Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.
Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
J Alzheimers Dis. 2023;91(1):203-214. doi: 10.3233/JAD-220424.
The Promoting Activity, Independence and Stability in Early Dementia (PrAISED) intervention is a programme of physical activity and exercise designed to maintain participation in activities of daily living, mobility, and quality of life for people living with dementia. During the COVID-19 pandemic first national lockdown in England, the PrAISED physiotherapists, occupational therapists, and rehabilitation support workers adapted to delivering the intervention remotely via telephone or video conferencing.
The aim of this study was to explore therapists' experience of delivering the PrAISED intervention during the COVID-19 pandemic and derive implications for clinical practice.
Qualitative semi-structured interviews were conducted with 16 therapists using purposive sampling. Thematic analysis was used to analyze the transcripts.
Therapists reported a change in the relationship between themselves, the person with dementia and the caregiver, with an increased reliance on the caregiver and a loss of autonomy for the person living with dementia. There was concern that this would increase the burden on the caregiver. The therapists reported using creativity to adapt to different modes of delivery. They felt their sessions were mostly focused on providing social and emotional support, and that assessing, progressing, and tailoring the intervention was difficult.
It is possible to deliver some elements of a physical intervention using remote delivery, but a dual modal approach including remote and face-to-face delivery would optimize treatment efficacy. Educational support would be required to enable people living with dementia and their caregivers to overcome barriers relating to digital literacy.
促进早期痴呆症活动、独立性和稳定性(PrAISED)干预是一项身体活动和锻炼计划,旨在维持痴呆症患者参与日常生活活动、移动能力和生活质量。在英格兰第一次全国封锁期间的 COVID-19 大流行期间,PrAISED 物理治疗师、职业治疗师和康复支持人员适应通过电话或视频会议远程提供干预。
本研究旨在探讨治疗师在 COVID-19 大流行期间提供 PrAISED 干预的经验,并为临床实践提供启示。
使用目的抽样对 16 名治疗师进行了定性半结构式访谈。使用主题分析对转录本进行分析。
治疗师报告说,他们自己、痴呆症患者和照顾者之间的关系发生了变化,更多地依赖照顾者,而痴呆症患者的自主权丧失。有人担心这会增加照顾者的负担。治疗师报告说,他们使用创造力来适应不同的交付模式。他们觉得他们的会议主要集中在提供社会和情感支持上,评估、推进和调整干预措施很困难。
虽然可以通过远程交付来提供一些身体干预措施,但包括远程和面对面交付的双重模式方法将优化治疗效果。需要提供教育支持,以使痴呆症患者及其照顾者能够克服与数字素养相关的障碍。