Wang Shanshan, Cheung Daphne Sze Ki, Leung Sze Him Isaac, Fan Avis Yat Ngar, Ning Wenjing, Leung Angela Yee Man
School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, Melbourne, VIC, Australia.
BMC Nurs. 2025 Apr 9;24(1):396. doi: 10.1186/s12912-025-02778-7.
Despite their own experience of mental health issues, informal caregivers of individuals with dementia are often overlooked, and there is a limited availability of community services tailored specifically for them. A self-help intervention, bibliotherapy, shows promise as an intervention to enhance the mental well-being of caregivers in resource-constrained settings, and social media has demonstrated its efficacy as a user-friendly platform for delivering health interventions. However, the efficacy of social media-based bibliotherapy remains untested.
This study aims to test the efficacy of social media-based bibliotherapy on improving the mental health of informal caregivers of people with dementia through a randomized controlled trial.
A total of 60 informal caregivers were enrolled in this randomized controlled trial. Participants were randomly assigned to either the social media-based bibliotherapy group, which received eight weekly sessions of bibliotherapy, or the usual care group, which only received routine services from community centers. Outcomes were assessed at baseline and immediately after the intervention. Post-intervention interviews were conducted to explore participants' experiences with this intervention. Descriptive statistics, t-tests, Mann-Whitney U tests, χ tests, and generalized estimating equations were used for quantitative data analysis. Content analysis was employed for qualitative data analysis.
The average age of caregivers was 57.41 (SD, 13.63), with a majority being female (79.3%). Baseline characteristics were similar between groups. Both quantitative and qualitative data demonstrated that social media-based bibliotherapy was acceptable for informal caregivers, with WhatsApp being the preferred medium in this study. The recruitment rate, retention rate, and completion rate of weekly tasks all met satisfactory levels. Caregivers found the intervention useful and flexible while experiencing changes in their perceptions towards caregiving responsibilities. The efficacy on mental health (Wald χ = 8.918, p =.003) and all the subscales of stress (Wald χ = 4.198, p =.040), anxiety (Wald χ = 7.667, p =.006), depression (Wald χ = 9.127, p =.003) was statistically significant. The efficacy on caregiving appraisal was only significant on the perceived caregiving burden subscale (Wald χ = 4.954, p =.026). However, caregivers expressed changes in caregiving appraisal in qualitative interviews. The efficacy on the mental component scale of health-related quality of life approached significance (Wald χ = 3.634, p =.057). However, the efficacy on the positive psychological well-being remains insignificant.
To the best of our knowledge, this is the first attempt to use social media-based bibliotherapy among informal caregivers of individuals with dementia. The utilization of WhatsApp was well received among caregivers, and the positive effects on their mental health was demonstrated.
The trial has been registered on ClinicalTrial.gov (Ref: NCT06327022).
尽管痴呆症患者的非正式照料者自身存在心理健康问题，但他们往往被忽视，专门为他们量身定制的社区服务也很有限。一种自助干预方法——阅读疗法，有望在资源有限的环境中提升照料者的心理健康，而社交媒体已证明其作为提供健康干预措施的用户友好平台的有效性。然而，基于社交媒体的阅读疗法的疗效尚未得到检验。
本研究旨在通过一项随机对照试验，检验基于社交媒体的阅读疗法对改善痴呆症患者非正式照料者心理健康的疗效。
共有60名非正式照料者参与了这项随机对照试验。参与者被随机分配到基于社交媒体的阅读疗法组，该组接受为期八周的每周一次阅读疗法课程，或常规护理组，该组仅接受社区中心的常规服务。在基线和干预结束后立即评估结果。干预后进行访谈，以探索参与者对该干预措施的体验。描述性统计、t检验、曼-惠特尼U检验、χ检验和广义估计方程用于定量数据分析。内容分析用于定性数据分析。
照料者的平均年龄为57.41岁（标准差为13.63），大多数为女性（79.3%）。两组的基线特征相似。定量和定性数据均表明，基于社交媒体的阅读疗法为非正式照料者所接受，在本研究中WhatsApp是首选媒介。每周任务的招募率、留存率和完成率均达到令人满意的水平。照料者发现该干预措施有用且灵活，同时他们对照料责任的看法也发生了变化。对心理健康的疗效（Wald χ=8.918，p=0.003）以及压力（Wald χ=4.198，p=0.040）、焦虑（Wald χ=7.667，p=0.006）、抑郁（Wald χ=9.127，p=0.003）所有子量表的疗效均具有统计学意义。对照料评估的疗效仅在感知照料负担子量表上具有显著性（Wald χ=4.954，p=0.026）。然而，照料者在定性访谈中表达了对照料评估的变化。对健康相关生活质量心理成分量表的疗效接近显著性（Wald χ=3.634，p=0.057）。然而，对积极心理健康的疗效仍不显著。
据我们所知，这是首次在痴呆症患者的非正式照料者中尝试使用基于社交媒体的阅读疗法。WhatsApp的使用在照料者中受到好评，并证明了对他们心理健康的积极影响。
该试验已在ClinicalTrial.gov上注册（注册号：NCT06327022）。
