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使用平板电脑改善老年痴呆症患者的情绪及其与照顾者的互动:试点干预研究。

Using Computer Tablets to Improve Moods for Older Adults With Dementia and Interactions With Their Caregivers: Pilot Intervention Study.

作者信息

Gilson Aaron, Dodds Debby, Kaur Arveen, Potteiger Michael, Ford Ii James H

机构信息

University of Wisconsin-Madison, School of Pharmacy, Madison, WI, United States.

Generation Connect, York, PA, United States.

出版信息

JMIR Form Res. 2019 Sep 3;3(3):e14530. doi: 10.2196/14530.

Abstract

BACKGROUND

Persons living with dementia represent a significant and growing segment of the older adult (aged 65 years and older) population. They are often challenged expressively and may experience difficulties with sharing their feelings or moods. Availability of, and easy access to, tablets facilitates the use of information and communication technologies (ICTs) as a delivery mechanism for nonpharmacological interventions, especially for persons living with dementia. Evidence of the impact of ICTs in different community settings on mood with older adults and the impact of engagement on their caregivers is needed to promote broader adoption and sustainment of these technologies in the United States.

OBJECTIVE

This study aimed to determine the extent of the effects of tablets on positive mood change and examine the effects of study variables on care recipients' mood changes and caregivers' daily interactions.

METHODS

The tablet intervention was developed and evaluated in five programs. The primary outcome was caregivers' assessment of care recipients' mood (n=1089) before and after a tablet engagement session using an eight-point mood visual analog scale. Session influence on caregivers' daily activities was captured for a subsample of participants (n=542). Frequency distributions were computed for each study variables. Chi-square tests of association were calculated to determine the association of the variables on mood changes for all care recipients, as well as those being treated in skilled nursing facilities and in-home, and then for those that affected caregivers' daily activities.

RESULTS

The study sample comprised 1089 care recipient and caregiver engagement sessions. Cumulatively, 50.78% (553/1089) of care recipients showed a transition from negative to positive moods, whereas another 41.78% (455/1089) maintained an already-positive mood after the caregiver engagement session. Chi-square analyses demonstrated that positive mood changes resulted from using music (χ=72.9; P<.001), using YouTube as the sole app (χ=64.5; P<.001), using multiple engagement strategies (χ=42.8; P<.001), and when cared for in a skilled nursing facility (χ=236.8; P<.001) across the entire care recipient sample. In addition, although many features of the engagement session positively influenced the caregivers' day, the largest effect was observed when care recipients' mood was considered to have improved following the session (χ=234.7; P<.001).

CONCLUSIONS

The study is one of the first in the United States to explore the impact of ICTs, in particular managed tablets and Web-based video services that can be used on a tablet through an app, on improving mood in persons living with dementia, and enhancing caregivers' perceptions about their care recipient interactions. Importantly, these pilot data substantiate ICTs as part of a personalized engagement approach, as beneficial alternatives to pharmaceutical interventions for mood enhancement. However, a more comprehensive study that explores the ICT's impact on additional clinical outcomes is needed to confirm these preliminary findings.

摘要

背景

痴呆症患者在老年(65岁及以上)人群中所占比例很大且呈增长趋势。他们在表达方面常常面临挑战,可能难以分享自己的感受或情绪。平板电脑的可用性和便捷获取促进了信息通信技术(ICT)作为非药物干预的一种传播机制的使用,特别是对于痴呆症患者。为了在美国更广泛地采用和持续使用这些技术,需要了解不同社区环境中ICT对老年人情绪的影响以及参与对其照顾者的影响的证据。

目的

本研究旨在确定平板电脑对积极情绪变化的影响程度,并研究研究变量对受照顾者情绪变化和照顾者日常互动的影响。

方法

在五个项目中开发并评估了平板电脑干预措施。主要结果是照顾者在平板电脑使用环节前后,使用八点情绪视觉模拟量表对受照顾者的情绪进行评估(n = 1089)。对部分参与者子样本(n = 542)记录了该环节对照顾者日常活动的影响。计算每个研究变量的频率分布。计算卡方关联检验,以确定变量与所有受照顾者、在专业护理机构和家中接受治疗的受照顾者的情绪变化之间的关联,然后确定那些影响照顾者日常活动的变量之间的关联。

结果

研究样本包括1089次受照顾者与照顾者的参与环节。累计而言,50.78%(553/1089)的受照顾者情绪从消极转变为积极,另有41.78%(455/1089)在照顾者参与环节后保持积极情绪。卡方分析表明,在整个受照顾者样本中,使用音乐(χ = 72.9;P <.001)、将YouTube作为唯一应用程序使用(χ = 64.5;P <.001)、使用多种参与策略(χ = 42.8;P <.001)以及在专业护理机构接受护理(χ = 236.8;P <.001)会导致积极的情绪变化。此外,尽管参与环节的许多特征对照顾者的一天产生了积极影响,但当认为受照顾者在该环节后的情绪有所改善时,观察到的影响最大(χ = 234.7;P <.001)。

结论

该研究是美国首批探索信息通信技术,特别是可通过应用程序在平板电脑上使用的管理型平板电脑和基于网络的视频服务,对改善痴呆症患者情绪以及增强照顾者对其与受照顾者互动的认知的影响的研究之一。重要的是,这些试点数据证实信息通信技术作为个性化参与方法的一部分,是增强情绪的药物干预的有益替代方案。然而,需要进行更全面的研究来探索信息通信技术对其他临床结果的影响,以证实这些初步发现。

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