College of Nursing and Health Sciences, Flinders University, Australia.
College of Medicine and Public Health, Flinders University, Australia.
Int J Nurs Stud. 2024 Nov;159:104868. doi: 10.1016/j.ijnurstu.2024.104868. Epub 2024 Aug 7.
Multicomponent interventions with carers of people with dementia demonstrate positive effects on the health and quality of life for carers and care recipients. The World Health Organization's iSupport for Dementia is an evidence-based online psychoeducation programme for carers. However, the programme was mainly implemented as a self-learning tool which might have limited its positive effects on carers and care recipients. Evidence for online multicomponent interventions with carers that incorporates the iSupport programme remains unknown.
This study aimed to partner with health and social care organisations to evaluate the effects of a facilitator-enabled online multicomponent Chinese iSupport programme, which included psychoeducation using the iSupport programme, facilitator-enabled carer support groups and access to care services.
A multicentre randomised controlled trial.
Participants were family carers in Australia and greater China. We recruited participants to the study from 1st November 2021 to 30th June 2022.
The intervention group received the Chinese iSupport programme delivered online. The intervention lasted for 6 months. Our primary outcome was carers' quality of life. Our secondary outcomes were carers' self-efficacy, social support, distress reactions to changed behaviours, care recipients' frequency of changed behaviours, quality of life, unplanned hospital admissions, emergency department presentations and permanent admissions to nursing homes. The outcomes were measured at baseline (T0), 6 months (T1) and 9 months (T2). We applied a multivariate mixed effect linear regression model to capture the group effect, time effect and their interaction.
In total, 266 eligible family carers agreed to participate and were randomly assigned to an intervention group (n = 131) or a usual care group (n = 135). Most carers were women with a mean age of 53 years. The intervention group showed a statistically significant higher score of mental-health-related quality of life (mean difference = 4.1, 95 % CI: 1.5, 6.8, p = 0.002), self-efficacy in controlling upsetting thoughts (mean difference = 7.1, 95 % CI: 2.2, 12.0, p = 0.005) and lower score of distress reactions to changed behaviours (mean difference = -0.1, 95 % CI: -0.3, -0.03, p = 0.012) than the usual care group at T1.
The facilitator-enabled online multicomponent Chinese iSupport programme demonstrated positive effects for carers on mental health-related quality of life, controlling upsetting thoughts and distress reactions to changed behaviours of people with dementia.
This study is registered in the Australia New Zealand Clinical Trials Registry on 12th March 2021 (ACTRN12621000276853).
The facilitator-enabled online multicomponent Chinese iSupport programme improved family carers' mental health-related quality of life, control of upsetting thoughts and distress reactions to changed behaviours of people with dementia.
针对痴呆症患者照顾者的多组分干预措施证明了对照顾者和被照顾者的健康和生活质量有积极影响。世界卫生组织的 iSupport for Dementia 是一种针对照顾者的基于证据的在线心理教育计划。然而，该计划主要作为一种自学工具实施，这可能限制了其对照顾者和被照顾者的积极影响。关于纳入 iSupport 计划的在线多组分干预措施对照顾者的影响的证据仍然未知。
本研究旨在与卫生和社会保健组织合作，评估一种有促进者支持的在线多组分中文 iSupport 计划的效果，该计划包括使用 iSupport 计划进行心理教育、有促进者支持的照顾者支持小组以及获得护理服务。
多中心随机对照试验。
参与者为澳大利亚和大中华地区的家庭照顾者。我们于 2021 年 11 月 1 日至 2022 年 6 月 30 日从研究中招募参与者。
干预组接受在线提供的中文 iSupport 计划。干预持续 6 个月。我们的主要结局是照顾者的生活质量。我们的次要结局是照顾者的自我效能感、社会支持、对行为变化的困扰反应、被照顾者行为变化的频率、生活质量、非计划性住院、急诊就诊和永久性入住养老院。在基线（T0）、6 个月（T1）和 9 个月（T2）时测量结果。我们应用多元混合效应线性回归模型来捕捉组效应、时间效应及其相互作用。
共有 266 名符合条件的家庭照顾者同意参与并被随机分配到干预组（n=131）或常规护理组（n=135）。大多数照顾者是女性，平均年龄为 53 岁。干预组在心理健康相关生活质量方面的评分有统计学意义上的显著提高（平均差异=4.1，95%置信区间：1.5，6.8，p=0.002），控制烦恼思维的自我效能感提高了 7.1（95%置信区间：2.2，12.0，p=0.005），对行为变化的困扰反应评分降低了 0.1（95%置信区间：0.3，-0.03，p=0.012），而常规护理组在 T1 时。
有促进者支持的在线多组分中文 iSupport 计划对痴呆症患者照顾者的心理健康相关生活质量、控制烦恼思维和对行为变化的困扰反应产生了积极影响。
本研究于 2021 年 3 月 12 日在澳大利亚和新西兰临床试验注册中心注册（ACTRN12621000276853）。
有促进者支持的在线多组分中文 iSupport 计划改善了痴呆症患者照顾者的心理健康相关生活质量、控制烦恼思维和对行为变化的困扰反应。
