Saragih Ita Daryanti, Wei Chun-Wang, Batubara Sakti Oktaria, Saragih Ice Septriani, Lee Bih-O
College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Health Care Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Nurs Scholarsh. 2023 Jan;55(1):291-303. doi: 10.1111/jnu.12808. Epub 2022 Sep 2.
The use of technology-assisted interventions in dementia care contributes to increased communication, reduced burden on the caregivers, improved health outcomes, and improved expense management. Technology-assisted interventions can be provided remotely to monitor, improve, and enable home care, benefiting the health of both patients and caregivers. Despite increasing use, the effectiveness of technology-assisted interventions for dementia care remains uncertain, with studies reporting inconclusive findings subject to interpretation. Therefore, the current study investigated the available evidence to explore the efficacy of technology-assisted interventions for people with dementia.
Systematic review and meta-analysis.
The study was preregistered with the PROSPERO international prospective register of systematic reviews using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided protocol. The primary search was conducted in eight databases from database inception to January 29, 2022. Using a random-effects model, the standardized mean differences (SMDs) with 95% confidence intervals (CIs) were synthesized to obtain pooled effect sizes (using Stata 16.0). The updated Cochrane Risk of Bias 2 tool (RoB-2) was used to evaluate the methodological quality of the studies.
A pooled analysis of 12 trials, including 584 people with dementia, showed more improvement associated with technology-assisted interventions compared with standard care, including in the domains of cognitive function (SMD = 0.39; 95% CI: 0.14 to 0.64; p < 0.001) and depression (SMD = -0.75; 95% CI: -1.33 to -0.17; p = 0.01). However, no significant effects were observed for activities of daily living (ADL) or quality of life.
Technology-assisted interventions appear to improve cognitive function and reduce depression in people with dementia compared with standard care.
This study may be used to demonstrate that interventions incorporating many modalities or technologies can be used to enhance dementia care, which may improve favorable outcomes when using technology-assisted interventions to remotely initiate appropriate activities for people with dementia. Because technology allows for simultaneous communication and access to shared multimedia, it removes environmental constraints and allows treatment to be administered remotely.
在痴呆症护理中使用技术辅助干预有助于加强沟通、减轻护理人员负担、改善健康结果并优化费用管理。技术辅助干预可以远程提供,以监测、改善并实现家庭护理,使患者和护理人员的健康均受益。尽管其使用日益增加,但技术辅助干预对痴呆症护理的有效性仍不确定,研究报告的结果尚无定论,有待解读。因此,本研究调查了现有证据,以探讨技术辅助干预对痴呆症患者的疗效。
系统评价和荟萃分析。
本研究已在国际前瞻性系统评价注册库PROSPERO中预先注册,采用系统评价和荟萃分析的首选报告项目(PRISMA)指南方案。主要检索从数据库建立至2022年1月29日的八个数据库。使用随机效应模型,综合标准化均数差(SMD)及其95%置信区间(CI),以获得合并效应量(使用Stata 16.0)。使用更新后的Cochrane偏倚风险2工具(RoB-2)评估研究的方法学质量。
对12项试验(包括584名痴呆症患者)的汇总分析表明,与标准护理相比,技术辅助干预带来了更多改善,包括在认知功能领域(SMD = 0.39;95% CI:0.14至0.64;p < 0.001)和抑郁方面(SMD = -0.75;95% CI:-1.33至-0.17;p = 0.01)。然而,在日常生活活动(ADL)或生活质量方面未观察到显著影响。
与标准护理相比,技术辅助干预似乎能改善痴呆症患者的认知功能并减轻抑郁。
本研究可用于证明,包含多种模式或技术的干预措施可用于加强痴呆症护理,在使用技术辅助干预为痴呆症患者远程启动适当活动时,这可能会改善有利结果。由于技术允许同时进行沟通并访问共享多媒体,它消除了环境限制,并允许远程实施治疗。