Duggleby Wendy, Ploeg Jenny, McAiney Carrie, Fisher Kathryn, Swindle Jenny, Chambers Tracey, Ghosh Sunita, Peacock Shelley, Markle-Reid Maureen, Triscott Jean, Williams Allison, Forbes Dorothy, Pollard Lori
Faculty of Nursing, University of Alberta, Level 3 Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
Aging, Community and Health Research Unit, School of Nursing, McMaster University, 1280 Main Street West, Room HSC3N25L, Hamilton, ON, L8S 4K1, Canada.
BMC Geriatr. 2017 Aug 14;17(1):181. doi: 10.1186/s12877-017-0581-6.
BACKGROUND: Family carers of older persons with Alzheimer's' disease and related dementia (ADRD) and multiple chronic conditions (MCC) experience significant, complex, and distressing transitions such as changes to their environment, roles and relationships, physical health, and mental health. An online intervention (My Tools 4 Care) was developed for family carers of persons with ADRD and MCC living at home, with the aim of supporting these carers through transitions and increasing their self-efficacy, hope, and health related quality of life (HRQoL). This study will evaluate My Tools 4 Care (MT4C) by asking the following research questions: 1. Does use of MT4C result in a 3 month (immediately post intervention) and 6-month (3 months after intervention) increase in HRQoL, self-efficacy, and hope, in carers of persons with ADRD and MCC compared to an educational control group? 2. Does use of MT4C help carers of community-dwelling older adults with ADRD and MCC deal with significant changes they experience as carers? and 3. Are the effects/benefits of the MT4C intervention achieved at no additional cost compared to an educational control group? METHODS/DESIGN: Using a pragmatic mixed methods randomized controlled trial design, 180 family carers of community dwelling older persons (65 years of age and older) with ADRD and MCC will participate in the study. Data will be collected from the intervention and an educational control group at four time points: baseline, 1 month, 3 and 6 months. We expect to find that family carers using MT4C will show greater improvement in hope, self-efficacy and HRQoL, at no additional cost from a societal perspective, compared to those in the educational control group. General estimating equations will be used to determine differences between groups and over time. DISCUSSION: Data collection began in Ontario and Alberta Canada in June 2015 and is expected to be completed in June 2017. The results will inform policy and practice as MT4C can be easily revised for local contexts and is scalable in terms of posting on websites such as those hosted by the Alzheimer Society. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02428387.
背景：患有阿尔茨海默病及相关痴呆症（ADRD）和多种慢性病（MCC）的老年人的家庭护理人员经历着重大、复杂且令人痛苦的转变，比如生活环境、角色和人际关系、身体健康及心理健康方面的变化。针对居家的患有ADRD和MCC的老年人的家庭护理人员开发了一种在线干预措施（我的护理工具），旨在帮助这些护理人员应对转变，并提高他们的自我效能感、希望和健康相关生活质量（HRQoL）。本研究将通过提出以下研究问题来评估我的护理工具（MT4C）：1. 与教育对照组相比，使用MT4C是否会使患有ADRD和MCC的老年人的家庭护理人员在干预后立即（3个月）和干预后3个月（6个月）的HRQoL、自我效能感和希望有所提高？2. 使用MT4C是否有助于社区居住的患有ADRD和MCC的老年人的家庭护理人员应对他们作为护理人员所经历的重大变化？以及3. 与教育对照组相比，MT4C干预措施的效果/益处是否在不增加额外成本的情况下实现？ 方法/设计：采用务实的混合方法随机对照试验设计，180名社区居住的患有ADRD和MCC的65岁及以上老年人的家庭护理人员将参与该研究。将在四个时间点从干预组和教育对照组收集数据：基线、1个月、3个月和6个月。我们预计会发现，从社会角度来看，与教育对照组相比，使用MT4C的家庭护理人员在希望、自我效能感和HRQoL方面将有更大改善，且无需增加额外成本。将使用广义估计方程来确定组间差异和随时间的变化。 讨论：数据收集于2015年6月在加拿大安大略省和艾伯塔省开始，预计于2017年6月完成。研究结果将为政策和实践提供参考，因为MT4C可以很容易地根据当地情况进行修订，并且在诸如阿尔茨海默病协会主办的网站上发布方面具有可扩展性。 试验注册：ClinicalTrials.gov标识符：NCT02428387。
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