Division of Psychiatry, University College London, London, UK.
Faculty of Health Sciences, University of Hull, Hull, UK.
Int Psychogeriatr. 2021 Jun;33(6):601-614. doi: 10.1017/S1041610220001386. Epub 2020 Aug 27.
Post-diagnostic psychosocial interventions could play an important role in supporting people with mild dementia remain independent. The Promoting Independence in Dementia (PRIDE) intervention was developed to address this.
The mixed methods non-randomized, pre-post feasibility study occurred across England. Facilitators were recruited from the voluntary sector and memory services. Participants and their supporters took part in the three-session intervention. Outcome measures were collected at baseline and follow-up. To evaluate acceptability, focus groups and interviews were conducted with a subsample of participants and facilitators.
Contextual challenges to delivery including national research governance changes, affected recruitment of study sites. Thirty-four dyads consented, with 14 facilitators providing the intervention. Dyads took part in at least two sessions (79%), and 73% in all three. Outcome measures were completed by 79% without difficulty, with minimal missing data. No significant changes were found on pre and post assessments. Post hoc analysis found moderate effect size improvements for self-management (SMAS instrument) in people with dementia (d = 0.41) and quality of life (EQ5D measure) in carers (d = 0.40). Qualitative data indicated that dyads found PRIDE acceptable, as did intervention facilitators.
The three-session intervention was well accepted by participant-dyads and intervention facilitators. A randomized controlled trial of PRIDE would need to carefully consider recruitment potential across geographically varied settings and site stratification according to knowledge of contextual factors, such as the diversity of post-diagnostic services across the country. Letting sites themselves be responsible for identifying suitable intervention facilitators was successful. The self-report measures showed potential to be included in the main trial.
诊断后心理社会干预可能在支持轻度痴呆症患者保持独立方面发挥重要作用。为了解决这个问题，开发了促进痴呆症独立性（PRIDE）干预措施。
这项混合方法的非随机、前后测可行性研究在英格兰进行。来自志愿部门和记忆服务的促进者被招募。参与者及其支持者参加了三阶段的干预。在基线和随访时收集了结果测量。为了评估可接受性，对参与者和促进者的亚组进行了焦点小组和访谈。
包括国家研究治理变化在内的交付方面的背景挑战影响了研究地点的招募。34 对夫妇同意了，有 14 名促进者提供了干预措施。对夫妇至少参加了两次会议（79%），73%的人参加了所有三次会议。79%的人没有困难地完成了结果测量，只有最小的缺失数据。在前后评估中没有发现显著变化。事后分析发现，痴呆症患者的自我管理（SMAS 量表）和照顾者的生活质量（EQ5D 量表）有中等效应大小的改善（痴呆症患者的 d = 0.41，照顾者的 d = 0.40）。定性数据表明，对夫妇发现 PRIDE 是可以接受的，促进者也是如此。
三阶段干预措施得到了参与者对夫妇和干预促进者的认可。PRIDE 的随机对照试验需要仔细考虑在地理上不同的环境中进行招募的潜力，并根据国家不同的诊断后服务多样性等背景因素进行站点分层。让站点自己负责确定合适的干预促进者是成功的。自我报告的测量方法有可能被纳入主要试验。
