个体化电话式照护支持方案对农村地区痴呆患者家庭照护者的影响：一项群组随机对照试验研究方案。
An individualized telephone-based care support program for rural family caregivers of people with dementia: study protocol for a cluster randomized controlled trial.
机构信息
Xiang Ya School of Nursing, Central South University, Changsha, Hunan Province, China.
College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.
出版信息
BMC Geriatr. 2021 Nov 4;21(1):629. doi: 10.1186/s12877-021-02575-2.
BACKGROUND
There are about 9.5 million people with dementia in China. Up to 99% of them are cared for by their family caregivers. Family caregivers are confronted with considerable difficulties and challenges while providing care. They often experience high levels of emotional, physical, financial, and social burdens. Caregivers in rural areas experience an even higher level of burden compared to their counterparts in urban areas due to fewer health resources for dementia care. However, so far, no intervention study has been conducted to support family caregivers in rural areas of China. The aim of this proposed study is to adapt and evaluate an evidence-based and culturally-tailored individualized telephone-based care support (ITBCS) program for family caregivers of people with dementia in rural China.
METHODS
A cluster randomized controlled trial (RCT) will be conducted to evaluate the effectiveness of the ITBCS compared with usual care for Chinese rural family caregivers of people with dementia. A total sample of 168 rural family caregivers will be recruited. The intervention components consist of a 3-month intensive telephone-based care support intervention followed by telephone-based follow-up consultations for 6 months. The control group will receive usual care services available for them. Outcome measures include carers' subjective burden, depressive symptoms, health-related quality of life, social support, caregiving self-efficacy, and care recipients' difficult behaviours and competence in activities of daily living at 3, 9 and 15 months after baseline. The potential cost-effectiveness of the ITBCS compared with usual care will be assessed as well.
DISCUSSION
If effective, the ITBCS program can be adapted and used in rural areas of China as a blueprint to improve the quality of home-based care for people with dementia. Findings from the present study are significant for developing evidence-based dementia care policy in rural China.
TRIAL REGISTRATION
Chinese Clinical Trial Registry, ChiCTR2000038821 , Registered 4 April 2020, http://www.chictr.org.cn/showprojen.aspx?proj=62268 .
背景
中国约有 950 万痴呆症患者。其中 99%的患者由其家庭照顾者照顾。家庭照顾者在提供护理时面临着相当大的困难和挑战。他们经常经历高水平的情感、身体、经济和社会负担。与城市地区的同行相比，农村地区的照顾者由于痴呆症护理的健康资源较少，因此负担更重。然而，到目前为止，还没有干预研究来支持中国农村地区的家庭照顾者。本研究旨在改编和评估一项针对中国农村地区痴呆症患者家庭照顾者的基于证据和文化定制的个体化电话护理支持（ITBCS）计划，并评估其效果。
方法
将开展一项集群随机对照试验（RCT），以评估 ITBCS 与常规护理对中国农村地区痴呆症患者家庭照顾者的效果。将招募总共 168 名农村家庭照顾者。干预措施包括为期 3 个月的强化电话护理支持干预，随后进行 6 个月的电话随访咨询。对照组将接受他们可获得的常规护理服务。在基线后 3、9 和 15 个月，将评估照顾者的主观负担、抑郁症状、健康相关生活质量、社会支持、照顾自我效能以及照顾对象的日常活动困难行为和能力。还将评估与常规护理相比，ITBCS 的潜在成本效益。
讨论
如果有效，ITBCS 计划可以在中国农村地区进行改编和使用，作为改善家庭为基础的痴呆症患者护理质量的蓝本。本研究的结果对于制定中国农村地区基于证据的痴呆症护理政策具有重要意义。
试验注册
中国临床试验注册中心，ChiCTR2000038821 ，注册于 2020 年 4 月 4 日，http://www.chictr.org.cn/showprojen.aspx?proj=62268。
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