Lee Abigail Rebecca, Gerritzen Esther Vera, McDermott Orii, Orrell Martin
Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
J Med Internet Res. 2021 Jul 26;23(7):e26551. doi: 10.2196/26551.
The increasing prevalence of dementia has promoted a move toward equipping people with the skills required for greater self-management of the condition to enable a better quality of life. Self-management encompasses numerous skills, such as goal setting and decision making, which aim to improve an individual's physical and mental well-being when they live with long-term health conditions. Effective self-management may lead to increased well-being and quality of life. Reviews of web-based and app-based interventions have suggested that they have the potential to provide self-management support for people living with a range of conditions, including dementia.
The aim of this review is to explore the existing use of web-based or app-based interventions that facilitate or support self-management in dementia and discuss their effectiveness in promoting self-management and independence.
A total of 5 electronic databases were systematically searched for relevant articles published between January 2010 and March 2020. Included studies were appraised using the Downs and Black checklist and the Critical Appraisal Skills Program qualitative research checklist. A narrative synthesis framework was applied using tables and conceptual mapping to explore the relationships within and among studies.
A total of 2561 articles were identified from the initial search, of which 11 (0.43%) met the inclusion criteria for the final analysis. These included 5 quantitative, 4 mixed methods, and 2 qualitative studies. All the included articles were of fair to high quality across the two appraisal measures. Interventions were delivered through a range of web-based and app-based technologies and targeted several self-management concepts. However, there was inconsistency regarding the domains, often affected by dementia, that were targeted by the interventions reviewed.
Web-based and app-based interventions for dementia can be delivered through a range of means and can target different aspects of self-management. The small number of studies included in this review report positive outcomes that seem to support the use of these interventions for people living with dementia. However, there is a clear need for more high-quality research into this type of intervention delivery and for studies that use a much larger number of participants across the dementia spectrum. Future research should consider the barriers to and facilitators of intervention adoption highlighted in this review and whether interventions can encompass the physical, social, cognitive, and emotional domains affected by dementia.
痴呆症患病率不断上升，促使人们朝着让患者掌握病情自我管理所需技能的方向发展，以实现更高的生活质量。自我管理涵盖众多技能，如目标设定和决策制定，旨在改善长期患有健康问题的个体的身心健康。有效的自我管理可能会提高幸福感和生活质量。对基于网络和应用程序的干预措施的综述表明，它们有可能为包括痴呆症患者在内的各种疾病患者提供自我管理支持。
本综述旨在探讨基于网络或应用程序的干预措施在痴呆症自我管理中的现有应用，并讨论其在促进自我管理和独立性方面的有效性。
系统检索了5个电子数据库，以查找2010年1月至2020年3月期间发表的相关文章。纳入的研究使用唐斯和布莱克清单以及批判性评估技能计划定性研究清单进行评估。应用叙事性综合框架，通过表格和概念图来探索研究内部和研究之间的关系。
初步检索共识别出2561篇文章，其中11篇（0.43%）符合最终分析的纳入标准。这些文章包括5篇定量研究、4篇混合方法研究和2篇定性研究。在这两种评估方法中，所有纳入的文章质量均为中等至高等。干预措施通过一系列基于网络和应用程序的技术实施，并针对多个自我管理概念。然而，所审查的干预措施针对的、常受痴呆症影响的领域存在不一致性。
针对痴呆症的基于网络和应用程序的干预措施可以通过多种方式实施，并可针对自我管理的不同方面。本综述纳入的少数研究报告了积极结果，似乎支持对痴呆症患者使用这些干预措施。然而，显然需要对这种干预措施的实施进行更多高质量研究，并开展涉及更广泛痴呆症患者群体的研究。未来的研究应考虑本综述中强调的干预措施采用的障碍和促进因素，以及干预措施是否能够涵盖受痴呆症影响的身体、社会、认知和情感领域。
