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针对印度痴呆症患者照顾者的在线培训和支持计划的可行性和初步效果:一项随机对照试验。

Feasibility and preliminary effectiveness of an online training and support program for caregivers of people with dementia in India: a randomized controlled trial.

机构信息

Department of Psychiatry, Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.

Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA.

出版信息

Int J Geriatr Psychiatry. 2021 Apr;36(4):606-617. doi: 10.1002/gps.5502. Epub 2021 Feb 8.

Abstract

OBJECTIVES

Internet-based interventions involving elements of cognitive behavior therapy, psychoeducation, relaxation and skills training for caregivers of people with dementia have been found to be promising in Western countries. Given these outcomes, the adapted version of a multi-component online caregiver skills training and support program of the World Health Organization, called iSupport, was tested for feasibility and preliminary effectiveness in India.

METHODS

One hundred fifty-one caregivers of family members with a diagnosis of Alzheimer's disease or dementia were randomized to either the intervention arm (iSupport; n = 74) or to the control group (an education-only e-book program; n = 77). Participants were assessed using self-rated measures of depression and perceived burden, which were the primary outcome measures, at baseline and 3-month follow-up. Person-centered attitude, self-efficacy, mastery and self-rated health were also assessed.

RESULTS

Fifty-five caregivers (29 in the iSupport group and 26 in the control condition) completed the study. The recruitment and retention rate of the study were 44.67% and 36.42% respectively. No significant differences were found between the two groups at 3-month follow-up on the primary outcomes. Among the secondary outcomes, significant improvement was only seen in caregivers' person-centered attitude towards persons with dementia in the iSupport group (t = 2.228; p < 0.05).

CONCLUSIONS

Despite efforts to recruit and retain participants to the online program, this study had a low recruitment and retention rate, which require closer attention and indicates a need for further adaptations of the Indian version of the iSupport program to improve its acceptability and accessibility. The lessons learned from this study will guide the further development of caregiver training and support interventions in India. The trial was registered with the Clinical Trials Registry-India (Trial Registration No. CTRI/2017/02/007876).

摘要

目的

在西方国家,基于互联网的干预措施,涉及认知行为疗法、心理教育、放松和技能培训等元素,对痴呆症患者的照顾者显示出了良好的效果。鉴于这些结果,对世界卫生组织的多组件在线照顾者技能培训和支持计划的改编版,即 iSupport,在印度进行了可行性和初步效果测试。

方法

151 名被诊断为阿尔茨海默病或痴呆症的家庭成员的照顾者被随机分配到干预组(iSupport;n=74)或对照组(仅教育电子书计划;n=77)。参与者使用自我评估的抑郁和负担感知量表进行评估,这是主要的评估结果,在基线和 3 个月随访时进行。还评估了以人为中心的态度、自我效能感、掌握感和自我评估的健康状况。

结果

55 名照顾者(iSupport 组 29 名,对照组 26 名)完成了研究。研究的招募和保留率分别为 44.67%和 36.42%。在 3 个月随访时,两组在主要结果上没有显著差异。在次要结果中,只有 iSupport 组的照顾者对痴呆症患者的以人为中心的态度有显著改善(t=2.228;p<0.05)。

结论

尽管努力招募和保留参与在线计划的参与者,但这项研究的招募和保留率较低,这需要更密切的关注,并表明需要进一步调整 iSupport 计划的印度版本,以提高其可接受性和可及性。从这项研究中吸取的经验教训将指导印度进一步发展照顾者培训和支持干预措施。该试验在印度临床试验注册处(临床试验注册号:CTRI/2017/02/007876)进行了注册。

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