School of Health Policy and Management, Faculty of Health, York University, Toronto, ON, Canada.
Alzheimer Society of York Region, Aurora, ON, Canada.
Syst Rev. 2024 Oct 23;13(1):265. doi: 10.1186/s13643-024-02683-1.
Adult day programs aim to facilitate aging in place by supporting the health and well-being of persons with dementia and providing respite to their caregivers. However, studies on the effects of day programs are inconclusive, and we especially lack insights into the context conditions and mechanisms of day programs that may produce different outcomes for different groups of persons with dementia and their caregivers. Our objective was to conduct a realist review, synthesizing research on day programs to develop program theories explaining how and why day programs do or do not produce positive or negative outcomes for different groups of persons with dementia, and caregivers.
We identified 14 literature reviews (including 329 references published between 1975 and 2021) on adult day programs. From this initial pool of studies, we will include those that focused on day program attendees with dementia or meaningful cognitive impairment, and/or their caregivers, and that report how day program contexts (C) and mechanisms (M) bring about outcomes (O) for attendees and caregivers. We will extract CMO statements (i.e., narratives that explain how and why day programs do or do not bring about certain outcomes for whom and under what circumstances). Using additional focused searches, citation mapping, citation tracking, and discussions with our researcher and expert team members, we will identify additional references. CMO statements will be synthesized, transformed into hypotheses, and linked and visualized to form program theories. Using focus groups and the James Lind Alliance Priority Setting Partnership method, we will discuss and prioritize our CMO statements and refine our program theories with 32 experts (older adults, caregivers, Alzheimer societies, caregiver organizations, day program staff and managers, and health system and policy decision makers).
By identifying essential elements and processes of day programs and related knowledge gaps, this study will generate much-needed knowledge to leverage the full potential of day programs so they can provide appropriate care, preventing premature institutionalization, and unnecessary acute and primary care use. This will ultimately improve the quality of life of persons with dementia and their caregivers, alleviate caregiver burden, and reduce social costs.
PROSPERO CRD42024504030.
成人日间照料项目旨在通过支持痴呆症患者的健康和福祉，为其护理人员提供喘息机会，从而促进他们在家中安度晚年。然而，关于日间照料项目效果的研究尚无定论，我们尤其缺乏对日间照料项目的背景条件和机制的深入了解，而这些机制可能会为不同类型的痴呆症患者及其护理人员带来不同的结果。我们的目标是进行一项实际主义综述，综合研究日间照料项目，以制定项目理论，解释日间照料项目如何以及为何为不同类型的痴呆症患者及其护理人员带来积极或消极的结果。
我们确定了 14 篇关于成人日间照料项目的文献综述（包括 1975 年至 2021 年期间发表的 329 篇参考文献）。从这个初步的研究池中，我们将纳入那些专注于日间照料项目参与者（患有痴呆症或有意义的认知障碍）及其护理人员，并报告日间照料项目的背景（C）和机制（M）如何为参与者和护理人员带来结果（O）的研究。我们将提取 CMO 陈述（即解释日间照料项目如何以及为何为特定人群在特定情况下带来特定结果的叙述）。通过额外的重点搜索、引文映射、引文跟踪以及与我们的研究人员和专家团队成员的讨论，我们将确定其他参考文献。CMO 陈述将被综合，转化为假设，并链接和可视化，以形成项目理论。通过焦点小组和詹姆斯·林德联盟优先事项设定伙伴关系方法，我们将与 32 位专家（老年人、护理人员、阿尔茨海默病协会、护理人员组织、日间照料项目工作人员和管理人员以及卫生系统和政策决策者）讨论并确定我们的 CMO 陈述的优先级，并完善我们的项目理论。
通过确定日间照料项目的基本要素和过程以及相关的知识空白，本研究将产生急需的知识，以充分发挥日间照料项目的潜力，为他们提供适当的护理，防止过早住院和不必要的急性和初级保健使用。这最终将提高痴呆症患者及其护理人员的生活质量，减轻护理人员的负担，并降低社会成本。
PROSPERO CRD42024504030。
