Meyer Kylie, Wei Wenxing, Yonashiro-Cho Jeanine, Mage Susanna, Kim Sohee, Irani Elliane, Burant Christopher, Gassoumis Zachary, Lamb Erin Gentry, Zauszniewski Jaclene A, Benton Donna
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, United States.
Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States.
JMIR Form Res. 2025 Jul 30;9:e73778. doi: 10.2196/73778.
Older adult mistreatment occurs in many as one-half of dementia care partners. Psychological mistreatment is the most common form of older adult mistreatment by family caregivers and is known to create mental health morbidities among care recipients. The Knowledge and Interpersonal Skills to Develop Enhanced Relationships (KINDER) intervention is among the first older adult mistreatment prevention interventions focused on family caregivers. KINDER was designed to prevent psychological mistreatment of older adults. Caregivers found the initial asynchronous web-based version (KINDER 1.0) to be acceptable but expressed a desire to engage with other family caregivers. KINDER was revised to integrate 3 facilitated small group discussion sessions conducted by videoconference. This study examines the acceptability of a revised KINDER intervention. This research addresses the extent to which caregivers find a novel approach to older adult mistreatment prevention to be acceptable.
This study aims to evaluate the acceptability of the revised KINDER intervention.
The investigators conducted semistructured qualitative interviews with a purposive sample of family caregivers following participation in KINDER (N=11) and collected postintervention survey data (N=71). The qualitative interview codebook and survey questions were informed by the Theoretical Framework of Acceptability by Sekhon et al. Components of acceptability in this framework include affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy at completing activities. Qualitative interviews were coded by 2 independent coders using a thematic analytic approach. Survey data were analyzed using frequencies and percentages.
Of the 98 caregivers who attended KINDER, 71 (72%) completed satisfaction surveys. Caregivers reported high levels of overall satisfaction with KINDER; 80% (53/66) of participants reported they were "Very Satisfied" with the intervention, and 20% (13/66) indicated they were "Satisfied." More than 80% of caregivers (56/69, 81%) rated the newly added group discussions as being "Very valuable." Qualitative findings supported positive attitudes revealed in survey responses. Themes addressed (1) the interventions' alignment with caregiver values (affective attitude, intervention coherence, ethicality), (2) beliefs about the effectiveness of the program (perceived effectiveness), (3) difficulty participating in the program relative to its perceived overall value (burden, opportunity cost, self-efficacy), and (4) recommendations to further improve the intervention.
These findings indicate that KINDER was well received among family caregivers, who reported high levels of satisfaction and positive feedback on its components. The addition of virtual group discussion sessions was particularly valued. The use of multiple data collection methods in this research provided a comprehensive understanding of caregiver experiences. This study contributes to current knowledge by demonstrating the acceptability of a novel intervention to prevent older adult mistreatment by family caregivers to persons with dementia. Future research should focus on testing the efficacy of KINDER and exploring its implementation in health and social service settings.
ClinicalTrials.gov NCT05783102; https://clinicaltrials.gov/study/NCT05783102.
多达一半的痴呆症护理伙伴存在虐待老年人的情况。心理虐待是家庭护理人员虐待老年人最常见的形式，且已知会在受护理者中引发心理健康问题。“增进关系的知识与人际技能”（KINDER）干预措施是最早针对家庭护理人员的预防老年人虐待干预措施之一。KINDER旨在预防对老年人的心理虐待。护理人员认为最初的异步网络版（KINDER 1.0）是可以接受的，但表示希望与其他家庭护理人员互动。KINDER进行了修订，纳入了3次通过视频会议进行的有指导的小组讨论。本研究考察了修订后的KINDER干预措施的可接受性。本研究探讨了护理人员在多大程度上认为一种预防老年人虐待的新方法是可以接受的。
本研究旨在评估修订后的KINDER干预措施的可接受性。
研究人员对参与KINDER的家庭护理人员进行了有目的抽样的半结构化定性访谈（N = 11），并收集了干预后的调查数据（N = 71）。定性访谈编码手册和调查问卷问题参考了塞鸿等人的可接受性理论框架。该框架中的可接受性组成部分包括情感态度、负担、道德性、干预连贯性、机会成本、感知有效性以及完成活动的自我效能感。定性访谈由2名独立编码员采用主题分析方法进行编码。调查数据采用频率和百分比进行分析。
在98名参加KINDER的护理人员中，71名（72%）完成了满意度调查。护理人员对KINDER总体满意度较高；80%（53/66）的参与者表示对该干预措施“非常满意”，20%（13/66）表示“满意”。超过80%的护理人员（56/69，81%）认为新增加的小组讨论“非常有价值”。定性研究结果支持了调查反馈中显示的积极态度。涉及的主题包括：（1）干预措施与护理人员价值观的契合度（情感态度、干预连贯性、道德性）；（2）对项目有效性的信念（感知有效性）；（3）相对于其感知的总体价值而言参与项目的难度（负担、机会成本、自我效能感）；（4）进一步改进干预措施的建议。
这些结果表明，KINDER在家庭护理人员中受到好评，他们对其组成部分满意度高且反馈积极。虚拟小组讨论环节的增加尤其受到重视。本研究中使用的多种数据收集方法提供了对护理人员经历的全面理解。本研究通过证明一种预防家庭护理人员对痴呆症患者虐待的新干预措施的可接受性，为现有知识做出了贡献。未来的研究应侧重于测试KINDER的有效性，并探索其在健康和社会服务环境中的实施情况。
ClinicalTrials.gov NCT05783102；https://clinicaltrials.gov/study/NCT05783102
