Rochon Elizabeth A, Sy Maimouna, Phillips Mirelle, Anderson Erik, Plys Evan, Ritchie Christine, Vranceanu Ana-Maria
Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.
Mongan Institute Center for Aging and Serious Illness and the Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States.
JMIR Res Protoc. 2023 Dec 29;12:e52799. doi: 10.2196/52799.
Alzheimer disease and related dementias are debilitating and incurable diseases. Persons with dementia and their informal caregivers (ie, dyads) experience high rates of emotional distress and negative health outcomes. Several barriers prevent dyads from engaging in psychosocial care including cost, transportation, and a lack of treatments that target later stages of dementia and target the dyad together. Technologically informed treatment and serious gaming have been shown to be feasible and effective among persons living with dementia and their care partners. To increase access, there is a need for technologically informed psychosocial interventions which target the dyad, together in the home.
This study aims to develop the toolkit for experiential well-being in dementia, a dyadic, "bio-experiential" intervention for persons with dementia and their caregivers. Per our conceptual model, the toolkit for experiential well-being in dementia platform aims to target sustained attention, positive emotions, and active engagement among dyads. In this paper, we outline the protocol and conceptual model for intervention development and partnership with design and development experts.
We followed the National Institutes of Health (NIH) stage model (stage 1A) and supplemented the model with principles of user-centered design. The first step includes understanding user needs, goals, and strengths. We met this step by engaging in methodology and definition synthesis and conducting focus groups with dementia care providers (N=10) and persons with dementia and caregivers (N=11). Step 2 includes developing and refining the prototype. We will meet this step by engaging dyads in up to 20 iterations of platform β testing workshops. Step 3 includes observing user interactions with the prototype. We will meet this step by releasing the platform for feasibility testing.
Key takeaways from the focus groups include balancing individualization and the dyadic relationship and avoiding confusing stimuli. As of September 2023, we have completed focus groups with providers, persons with dementia, and their caregivers. Additionally, we have conducted 4 iterations of β testing workshops with dyads. Feedback from focus groups informed the β testing workshops; data have not yet been formally analyzed and will be reported in future publications.
Technological interventions, particularly "bio-experiential" technology, can be used in dementia care to support emotional health among persons with a diagnosis and caregivers. Here, we outline a collaborative intervention development process of bio-experiential technology through a research, design, and development partnership. Next, we are planning to test the platform's feasibility as well as its impact on clinical outcomes and mechanisms of action.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/52799.
阿尔茨海默病及相关痴呆症是使人衰弱且无法治愈的疾病。患有痴呆症的患者及其非正式照护者(即二元组)经历着高比例的情绪困扰和不良健康后果。存在多种障碍阻碍二元组参与心理社会护理,包括成本、交通问题,以及缺乏针对痴呆症晚期且同时针对二元组的治疗方法。技术辅助治疗和严肃游戏已被证明在痴呆症患者及其照护伙伴中是可行且有效的。为了增加可及性,需要有针对二元组、在家中共同实施的技术辅助心理社会干预措施。
本研究旨在开发痴呆症体验幸福感工具包,这是一种针对痴呆症患者及其照护者的二元“生物体验”干预措施。根据我们的概念模型,痴呆症体验幸福感工具包平台旨在针对二元组中的持续注意力、积极情绪和积极参与度。在本文中,我们概述了干预措施开发以及与设计和开发专家合作的方案和概念模型。
我们遵循美国国立卫生研究院(NIH)的阶段模型(1A阶段),并用以用户为中心的设计原则对该模型进行补充。第一步包括了解用户需求、目标和优势。我们通过进行方法和定义综合以及与痴呆症护理提供者(N = 10)以及痴呆症患者及其照护者(N = 11)开展焦点小组讨论来完成这一步骤。第二步包括开发和完善原型。我们将通过让二元组参与多达20次的平台β测试工作坊来完成这一步骤。第三步包括观察用户与原型的交互。我们将通过发布该平台进行可行性测试来完成这一步骤。
焦点小组讨论的主要收获包括平衡个性化与二元关系以及避免令人困惑的刺激因素。截至2023年9月,我们已经完成了与护理提供者、痴呆症患者及其照护者的焦点小组讨论。此外,我们已经与二元组进行了4次β测试工作坊。焦点小组讨论的反馈为β测试工作坊提供了信息;数据尚未进行正式分析,将在未来的出版物中报告。
技术干预措施,特别是“生物体验”技术,可用于痴呆症护理,以支持确诊患者及其照护者的情绪健康。在此,我们概述了通过研究、设计和开发伙伴关系进行生物体验技术的协作干预措施开发过程。接下来,我们计划测试该平台的可行性及其对临床结果和作用机制的影响。
国际注册报告标识符(IRRID):DERR1-10.2196/52799