Laboratoire de Plasticité cérébrale, Communication et Vieillissement, Centre de recherche de l'Institut Universitaire de gériatrie de Montréal, Université de Montréal, Montréal, QC, Canada.
John Hopkins Hospital, John Hopkins University, Baltimore, MD, United States.
JMIR Aging. 2024 Jul 4;7:e47565. doi: 10.2196/47565.
Persons living with dementia experience autonomy loss and require caregiver support on a daily basis. Dementia involves a gradual decline in communication skills, leading to fewer interactions and isolation for both people living with dementia and their caregivers, negatively impacting the quality of life for both members of the dyad. The resulting stress and burden on caregivers make them particularly susceptible to burnout.
This study aims to examine the efficacy of Communication Proches Aidants (COMPAs), an app designed following the principles of person-centered and emotional communication, which is intended to improve well-being in persons living with dementia and caregivers and reduce caregiver burden.
In this implementation study, volunteer caregivers in 2 long-term care facilities (n=17) were trained in using COMPAs and strategies to improve communication with persons living with dementia. Qualitative and quantitative analyses, semistructured interviews, and questionnaires were completed before and after 8 weeks of intervention with COMPAs.
Semistructured interviews revealed that all caregivers perceived a positive impact following COMPAs interventions, namely, improved quality of communication and quality of life among persons living with dementia and caregivers. Improved quality of life was also supported by a statistically significant reduction in the General Health Questionnaire-12 scores (caregivers who improved: 9/17, 53%; z=2.537; P=.01). COMPAs interventions were also associated with a statistically significant increased feeling of personal accomplishment (caregivers improved: 11/17, 65%; t=2.430; P=.03; d=0.61 [medium effect size]).
COMPAs intervention improved well-being in persons living with dementia and their caregivers by developing person-centered communication within the dyad, increasing empathy, and reducing burden in caregivers although most caregivers were unfamiliar with technology. The results hold promise for COMPAs interventions in long-term care settings. Larger group-controlled studies with different populations, in different contexts, and at different stages of dementia will provide a clearer picture of the benefits of COMPAs interventions.
痴呆症患者会逐渐丧失自主性，每天都需要护理人员的支持。痴呆症会导致沟通能力逐渐下降，从而减少痴呆症患者和护理人员之间的互动和交流，使双方都感到孤立，进而降低他们的生活质量。这种情况会给护理人员带来压力和负担，使他们更容易出现倦怠。
本研究旨在检验“沟通辅助 APP（Communication Proches Aidants，COMPAs）”的疗效，该 APP 是根据以人为本和情感沟通的原则设计的，旨在改善痴呆症患者和护理人员的幸福感，减轻护理人员的负担。
在这项实施研究中，2 家长期护理机构的志愿者护理人员（n=17）接受了使用 COMPAs 以及改善与痴呆症患者沟通的策略的培训。在使用 COMPAs 干预 8 周前后，完成了定性和定量分析、半结构化访谈和问卷调查。
半结构化访谈显示，所有护理人员在使用 COMPAs 干预后都认为其产生了积极影响，具体表现为改善了痴呆症患者和护理人员之间的沟通质量和生活质量。一般健康问卷-12 评分的显著降低也支持了生活质量的改善（改善的护理人员：17 人中有 9 人，占 53%；z=2.537；P=.01）。COMPAs 干预还与护理人员个人成就感的显著增加相关（改善的护理人员：17 人中有 11 人，占 65%；t=2.430；P=.03；d=0.61[中等效应量]）。
通过在护理人员与痴呆症患者的关系中发展以人为本的沟通，提高同理心，并减轻护理人员的负担，COMPAs 干预改善了痴呆症患者和护理人员的幸福感。尽管大多数护理人员对技术不熟悉，但该干预措施仍具有前景。在不同人群、不同环境和不同痴呆症阶段的更大的、有对照组的研究将更清楚地了解 COMPAs 干预措施的益处。
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