一项针对 Learning Skills Together (LST) 干预措施的随机对照试验，以提高痴呆症家庭照顾者在复杂护理方面的自我效能感。

A randomised controlled trial of the Learning Skills Together (LST) intervention to improve dementia family caregivers' self-efficacy with complex care.

机构信息

Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, 44106, USA.

School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.

出版信息

Trials. 2024 Jun 8;25(1):369. doi: 10.1186/s13063-024-08204-8.

DOI:10.1186/s13063-024-08204-8

PMID:38851719

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11161926/

Abstract

BACKGROUND

Nearly two-thirds of family caregivers of persons living with Alzheimer's disease or related dementias (AD/ADRD) provide complex care, including medical care. Family caregivers typically receive little to no training on how to provide this care. Furthermore, family caregivers simultaneously grapple with the presence of behavioral and psychological symptoms of dementia (BPSD), diminished communication abilities, and comorbidities such as diabetes. We developed Learning Skills Together (LST), a 6-week digitally delivered psychoeducational program, to facilitate family caregiver abilities to administer complex care tasks. The goal of the present study is to test the efficacy of LST and to reduce adverse outcomes associated with caregiving, such as depressive symptomology and negative appraisal of BPSD.

METHODS

To test the efficacy of LST, we will conduct a two-arm single-site randomized controlled trial (RCT) with N = 200 family caregivers of persons living with AD/ADRD. Eligible family caregivers will be randomly assigned to participate in either the LST intervention or a structurally equivalent control condition focused on healthy living. All family caregivers will complete four surveys, including a baseline survey administered prior to randomization, a post-intervention survey, and a 3- and 6-month follow-up survey to assess change in study outcomes. Between-group comparisons of each outcome will be evaluated using generalized estimating equation models. Mediation analyses will assess family caregiver self-efficacy as the intervention's mechanism of change in depressive symptomology and BPSD. We will also examine caregiver race, ethnicity, and gender as effect modifiers of the intervention.

DISCUSSION

LST findings will inform the field of AD/ADRD and caregiving regarding optimally supporting family caregivers in managing complex care tasks. If efficacious, the LST intervention will support family caregivers in preserving their own mental health while providing complex care.

TRIAL REGISTRATION

Clinical Trials.gov NCT05846984 . This study was registered on May 6, 2023.

摘要

背景

近三分之二的阿尔茨海默病或相关痴呆症（AD/ADRD）患者的家庭照护者提供复杂的护理，包括医疗护理。家庭照护者通常很少接受如何提供这种护理的培训。此外，家庭照护者同时面临行为和心理症状的痴呆症（BPSD）、沟通能力下降以及糖尿病等合并症的困扰。我们开发了学习技能一起（LST），这是一个为期 6 周的数字交付心理教育计划，以促进家庭照护者管理复杂护理任务的能力。本研究的目的是测试 LST 的疗效，并减少与护理相关的不良后果，如抑郁症状和对 BPSD 的负面评价。

方法

为了测试 LST 的疗效，我们将进行一项为期 2 臂、单站点、随机对照试验（RCT），共有 200 名 AD/ADRD 患者的家庭照护者参与。符合条件的家庭照护者将被随机分配参加 LST 干预或关注健康生活的结构等效对照组。所有家庭照护者将完成 4 项调查，包括在随机分组前进行的基线调查、干预后调查以及 3 个月和 6 个月的随访调查，以评估研究结果的变化。使用广义估计方程模型对每个结果的组间比较进行评估。中介分析将评估家庭照护者自我效能感作为干预对抑郁症状和 BPSD 的变化机制。我们还将检查护理人员的种族、民族和性别是否对干预有影响。