Division of Psychiatry, UCL , London , United Kingdom of Great Britain and Northern Ireland.
Research Department of Behavioural Science and Health, UCL, Institute of Epidemiology & Health Care , London , United Kingdom of Great Britain and Northern Ireland.
Aging Ment Health. 2021 Aug;25(8):1463-1474. doi: 10.1080/13607863.2020.1845299. Epub 2020 Nov 23.
To examine the feasibility and acceptability of NIDUS-Family, a 6-8 session manualised, individually tailored, modular intervention supporting independence at home for people with dementia; and explore participants' and facilitators' experiences of the intervention.
In this single group multi-site feasibility study, trained, supervised non-clinically qualified graduates (facilitators) delivered NIDUS-Family to family carer and people living with dementia dyads. We recruited participants from GP practices and memory services in London and Bradford. We completed quantitative outcomes pre- and post-intervention; and conducted qualitative interviews with participants and facilitators. Our pre-specified main outcomes were proportion of potential participants approached who agreed to participate, intervention adherence and acceptability to family carers, and facilitator fidelity to the manual.
We recruited 16 dyads (57% of those approached); 12 (75%) completed the intervention. Of 12 participants rating intervention acceptability, 9 (75%) agreed or strongly agreed that it had helped; 2 (18%) neither agreed nor disagreed and 1 (8%) disagreed. Mean facilitator fidelity was high (81.5%). Dyads set on average 3.9 goals; these most commonly related to getting out and about and increasing activity/hobby participation ( = 10); carer wellbeing ( = 6), managing physical complaints ( = 6); meal preparation/cooking ( = 5); and reducing irritability, frustration or aggression ( = 5). Almost all secondary outcomes changed in a direction indicating improvement. In our qualitative analysis we identified three overarching themes; relationships facilitate change, goal-focused versus manualised approach and balancing the needs of carers and people with dementia.
NIDUS-Family was feasible and acceptable to participants. Following refinements, testing in a pragmatic trial is underway.
考察 NIDUS-Family 的可行性和可接受性，这是一种 6-8 节的手册化、个体化定制、模块化干预措施，为痴呆症患者提供居家独立支持；并探讨参与者和促进者对干预措施的体验。
在这项单组多地点可行性研究中，经过培训和监督的非临床合格毕业生（促进者）为家庭照顾者和与痴呆症患者同住的人提供 NIDUS-Family。我们从伦敦和布拉德福德的全科医生诊所和记忆服务中心招募参与者。我们在干预前后完成了定量结果；并对参与者和促进者进行了定性访谈。我们预先指定的主要结果是，有多少潜在参与者同意参与，家庭照顾者对干预措施的依从性和可接受性，以及促进者对手册的忠实程度。
我们招募了 16 对（占被邀请者的 57%）；12 对（75%）完成了干预。在 12 名对干预措施可接受性进行评分的参与者中，有 9 名（75%）表示同意或强烈同意该干预措施有所帮助；2 名（18%）既不同意也不反对，1 名（8%）表示反对。促进者的平均忠实程度很高（81.5%）。夫妇平均设定了 3.9 个目标；这些目标最常见的是外出和增加活动/爱好参与（ = 10）；照顾者的幸福感（ = 6），管理身体不适（ = 6）；准备/烹饪饭菜（ = 5）；以及减少烦躁、沮丧或攻击性（ = 5）。几乎所有的次要结果都朝着改善的方向变化。在我们的定性分析中，我们确定了三个总体主题；关系促进了变化，目标导向与手册化方法以及平衡照顾者和痴呆症患者的需求。
NIDUS-Family 对参与者是可行和可接受的。经过改进后，正在进行一项实用试验。
