一项基于社交媒体的身心干预措施对体弱老年人家庭照顾者减压效果的研究：试点随机对照试验，该干预措施融入了指压疗法和正念减压法

Effects of a Social Media-Based Mind-Body Intervention Embedded With Acupressure and Mindfulness for Stress Reduction Among Family Caregivers of Frail Older Adults: Pilot Randomized Controlled Trial.

作者信息

Sui Yufang, Kor Patrick Pui Kin, Li Mengli, Wang Jingjing

机构信息

School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.

School of Nursing and Health, Zhengzhou University, Zhengzhou, China.

出版信息

JMIR Form Res. 2023 Feb 20;7:e42861. doi: 10.2196/42861.

DOI:10.2196/42861

PMID:36804167

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9989915/

Abstract

BACKGROUND

Family caregivers of frail older adults experience high levels of stress. Mind-body interventions (MBIs) focused on caregiver stress are often limited in teaching approaches, difficult to practice, and costly. A social media-based MBI embedded with mindfulness meditation (MM) and self-administered acupressure (SA) may be effective for family caregivers, offer greater usability, and lead to greater adherence.

OBJECTIVE

The aim of this study was to test the feasibility and preliminary effects of a social media-based MBI embedded with MM and SA on family caregivers of frail older adults and to investigate the preliminary effects of the intervention using a pilot randomized controlled trial.

METHODS

A 2-arm randomized controlled trial design was adopted. Family caregivers of frail older adults (n=64) were randomized into either the intervention group (n=32), receiving 8 weeks of social media-based MM and SA, or the control group (n=32), receiving brief education on caregiving for people with frailty. The primary outcome (caregiver stress) and secondary outcomes (caregiver burden, sleep quality, and mindfulness awareness and attention) were measured using a web-based survey at baseline (T0), immediately after the intervention (T1), and at the 3-month follow-up (T2).

RESULTS

The feasibility of the intervention was established with a high attendance rate (87.5%), high usability score (79), and low attrition rate (1.6%). The generalized estimating equation results showed that participants in the intervention group at T1 and T2 experienced a significant improvement in stress reduction (P=.02 and P=.04, respectively), sleep quality (P=.004 and P=.01, respectively), and mindful awareness and attention (P=.006 and P=.02, respectively) compared with the control group. There were no substantial improvements in caregiver burden at T1 and T2 (P=.59 and P=.47, respectively). A focus group session conducted after the intervention had 5 themes: impact on the family caregivers, difficulty in practicing the intervention, the strength of the program, the limitations of the program, and perception of the intervention.

CONCLUSIONS

The findings support the feasibility and preliminary effects of social media-based MBI embedded with acupressure and MM on reducing stress among family caregivers of frail older people and enhancing sleep quality and mindfulness levels. A future study with a larger and more diverse sample is proposed to evaluate the longer-term effects and generalizability of the intervention.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2100049507; http://www.chictr.org.cn/showproj.aspx?proj=128031.

摘要

背景

体弱老年人的家庭照顾者承受着高水平的压力。专注于照顾者压力的身心干预（MBIs）在教学方法上往往有限，难以实践且成本高昂。一种基于社交媒体的身心干预，融入正念冥想（MM）和自我按摩（SA），可能对家庭照顾者有效，具有更高的可用性，并能带来更高的依从性。

目的

本研究旨在测试一种基于社交媒体的、融入MM和SA的身心干预对体弱老年人家庭照顾者的可行性和初步效果，并通过一项试点随机对照试验调查该干预的初步效果。

方法

采用双臂随机对照试验设计。体弱老年人的家庭照顾者（n = 64）被随机分为干预组（n = 32），接受为期8周的基于社交媒体的MM和SA干预，或对照组（n = 32），接受关于体弱人群护理的简短教育。在基线（T0）、干预结束后立即（T1）和3个月随访（T2）时，通过基于网络的调查测量主要结局（照顾者压力）和次要结局（照顾者负担、睡眠质量以及正念意识和注意力）。

结果

干预的可行性得到确立，出勤率高（87.5%），可用性得分高（79），流失率低（1.6%）。广义估计方程结果显示，与对照组相比，干预组在T1和T2时的压力减轻（分别为P = 0.02和P = 0.04）、睡眠质量（分别为P = 0.004和P = 0.01）以及正念意识和注意力（分别为P = 0.006和P = 0.02）均有显著改善。在T1和T2时，照顾者负担没有实质性改善（分别为P = 0.59和P = 0.47）。干预后进行的焦点小组讨论有5个主题：对家庭照顾者的影响、干预实践的困难、项目的优势、项目的局限性以及对干预的看法。