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轻度认知障碍或早期痴呆症老年人及其照顾者对信息通信技术的态度与使用:横断面研究

Attitudes and Use of Information and Communication Technologies in Older Adults With Mild Cognitive Impairment or Early Stages of Dementia and Their Caregivers: Cross-Sectional Study.

作者信息

Guzman-Parra Jose, Barnestein-Fonseca Pilar, Guerrero-Pertiñez Gloria, Anderberg Peter, Jimenez-Fernandez Luis, Valero-Moreno Esperanza, Goodman-Casanova Jessica Marian, Cuesta-Vargas Antonio, Garolera Maite, Quintana Maria, García-Betances Rebeca I, Lemmens Evi, Sanmartin Berglund Johan, Mayoral-Cleries Fermin

机构信息

Mental Health Department, Instituto de Investigación Biomédica de Málaga, University Regional Hospital of Malaga, Malaga, Spain.

Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.

出版信息

J Med Internet Res. 2020 Jun 1;22(6):e17253. doi: 10.2196/17253.

DOI:10.2196/17253
PMID:32442136
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7296403/
Abstract

BACKGROUND

Information and communication technologies are promising tools to increase the quality of life of people with dementia or mild cognitive impairment and that of their caregivers. However, there are barriers to their use associated with sociodemographic factors and negative attitudes, as well as inadequate knowledge about technologies.

OBJECTIVE

The aim of this study was to analyze technophilia (attitudes toward new technologies) and the use of smartphones and tablets along with associated factors in people with dementia/mild cognitive impairment and their caregivers.

METHODS

Data from the first visit of the Support Monitoring and Reminder for Mild Dementia (SMART4MD) randomized multicenter clinical trial were used for this analysis. Data were obtained from two European countries, Spain and Sweden, and from three centers: Consorci Sanitari de Terrassa (Catalonia, Spain), Servicio Andaluz de Salud (Andalusia, Spain), and the Blekinge Institute of Technology (Sweden). Participants with a score between 20 and 28 in the Mini Mental State Examination, with memory problems (for more than 6 months), and who were over the age of 55 years were included in the study, along with their caregivers. The bivariate Chi square and Mann-Whitney tests, and multivariate linear and logistic regression models were used for statistical analysis.

RESULTS

A total of 1086 dyads were included (N=2172). Overall, 299 (27.53%) of people with dementia/mild cognitive impairment had a diagnosis of dementia. In addition, 588 (54.14%) of people with dementia/mild cognitive impairment reported using a smartphone almost every day, and 106 (9.76%) used specific apps or software to support their memory. Among the caregivers, 839 (77.26%) used smartphones and tablets almost every day, and 181 (16.67%) used specific apps or software to support their memory. The people with dementia/mild cognitive impairment showed a lower level of technophilia in comparison to that of their caregivers after adjusting for confounders (B=0.074, P=.02) with differences in technology enthusiasm (B=0.360, P<.001), but not in technology anxiety (B=-0.042, P=.37). Technophilia was associated with lower age (B=-0.009, P=.004), male gender (B=-0.160, P<.001), higher education level (P=.01), living arrangement (living with children vs single; B=-2.538, P=.01), country of residence (Sweden vs Spain; B=0.256, P<.001), lower depression (B=-0.046, P<.001), and better health status (B=0.004, P<.001) in people with dementia/mild cognitive impairment. Among caregivers, technophilia was associated with comparable sociodemographic factors (except for living arrangement), along with a lower caregiver burden (B=-0.005, P=.04) and better quality of life (B=0.348, P<.001).

CONCLUSIONS

Technophilia was associated with a better quality of life and sociodemographic variables in people with dementia/mild cognitive impairment and caregivers, suggesting potential barriers for technological interventions. People with dementia/mild cognitive impairment frequently use smartphones and tablets, but the use of specific apps or software to support memory is limited. Interventions using these technologies are needed to overcome barriers in this population related to sociodemographic characteristics and the lack of enthusiasm for new technologies.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03325699; https://clinicaltrials.gov/ct2/show/NCT03325699.

摘要

背景

信息通信技术有望提高痴呆症或轻度认知障碍患者及其护理人员的生活质量。然而,其使用存在与社会人口学因素、消极态度以及对技术了解不足相关的障碍。

目的

本研究旨在分析痴呆症/轻度认知障碍患者及其护理人员对新技术的喜爱程度(对新技术的态度)、智能手机和平板电脑的使用情况以及相关因素。

方法

本分析使用了轻度痴呆症支持监测与提醒(SMART4MD)随机多中心临床试验首次访视的数据。数据来自两个欧洲国家,西班牙和瑞典,以及三个中心:圣特拉萨卫生联合会(西班牙加泰罗尼亚)、安达卢西亚卫生服务局(西班牙安达卢西亚)和布莱金厄理工学院(瑞典)。纳入研究的参与者为简易精神状态检查得分在20至28分之间、有记忆问题(超过6个月)且年龄超过55岁的患者及其护理人员。采用双变量卡方检验和曼-惠特尼检验以及多变量线性和逻辑回归模型进行统计分析。

结果

共纳入1086对(N = 2172)。总体而言,299名(27.53%)痴呆症/轻度认知障碍患者被诊断为痴呆症。此外,588名(54.14%)痴呆症/轻度认知障碍患者报告几乎每天使用智能手机,106名(9.76%)使用特定应用程序或软件来辅助记忆。在护理人员中,839名(77.26%)几乎每天使用智能手机和平板电脑,181名(16.67%)使用特定应用程序或软件来辅助记忆。在调整混杂因素后,痴呆症/轻度认知障碍患者与护理人员相比,对新技术的喜爱程度较低(B = 0.074,P = 0.02),在技术热情方面存在差异(B = 0.360,P < 0.001),但在技术焦虑方面无差异(B = -0.042,P = 0.37)。对新技术的喜爱程度与痴呆症/轻度认知障碍患者年龄较小(B = -0.009,P = 0.004)、男性(B = -0.160,P < 0.001)、教育水平较高(P = 0.01)、居住安排(与子女同住与独居;B = -2.538,P = 0.01)、居住国家(瑞典与西班牙;B = 0.256,P < 0.001)、抑郁程度较低(B = -0.046,P < 0.001)以及健康状况较好(B = 0.004,P < 0.001)相关。在护理人员中,对新技术的喜爱程度与类似的社会人口学因素(居住安排除外)相关,同时护理负担较低(B = -0.005,P = 0.04)且生活质量较好(B = 0.348,P < 0.001)。

结论

对新技术的喜爱程度与痴呆症/轻度认知障碍患者及其护理人员的生活质量和社会人口学变量相关,提示技术干预可能存在障碍。痴呆症/轻度认知障碍患者经常使用智能手机和平板电脑,但使用特定应用程序或软件辅助记忆的情况有限。需要采用这些技术进行干预,以克服该人群中与社会人口学特征和对新技术缺乏热情相关的障碍。

试验注册

ClinicalTrials.gov NCT03325699;https://clinicaltrials.gov/ct2/show/NCT03325699

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