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通过环境提示在家中营造和谐氛围:一项针对农村痴呆症患者照料者的非药物干预可行性试验。

Creating harmony at home via environmental cueing: A feasibility trial of a non-pharmacological intervention for rural caregivers of persons with dementia.

作者信息

Rhodus Elizabeth K, Kryscio Richard, Jicha Gregory, Baum Carolyn, Henley Laura, Fairchild Vickie, Roberts Celeste, Gibson Allison

机构信息

Sanders-Brown Center on Aging, College of Medicine, University of Kentucky, Lexington, Kentucky, USA.

Dr. Bing Zhang Department of Statistics, College of Arts and Sciences, University of Kentucky, Lexington, Kentucky, USA.

出版信息

Alzheimers Dement. 2025 Jul;21(7):e70405. doi: 10.1002/alz.70405.

Abstract

INTRODUCTION

Behavioral and psychiatric symptoms of dementia (BPSDs) and functional impairment have a major impact on quality of life for people living with dementia (PLWD). Development of caregiver-initiated interventions, including environmental assessment and modification, are priorities in the field.

METHODS

An open-label study of 40 caregivers of PLWD with BPSDs that underwent a 6-week telehealth person-environment intervention, Harmony at HOME, was conducted. Feasibility was assessed by improved caregiver mastery.

RESULTS

Twenty-eight caregivers completed the intervention, which increased caregiver mastery and decreased stress and burden. There were statistically significant improvements in functional performance of the person living with dementia (p < 0.005) and caregivers' satisfaction with the person living with dementia's functional performance (p < 0.001).

DISCUSSION

The intervention increased caregivers' skills and knowledge in assessing and modifying the environment to address BPSDs. Although overall caregiver mastery was not changed significantly, additional clinical research assessing caregiver mastery in relation to specific caregiving tasks within the home environment is needed.

CLINICAL TRIAL REGISTRATION

Clinicaltrials.gov NCT05202223 HIGHLIGHTS: Aging in place is difficult to achieve for individuals with dementia. A novel dyadic care intervention, Harmony at HOME, improved caregiver outcomes. Future care research should explore performance-based patient outcomes.

摘要

引言

痴呆症的行为和精神症状(BPSDs)以及功能障碍对痴呆症患者(PLWD)的生活质量有重大影响。开发由护理人员发起的干预措施,包括环境评估和改造,是该领域的优先事项。

方法

对40名患有BPSDs的PLWD护理人员进行了一项开放标签研究,他们接受了为期6周的远程健康人-环境干预“居家和谐”。通过提高护理人员的掌控感来评估可行性。

结果

28名护理人员完成了干预,这提高了护理人员的掌控感,减轻了压力和负担。痴呆症患者的功能表现有统计学上的显著改善(p < 0.005),护理人员对痴呆症患者功能表现的满意度也有显著提高(p < 0.001)。

讨论

该干预提高了护理人员在评估和改造环境以解决BPSDs方面的技能和知识。尽管护理人员的总体掌控感没有显著变化,但需要进行更多临床研究,以评估护理人员在家庭环境中与特定护理任务相关的掌控感。

临床试验注册

Clinicaltrials.gov NCT05202223 要点:痴呆症患者难以实现就地养老。一种新型的二元护理干预措施“居家和谐”改善了护理人员的结局。未来的护理研究应探索基于表现的患者结局。

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