School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, UK.
Research and Development, Solent NHS Trust, Southampton, UK.
Gerontologist. 2020 May 15;60(4):682-692. doi: 10.1093/geront/gnz100.
A core outcome set (COS) to evaluate physical activity (PA) interventions for people living with dementia is needed, as the development of guidelines is currently limited by important heterogeneity in this field of research. Development of COS often includes Delphi surveys, but people living with dementia are often excluded. This study aimed to reach consensus on this COS using a modified Delphi survey to enable the participation of people living with dementia.
Two stakeholders groups took part in a Delphi survey (Group 1: people living with dementia and family caregivers; Group 2: professionals from different backgrounds, including physiotherapists, occupational therapists, and researchers). Caregivers and professionals completed the survey remotely. Participants living with dementia took part face-to-face, using a card sorting strategy. The consensus process was finalized with a consensus meeting.
Ninety-five participants of both groups completed the modified Delphi. Of those, 11 attended the consensus meeting. The card sorting strategy was successful at including people living with dementia. Seven outcomes reached consensus: preventing falls; doing what you can do; staying healthy and fit; walking better, being able to stand up and climb stairs; feeling brighter; enjoying the moment; and, feeling useful and having a purpose.
Robust and innovative methodological strategies were used to reach a consensus on a COS (what to measure) to evaluate PA for people living with dementia. Future work will focus on the selection of the most appropriate tools to measure these outcomes (how to measure).
需要制定一个针对痴呆症患者的体力活动（PA）干预措施的核心结局集（COS），因为该领域的研究存在重要的异质性，目前指南的制定受到限制。COS 的制定通常包括德尔菲调查，但往往排除了痴呆症患者。本研究旨在通过一项修改后的德尔菲调查达成共识，使痴呆症患者能够参与其中。
两组利益相关者（Group 1：痴呆症患者和家庭照顾者；Group 2：来自不同背景的专业人员，包括物理治疗师、职业治疗师和研究人员）参与了德尔菲调查。照顾者和专业人员远程完成调查。痴呆症患者通过卡片分类策略面对面参与。共识过程最终通过共识会议确定。
两组共有 95 名参与者完成了修改后的德尔菲调查，其中 11 名参加了共识会议。卡片分类策略成功地包括了痴呆症患者。有 7 个结果达成共识：预防跌倒；做力所能及的事；保持健康和体能；走得更好，能够站立和爬楼梯；感觉更愉快；享受当下；以及，感觉有用和有目标。
采用了稳健和创新的方法策略，就评估痴呆症患者 PA 的 COS（测量什么）达成了共识。未来的工作将侧重于选择最合适的工具来衡量这些结果（如何衡量）。
