“更熟悉痴呆症”计划：一项随机对照研究方案，旨在确定护理人员培训如何影响患者和护理人员的幸福感。
The "more at home with dementia" program: a randomized controlled study protocol to determine how caregiver training affects the well-being of patients and caregivers.
机构信息
Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands.
Laurens Care Centers, Nieuwe Binnenweg 29, 3014, GB, Rotterdam, the Netherlands.
出版信息
BMC Geriatr. 2018 Oct 22;18(1):252. doi: 10.1186/s12877-018-0948-3.
BACKGROUND
Caring for people with dementia imposes heavy burdens on caregivers, especially spouses. This can lead to depression, anxiety, and physical symptoms in the caregiver, with early institutionalization for the patient. An Australian study reported that a residential caregiver training program delivered in medical settings could delay nursing home admission, lower mortality, reduce psychological morbidity in caregivers, and lower healthcare costs. In this replication study, we aim to determine the effectiveness of an adaptation of this program to non-medical settings in the Dutch health care system.
METHODS
A randomized controlled study design will be used, comparing an intervention group with a control group. The intervention will last for five days and will be delivered in either a holiday park or a bed and breakfast setting. The control group will receive care as usual. Data will be collected at baseline and after 3 and 6 months, and outcomes will be assessed in the caregiver group and in the dementia group. The primary outcome will be caregiver-related quality of life after 3 months. The main secondary outcome will be the neuropsychiatric symptoms in the dementia group. Secondary outcomes in the dementia group will be activities of daily living and instrumental activities of daily living, use of health facilities, quality of life, agitation, dementia severity, and use of psychotropic medication. Secondary outcomes in the caregiver group will be the subjective and objective burdens, health and health care facility use, psychotropic medication use, depression, anxiety, and perseverance time.
DISCUSSION
We anticipate that the outcomes will allow us to confirm the effectiveness of the intervention, and in turn, potentially inform the introduction of this program into care plans. It is also expected that the experiences and recommendations of participants will help us to develop the training program further.
TRIAL REGISTRATION
Registered in the Netherlands Trial Register on March 9, 2016, number 5775 .
背景
照顾痴呆症患者给照顾者带来了沉重的负担，尤其是配偶。这可能导致照顾者出现抑郁、焦虑和身体症状，并导致患者提前入住养老院。澳大利亚的一项研究报告称，在医疗环境中实施的住宅照顾者培训计划可以延迟养老院入院，降低死亡率，降低照顾者的心理发病率，并降低医疗保健成本。在这项复制研究中，我们旨在确定对荷兰医疗保健系统中非医疗环境中该计划的适应性的有效性。
方法
将使用随机对照研究设计，比较干预组和对照组。干预将持续五天，并在度假公园或住宿加早餐环境中进行。对照组将接受常规护理。将在基线时以及 3 个月和 6 个月后收集数据，并在照顾者组和痴呆症组中评估结果。主要结局是 3 个月后照顾者相关生活质量。主要次要结局是痴呆症组的神经精神症状。痴呆症组的次要结局将是日常生活活动和工具性日常生活活动、使用卫生设施、生活质量、激越、痴呆严重程度和使用精神药物。照顾者组的次要结局将是主观和客观负担、健康和卫生保健设施使用、精神药物使用、抑郁、焦虑和坚持时间。
讨论
我们预计结果将使我们能够确认干预的有效性，并可能为将该计划纳入护理计划提供信息。参与者的经验和建议也有望帮助我们进一步开发培训计划。
试验注册
2016 年 3 月 9 日在荷兰试验注册处注册，编号为 5775 。
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