Department of Community Health Nursing, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan.
Department of Community and Public Health Nursing, Graduate School of Health Sciences and Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
PLoS One. 2022 Aug 18;17(8):e0273278. doi: 10.1371/journal.pone.0273278. eCollection 2022.
To test the effectiveness of the web-based intervention "Koji-family.net 3-day program" (KF3 PGM) for life-change adaptation in family caregivers of community-dwelling individuals with acquired brain injury (ABI).
A cluster-randomized trial.
All 82 institutions for families of individuals with ABI in Japan.
Participants were 240 families at 16 different institutions for families of individuals with ABI. Inclusion criteria for participants were (1) families caring for an individual with ABI, (2) family members aged 20 years and over, and (3) the individual with ABI developed ABI when aged more than 16 years and less than 65 years.
Clusters were randomly assigned to the intervention (8 clusters, n = 120) or the control (8 clusters, n = 120) group. For the intervention group, the KF3 PGM was assigned, in addition to routine family group activities to enhance the life-change adaptation. The control group followed their daily routine and received usual services. The primary outcome was the life-change adaptation scale (LCAS); secondary outcomes were the multidimensional scale of perceived social support (MSPSS) and the positive appraisal of care (PAC) scale at the baseline, after 3 days (short-term follow-up), and after 1 month (long-term follow-up). A mixed model for repeated measures (MMRM) was applied.
A total of 91 participants were enrolled. The mean age (SE) of the participants was 64.0 (9.2) years; 87.8% of them were female. The intervention group showed better improvement in the LCAS than the control group in the whole study period (F = 6.5, p = 0.002). The mean observed change in LCAS from baseline was +8.0 (SE = 2.0) at 3 days and +11.6 (SE = 2.0) at 1 month in the intervention group (F = 18.7, p < 0.001). No significant differences in MSPSS and PAC were observed among the intervention and control groups in the whole study.
The KF3 PGM can be an effective method of enhancing the adaptation to daily life in family caregivers of community-dwelling individuals with ABI. The results show that a potential web-based intervention in institutions for families of individuals with ABI plays a substantial, longer-term role in their support in Japan. Future studies could address the same research questions in different settings and cultures for family caregivers for even longer time periods.
测试基于网络的干预措施“Koji-family.net 3 天计划”（KF3PGM）在社区居住的后天性脑损伤（ABI）患者家庭照顾者生活变化适应中的有效性。
集群随机试验。
日本所有 82 家为 ABI 患者家庭提供服务的机构。
共有来自 16 家不同 ABI 患者家庭服务机构的 240 个家庭参加了研究。参与者的纳入标准为：（1）照顾 ABI 患者的家庭，（2）年龄在 20 岁及以上的家庭成员，以及（3）ABI 患者在 16 岁以上 65 岁以下时发生 ABI。
将参与者按照聚类随机分配到干预组（8 个聚类，n=120）或对照组（8 个聚类，n=120）。对于干预组，除了常规的家庭小组活动外，还分配了 KF3PGM，以增强生活变化适应能力。对照组遵循日常常规并接受常规服务。主要结局指标为生活变化适应量表（LCAS）；次要结局指标为多维感知社会支持量表（MSPSS）和照顾的积极评价量表（PAC），在基线时、3 天后（短期随访）和 1 个月后（长期随访）进行评估。采用重复测量混合模型（MMRM）进行分析。
共纳入 91 名参与者。参与者的平均年龄（SE）为 64.0（9.2）岁；87.8%为女性。在整个研究期间，干预组的 LCAS 改善优于对照组（F=6.5，p=0.002）。干预组 LCAS 的观察到的平均变化为：3 天时增加 8.0（SE=2.0），1 个月时增加 11.6（SE=2.0）（F=18.7，p<0.001）。在整个研究期间，干预组和对照组之间 MSPSS 和 PAC 没有显著差异。
KF3PGM 可能是一种增强社区居住的后天性脑损伤患者家庭照顾者适应日常生活的有效方法。结果表明，在日本，为 ABI 患者家庭服务机构提供的潜在网络干预措施在其支持方面发挥了实质性的、更长期的作用。未来的研究可以在不同的环境和文化中针对家庭照顾者提出相同的研究问题，并进行更长时间的研究。
