一项针对患有痴呆症的养老院居民及其护理人员的数码照片活动干预：混合方法过程评估

A Digital Photo Activity Intervention for Nursing Home Residents With Dementia and Their Carers: Mixed Methods Process Evaluation.

作者信息

Tan Josephine Rose Orejana, Neal David P, Vilmen Maria, Boersma Petra, Ettema Teake P, Gobbens Robbert J J, Sikkes Sietske A M, Dröes Rose-Marie

机构信息

Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, location Vrije Universiteit, Amsterdam, The Netherlands.

eHealth Living & Learning Lab, Department of Medical Informatics, Amsterdam UMC, Amsterdam, The Netherlands.

出版信息

JMIR Form Res. 2025 Apr 16;9:e56586. doi: 10.2196/56586.

DOI:10.2196/56586

PMID:40239200

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12044310/

Abstract

BACKGROUND

Within the framework of a randomized controlled trial investigating the impact of a digital, psychosocial photo activity intervention for residents living with dementia in nursing homes and their informal and formal carers, a process evaluation was conducted to determine factors that affected the implementation of the intervention and potentially influenced the intervention outcomes.

OBJECTIVE

By tracing facilitators and barriers to implementation, the study also aimed to inform future implementation of the photo activity intervention.

METHODS

Following Medical Research Council guidance, mixed methods were used to investigate context, implementation, and mechanism-of-impact factors during the photo activity intervention via the Fotoscope web application versus a general conversation activity (control). Google Analytics was set up to gain insight into how the Fotoscope web application was used in practice. For quantitative data, descriptive statistics were calculated and differences between groups tested. For qualitative data, thematic analysis was performed.

RESULTS

In total, 163 semistructured interviews were conducted with residents (photo activity group: n=29, 17.8%; control: n=29, 17.8%), formal carers (photo activity group: n=23, 14.1%; control: n=27, 16.6%), and informal carers (photo activity group: n=28, 17.2%; control: n=27, 16.6%). Regarding contextual factors, a minority of formal carers in both groups (photo activity group: 4/18, 22%; control: 9/24, 38%) mentioned time and workload as barriers to implementing the intervention. Regarding implementation, 86% (25/29) of the residents in the intervention group felt that the digital photo activity worked well on a tablet. Informal carers from both groups wanted more intervention updates from formal carers. The majority of formal carers from both groups were satisfied with how the training and activities were implemented. Regarding the mechanisms of impact, residents in the photo activity group (27/29, 93%) felt significantly more positive about the conversations with their carer (U=533.0, z=2.865, r=0.39; P=.004). Formal carers in the photo activity group (20/23, 87%) got to know the resident better (U=390.5, z=2.114, r=0.302; P=.04) compared to the formal carers in the control group (21/27, 78%). Formal carers in the photo activity group (23/50, 46%) gave a significantly higher rating to the digital photo activity as a way of getting to know the resident living with dementia better (median 9.00, IQR 7-9; U=419.0, z=2.169, r=0.307; P=.03) compared to formal carers in the control group (27/50, 54%; median 8.00, IQR 6-8). Finally, the majority of formal carers in the photo activity group (14/18, 78%) agreed that the Fotoscope app can be used as part of care activities in the nursing home.

CONCLUSIONS

The work invested by formal carers in implementing the photo activity did not seem to differ greatly compared to implementing a general conversation activity, suggesting that the digital photo activity, as an easy-to-implement and enjoyable intervention, could be widely implemented and disseminated in nursing homes.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-https://doi.org/10.1186/s12877-021-02632-w.

摘要

背景

在一项随机对照试验的框架内，研究针对养老院中患有痴呆症的居民及其非正式和正式护理人员的数字心理社会照片活动干预措施的影响，进行了一项过程评估，以确定影响干预措施实施并可能影响干预结果的因素。

目的

通过追踪实施过程中的促进因素和障碍，该研究还旨在为照片活动干预措施的未来实施提供信息。

方法

遵循医学研究理事会的指导方针，采用混合方法，通过Fotoscope网络应用程序与一般对话活动（对照），调查照片活动干预期间的背景、实施和影响机制因素。设置谷歌分析以深入了解Fotoscope网络应用程序在实际中的使用情况。对于定量数据，计算描述性统计量并检验组间差异。对于定性数据，进行主题分析。

结果

总共对居民（照片活动组：n = 29，17.8%；对照组：n = 29，17.8%）、正式护理人员（照片活动组：n = 23，14.1%；对照组：n = 27，16.6%）和非正式护理人员（照片活动组：n = 28，17.2%；对照组：n = 27，16.6%）进行了163次半结构化访谈。关于背景因素，两组中的少数正式护理人员（照片活动组：4/18，22%；对照组：9/24，38%）提到时间和工作量是实施干预措施的障碍。关于实施情况，干预组中86%（25/29）的居民认为数字照片活动在平板电脑上效果良好。两组的非正式护理人员都希望正式护理人员提供更多干预进展情况。两组中的大多数正式护理人员对培训和活动的实施方式感到满意。关于影响机制，照片活动组中的居民（27/29，93%）对与护理人员的对话感觉明显更积极（U = 533.0，z = 2.865，r = 0.39；P = 0.004）。与对照组中的正式护理人员（21/27，78%）相比，照片活动组中的正式护理人员（20/23，87%）对居民有了更好的了解（U = 390.5，z = 2.114，r = 0.302；P = 0.04）。与对照组中的正式护理人员（27/50，54%；中位数8.00，四分位距6 - 8）相比，照片活动组中的正式护理人员（23/50，46%）对数字照片活动作为更好地了解患有痴呆症居民的方式给予了显著更高的评价（中位数9.00，四分位距7 - 9；U = 419.0，z = 2.169，r = 0.307；P = 0.03）。最后，照片活动组中的大多数正式护理人员（14/18，78%）同意Fotoscope应用程序可作为养老院护理活动的一部分使用。