DISCUSSION

When proven effective, the Online Life Story Book can be a valuable addition to the existing provision of care for persons with dementia and their informal caregivers.

TRIAL REGISTRATION

This study has been approved by the Twente Medical Ethics Committee under the file number p16-04 (Dutch Trial Register: NTR5939 , date of registration: 14 March 2016).

摘要

背景

痴呆症给患者、非正式照护者和社会带来了沉重负担。鉴于照护系统的变化,更多痴呆症患者将在家中生活更长时间。然而,(患有痴呆症)在家中高质量地生活并非易事。痴呆症常伴有冷漠、激动、抑郁和焦虑等神经精神症状,这些症状会对生活质量产生负面影响。虽然认知衰退很难得到改善,但减轻神经精神症状是有可能的。由于自传体记忆在痴呆症患者中相对较长时间内保持完整,回忆干预可以增进愉悦感和信任感。在线生活故事书(OLSB)能够以数字方式分享记忆(故事、图片、视频或音频片段)。主要目的是研究在线生活故事书对神经精神症状的影响。该研究有四个次要目的:1)研究干预措施对主要非正式照护者的负担和生活质量的有效性;2)进行初步的健康经济评估;3)研究养老院入住情况(时间)作为长期影响;4)进行过程评估。

方法与设计

进行一项随机对照试验,将个体随机分配到以下两种情况之一:1)干预“在线生活故事书”;2)对照情况(照常护理)。参与者为早期痴呆症患者及其主要照护者。在干预性在线生活故事书中,一名经过培训的志愿者在8至10周的时间内通过5次会面指导参与者整理他们生活的时间线。为了评估干预措施对主要结局神经精神症状的影响,将在三个时间点使用神经精神科问卷(NPI)进行评估:干预前(基线,T0)、基线后3个月(T1)和6个月(T2)。

讨论

如果经证实有效,在线生活故事书可以成为现有痴呆症患者及其非正式照护者护理服务的一项有价值的补充。

试验注册

本研究已获得特温特医学伦理委员会批准,文件编号为p16 - 04(荷兰试验注册:NTR5939,注册日期:2016年3月14日)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83c5/5399324/85df9dcc74e2/12877_2017_471_Fig1_HTML.jpg

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