Silva Rosa, Bobrowicz-Campos Elzbieta, Santos-Costa Paulo, Cruz Ana Rita, Apóstolo João
Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal.
Faculty of Psychology and Educational Sciences, Centre of 20th Century Interdisciplinary Studies, University of Coimbra, Coimbra, Portugal.
Front Psychol. 2021 Nov 22;12:741955. doi: 10.3389/fpsyg.2021.741955. eCollection 2021.
This study aims to assess the feasibility and meaningfulness of a home-based individual cognitive stimulation (iCS) program delivered by caregivers to persons with cognitive impairment (PwCIs). It also aims to assess whether the older adults receiving this program improved their cognitive, neuropsychiatric, and depressive symptoms and quality of life and whether their caregivers improved their mental and physical health. A randomized controlled trial (RCT) was conducted with PwCI-caregiver dyads recruited from the community. Participants were allocated to two groups: intervention ( = 28) and control ( = 24). The intervention group received the European Portuguese version of the Individual Cognitive Stimulation Program-Making a Difference 3 (MD3-P). The control group received usual care. The iCS therapy program was implemented three times a week for 12 weeks. Caregivers were supported by the researchers to deliver the sessions at home. Participants were assessed at baseline and at the end of the intervention (week 13). Feasibility and meaningfulness were assessed through the attrition rate, adherence, and degree of satisfaction with the sessions. Four interviews were conducted (after week 13) to understand participants' experiences. The attrition rate was 23.1%. The dyads reported that they did not have high expectations about the iCS program before starting the study. Nevertheless, as the program evolved, caregivers noted that their family members had improved some areas of functioning. Intention-to-treat analysis based on group differences revealed a significant improvement in PwCIs' cognition, specifically in their orientation and ability to follow commands. The intervention had no impact on other variables such as caregivers' physical and mental health. The iCS program implemented by caregivers showed promising results in improving PwCIs' cognition. The participants who completed the intervention attributed a positive meaning to the MD3-P, confirming it as a valid non-pharmacological therapeutic approach to reducing frailty in PwCIs in community settings. www.ClinicalTrials.gov, identifier [NCT03514095].
本研究旨在评估由照料者向认知障碍患者(PwCIs)提供的居家个体认知刺激(iCS)项目的可行性和意义。它还旨在评估接受该项目的老年人是否改善了其认知、神经精神和抑郁症状及生活质量,以及他们的照料者是否改善了其身心健康。对从社区招募的PwCI-照料者二元组进行了一项随机对照试验(RCT)。参与者被分为两组:干预组(n = 28)和对照组(n = 24)。干预组接受欧洲葡萄牙语版的个体认知刺激项目——《创造不同3》(MD3-P)。对照组接受常规护理。iCS治疗项目每周实施三次,共12周。研究人员支持照料者在家中开展课程。在基线和干预结束时(第13周)对参与者进行评估。通过损耗率、依从性和对课程的满意度来评估可行性和意义。在第13周后进行了四次访谈,以了解参与者的体验。损耗率为23.1%。二元组报告称,在开始研究之前,他们对iCS项目的期望不高。然而,随着项目的推进,照料者注意到他们的家庭成员在一些功能领域有所改善。基于组间差异的意向性分析显示,PwCIs的认知有显著改善,特别是在定向和听从指令的能力方面。干预对诸如照料者的身心健康等其他变量没有影响。照料者实施的iCS项目在改善PwCIs的认知方面显示出了有前景的结果。完成干预的参与者赋予了MD3-P积极的意义,证实其为在社区环境中减少PwCIs虚弱的一种有效的非药物治疗方法。ClinicalTrials.gov网站,标识符[NCT03514095]。