The effects of a facilitator-enabled online multicomponent iSupport for dementia programme: A multicentre randomised controlled trial

IF 7.5 1区 医学 Q1 NURSING
Lily Xiao , Shahid Ullah , Rujun Hu , Jing Wang , Huali Wang , Chia-Chi Chang , Timothy Kwok , Mingxia Zhu , Julie Ratcliffe , Henry Brodaty , Bianca Brijnath , Hui-Chen (Rita) Chang , Bel Wong , Yunrui Zhou , Jinjie He , Mengmeng Xia , Jhih-Yang Hong , Shirley Che , Rachel Milte
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引用次数: 0

Abstract

Background

Multicomponent interventions with carers of people with dementia demonstrate positive effects on the health and quality of life for carers and care recipients. The World Health Organization's iSupport for Dementia is an evidence-based online psychoeducation programme for carers. However, the programme was mainly implemented as a self-learning tool which might have limited its positive effects on carers and care recipients. Evidence for online multicomponent interventions with carers that incorporates the iSupport programme remains unknown.

Objectives

This study aimed to partner with health and social care organisations to evaluate the effects of a facilitator-enabled online multicomponent Chinese iSupport programme, which included psychoeducation using the iSupport programme, facilitator-enabled carer support groups and access to care services.

Design

A multicentre randomised controlled trial.

Settings and participants

Participants were family carers in Australia and greater China. We recruited participants to the study from 1st November 2021 to 30th June 2022.

Methods

The intervention group received the Chinese iSupport programme delivered online. The intervention lasted for 6 months. Our primary outcome was carers' quality of life. Our secondary outcomes were carers' self-efficacy, social support, distress reactions to changed behaviours, care recipients' frequency of changed behaviours, quality of life, unplanned hospital admissions, emergency department presentations and permanent admissions to nursing homes. The outcomes were measured at baseline (T0), 6 months (T1) and 9 months (T2). We applied a multivariate mixed effect linear regression model to capture the group effect, time effect and their interaction.

Results

In total, 266 eligible family carers agreed to participate and were randomly assigned to an intervention group (n = 131) or a usual care group (n = 135). Most carers were women with a mean age of 53 years. The intervention group showed a statistically significant higher score of mental-health-related quality of life (mean difference = 4.1, 95 % CI: 1.5, 6.8, p = 0.002), self-efficacy in controlling upsetting thoughts (mean difference = 7.1, 95 % CI: 2.2, 12.0, p = 0.005) and lower score of distress reactions to changed behaviours (mean difference = − 0.1, 95 % CI: − 0.3, − 0.03, p = 0.012) than the usual care group at T1.

Conclusion

The facilitator-enabled online multicomponent Chinese iSupport programme demonstrated positive effects for carers on mental health-related quality of life, controlling upsetting thoughts and distress reactions to changed behaviours of people with dementia.

Trial registration

This study is registered in the Australia New Zealand Clinical Trials Registry on 12th March 2021 (ACTRN12621000276853).

Tweetable abstract

The facilitator-enabled online multicomponent Chinese iSupport programme improved family carers' mental health-related quality of life, control of upsetting thoughts and distress reactions to changed behaviours of people with dementia.

促进者支持的痴呆症在线多组件 iSupport 计划的效果:多中心随机对照试验
对痴呆症患者的照护者采取多成分干预措施,对照护者和受照护者的健康和生活质量产生了积极影响。世界卫生组织的 iSupport for Dementia 是一项针对照护者的循证在线心理教育计划。然而,该计划主要是作为一种自学工具来实施的,这可能会限制其对照护者和受照护者的积极影响。针对照护者的在线多成分干预措施(包括 iSupport 计划)的证据仍然未知。本研究旨在与医疗和社会护理机构合作,评估由促进者支持的在线多成分中文 iSupport 计划的效果,该计划包括使用 iSupport 计划进行心理教育、由促进者支持的护理者支持小组以及获取护理服务。多中心随机对照试验。参与者为澳大利亚和大中华区的家庭照护者。我们在2021年11月1日至2022年6月30日期间招募研究参与者。干预组接受在线提供的中文 iSupport 计划。干预为期 6 个月。我们的主要结果是照护者的生活质量。次要结果包括照顾者的自我效能感、社会支持、对改变行为的痛苦反应、受照顾者改变行为的频率、生活质量、意外入院、急诊就诊和长期入住疗养院。这些结果分别在基线(T0)、6 个月(T1)和 9 个月(T2)时进行测量。我们采用多变量混合效应线性回归模型来捕捉群体效应、时间效应及其交互作用。共有 266 名符合条件的家庭照护者同意参与,并被随机分配到干预组(131 人)或常规照护组(135 人)。大多数照顾者为女性,平均年龄为 53 岁。干预组的心理健康相关生活质量得分(平均差异 = 4.1,95 % CI:1.5, 6.8,p = 0.002)、控制烦乱想法的自我效能(平均差异 = 7.1,95 % CI:2.2, 12.0,p = 0.005)和行为改变后的痛苦反应得分(平均差异 = -0.1,95 % CI:-0.3, -0.03,p = 0.012)均显著高于常规护理组。由促进者支持的在线多成分中文 iSupport 计划对照护者的心理健康相关生活质量、控制对痴呆症患者行为改变的不安想法和痛苦反应产生了积极影响。这项研究已于2021年3月12日在澳大利亚-新西兰临床试验注册中心注册(ACTRN12621000276853)。由促进者支持的在线多成分中文iSupport项目提高了家庭照护者的心理健康相关生活质量,控制了对痴呆症患者行为改变的不安想法和痛苦反应。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
15.00
自引率
2.50%
发文量
181
审稿时长
21 days
期刊介绍: The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).
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