Ali Afia, Brown Emma, Tsang Winnie, Spector Aimee, Aguirre Elisa, Hoare Sarah, Hassiotis Angela
Division of Psychiatry, University College London, London, UK.
Clinical, Education and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK.
Aging Ment Health. 2022 Apr;26(4):698-708. doi: 10.1080/13607863.2020.1869180. Epub 2021 Jan 4.
To examine the feasibility, acceptability and fidelity of individual Cognitive Stimulation Therapy (iCST) in people with intellectual disability (ID) and dementia.
We aimed to recruit forty dyads (carer and individual with dementia and ID) who were randomised to iCST or a waiting list control group. Both groups received treatment as usual. Family and paid carers delivered the manualised intervention (40 sessions over 20 weeks). Recruitment and retention of participants, intervention adherence, fidelity and acceptability were assessed. Outcome measures of cognition, adaptive functioning, quality of life (QoL) and carer outcomes were collected at baseline, midpoint (11 weeks) and at 21 weeks. Qualitative interviews were conducted with six carers about their experience of iCST.
Forty dyads were recruited over 10 months from 12 National Health Service trusts. One dyad dropped out and 87.5% and 97.5% completed the midpoint and end-point assessments respectively. Assessment of fidelity indicated that the correct session structure was not followed; 70% completed at least 20 sessions and there was a high level of satisfaction with iCST. QoL was significantly higher in the iCST arm at 21 weeks (adjusted mean difference: 3.11; 95% CI: 0.64 to 5.58). There were no differences in the other outcome measures.
The intervention was feasible and acceptable. A full-scale trial is warranted but some modifications are needed, including improved training and supervision for carers to improve fidelity.
探讨个体认知刺激疗法（iCST）对智障和痴呆患者的可行性、可接受性及治疗保真度。
我们旨在招募40对（照顾者与患有痴呆和智障的个体），将其随机分为iCST组或等待名单对照组。两组均接受常规治疗。家庭照顾者和付费照顾者实施标准化干预（20周内进行40次治疗）。评估参与者的招募与留存情况、干预依从性、治疗保真度及可接受性。在基线、中点（11周）和21周收集认知、适应性功能、生活质量（QoL）及照顾者结局的指标。对6名照顾者进行了关于他们iCST体验的定性访谈。
在10个月内从12个国民健康服务信托机构招募了40对。一对退出，分别有87.5%和97.5%的参与者完成了中点和终点评估。治疗保真度评估表明未遵循正确的治疗结构；70%的人完成了至少20次治疗，对iCST的满意度较高。在21周时，iCST组的生活质量显著更高（调整后平均差异：3.11；95%置信区间：0.64至5.58）。其他结局指标无差异。
该干预措施具有可行性和可接受性。有必要进行全面试验，但需要进行一些改进，包括加强对照顾者的培训和监督以提高治疗保真度。
