Department of Psychology, Beaumont Hospital, Dublin, Ireland
Academic Unit of Neurology, Trinity Biomedical Sciences Institute, University of Dublin Trinity College, Dublin, Ireland.
BMJ Open. 2019 Sep 20;9(9):e030684. doi: 10.1136/bmjopen-2019-030684.
Amyotrophic lateral sclerosis (ALS) is a rapid and fatal motor disease marked by progressive physical impairment due to muscle weakness and wasting. It is multidimensional with many patients presenting with cognitive and/or behavioural impairment. Caregivers of patients with ALS, commonly non-paid immediate family members, often take primary responsibility for the complex care needs of patients in non-medicalised setting, and many as a consequence experience caregiver burden, anxiety, and/or depression.
This randomised controlled trial (RCT) will use randomisation to allocate n=75 caregivers of patients with ALS from the national ALS clinic into three groups with an equal distribution. The RCT consists of two intervention groups and a wait list control (treatment as usual [TAU]) group. The intervention arms of the trial consist of a 'mindfulness-based stress reduction' and 'building better caregivers' manualised group-based intervention, with 9 and 6 weekly sessions, respectively. The TAU group will have access to intervention at the end of the trial period. Primary outcomes are self-report questionnaires on anxiety and depression symptoms, with caregiver burden and quality of life considered secondary outcomes. Assessment will commence at baseline, immediately following the intervention period, and after a period of 12 weeks to assess the effectiveness and efficacy of participating in an intervention. Patient cognitive and behavioural data will also be considered. Means of treatment and control groups at Time 0 and 1 will be analysed using mixed model multivariate analysis of variance followed by analysis of variance, and treatment effect-sizes will be calculated. This RCT protocol is pre-results and has been registered with an international database resulting in an International Standard Randomised Controlled Trials Number (ISRCTN53226941).
Ethics approval was obtained from the Beaumont Hospital Medical Research Ethics Committee. Results of the main trial will be submitted for publication in a peer-reviewed journal.
肌萎缩侧索硬化症(ALS)是一种快速且致命的运动疾病,其特征是肌肉无力和萎缩导致身体逐渐受损。它具有多维性,许多患者表现出认知和/或行为障碍。ALS 患者的照顾者,通常是非付费的直系亲属,经常在非医疗环境中承担患者复杂的护理需求的主要责任,许多人因此经历了照顾者负担、焦虑和/或抑郁。
本随机对照试验(RCT)将通过随机分配将来自国家 ALS 诊所的 75 名 ALS 患者的照顾者分为三组,分配比例相等。RCT 由两个干预组和一个等待名单对照(常规治疗 [TAU])组组成。试验的干预臂包括一个“基于正念的应激减少”和“培养更好的照顾者”的基于手册的小组干预,分别有 9 次和 6 次每周的课程。TAU 组将在试验结束后获得干预。主要结果是焦虑和抑郁症状的自我报告问卷,照顾者负担和生活质量被认为是次要结果。评估将在基线时开始,在干预期结束后立即进行,并在 12 周后进行,以评估参与干预的效果和疗效。还将考虑患者的认知和行为数据。使用混合模型多元方差分析分析时间 0 和 1 时的治疗组和对照组的平均值,然后进行方差分析,并计算治疗效果大小。本 RCT 方案是预结果,并已在国际数据库中注册,产生了一个国际标准随机对照试验编号(ISRCTN53226941)。
Beaumont 医院医学研究伦理委员会已批准该伦理。主要试验的结果将提交给同行评议的期刊发表。