Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand.
College of Social Work, University of South Carolina, Columbia, SC, USA.
J Alzheimers Dis. 2022;87(4):1603-1614. doi: 10.3233/JAD-215253.
The Reducing Disability in Alzheimer's Disease (RDAD) program is an evidence-based intervention found to be feasible for implementation in community settings in the United States, and effective in reducing depression, one of the major behavioral and psychological symptoms of dementia (BPSD).
The goal of the study is to culturally adapt the RDAD for persons with dementia living in community settings of Thailand.
Key adaptation steps included: 1) assess the community, 2) understand/select the intervention, 3) consult with experts/stakeholders, 4) decide what needs to be adapted, 5) adapt the original program, 6) train staff, and 7) pilot test the adapted materials.
Modifications to the original RDAD protocol included changes in number of sessions, mode of delivery, and the specific pleasant activities targeted. The pilot test demonstrated the feasibility and acceptance of the adapted RDAD intervention protocol. Implementers were able to comprehend and implement the core components of the intervention, while family members demonstrated ability to follow instructions, gain knowledge about dementia, and improve skills for setting up realistic goals.
Following the key adaptation steps outlined above, we were able to successfully modify the RDAD for the Thai cultural context, maintaining core components of the original protocol. Program implementers demonstrated their ability to supervise family caregivers and help them gain the knowledge and skills needed to provide care for older adults with dementia. Findings from the pilot studies were incorporated into final training and intervention protocols currently being implemented and evaluated in a randomized implementation trial in Thailand.
减少阿尔茨海默病残疾项目（RDAD）是一种基于证据的干预措施，已被证明在美国社区环境中具有实施可行性，并且能有效减少抑郁症，这是痴呆症（BPSD）的主要行为和心理症状之一。
本研究的目的是对生活在泰国社区环境中的痴呆症患者进行 RDAD 的文化适应性调整。
关键的适应步骤包括：1）评估社区；2）了解/选择干预措施；3）咨询专家/利益相关者；4）确定需要适应的内容；5）改编原始程序；6）培训工作人员；7）对改编后的材料进行试点测试。
对原始 RDAD 方案的修改包括：课程数量、交付模式以及针对特定愉快活动的改变。试点测试表明，改编后的 RDAD 干预方案具有可行性和可接受性。实施者能够理解并实施干预的核心内容，而家庭成员则表现出能够按照说明操作、了解痴呆症相关知识并提高设定实际目标的技能。
按照上述关键适应步骤，我们成功地对 RDAD 进行了调整，以适应泰国的文化背景，同时保留了原始方案的核心内容。方案实施者表现出监督家庭照顾者的能力，并帮助他们获得为痴呆症老年人提供护理所需的知识和技能。试点研究的结果已纳入目前正在泰国进行的随机实施试验中最终的培训和干预方案。
