Maarja Vislapuu, Monica Patrascu, Heather Allore, Bettina S Husebo, Egil Kjerstad, Marie H Gedde, Line I Berge
{"title":"对居家痴呆症患者及其护理人员进行多成分干预的反馈系统分析：LIVE@Home.Path 试验结果。","authors":"Maarja Vislapuu, Monica Patrascu, Heather Allore, Bettina S Husebo, Egil Kjerstad, Marie H Gedde, Line I Berge","doi":"10.1093/geroni/igae020","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Proper symptom management, informal caregiver support, and service innovation are required to reduce dementia care burden. The objective of this study is to investigate the effect of the multicomponent LIVE (Learning, Innovation, Volunteering, Empowerment) intervention on caregiver experience of the self-perceived care situation, coordinator performance, and informal care time.</p><p><strong>Research design and methods: </strong>We conducted a 24-month multicomponent, stepped-wedge randomized control trial including dyads of people ≥65 years with mild-to-moderate dementia with minimum weekly contact with their informal caregivers in Norway. The intervention was implemented by municipal coordinators over a 6-month period. This study investigates the first 6-month period (September 2019-March 2020) of the trial, due to the coronavirus disease 2019 (COVID-19) pandemic. Primary outcomes are changes in provision of informal care time assessed by Resource Utilization in Dementia Care (RUD) and informal caregiver experience assessed by the Clinical Global Impression of Change (CGIC). We use logistic regression and feedback system analysis to assess the reach of the multicomponent intervention.</p><p><strong>Results: </strong>A total of 280 dyads were included at baseline, mean age of the person with dementia was 81.8 years, and 62.5% were female. After 6 months, the feedback system analysis reveals that the caregivers randomized to the intervention period reported improved caregiver situation (CGIG-T: intervention 0.63 (<i>SD</i> 2.4) vs control -0.43 (<i>SD</i> 1.7), <i>p</i> < .01), even though informal care time for activities of daily living was not reduced (<i>p</i> = .31). Informal caregivers registered a positive change for the Learning, Innovation, and Empowerment components, while no change was found for Volunteer support.</p><p><strong>Discussion and implications: </strong>Findings illustrate the usefulness of dementia care coordinators that provide regular follow-up. We also show that complex intervention studies benefit from applying feedback system analysis. Meeting the needs of persons with dementia and their caregivers is a complex process that requires coordinated input from health services and user communities.</p><p><strong>Clinical trial registration number: </strong>NCT04043364.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"8 3","pages":"igae020"},"PeriodicalIF":4.9000,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10976912/pdf/","citationCount":"0","resultStr":"{\"title\":\"Feedback System Analysis of a Multicomponent Intervention on Dyads of Home-Dwelling Persons With Dementia and Their Caregivers: Results From the LIVE@Home.Path Trial.\",\"authors\":\"Maarja Vislapuu, Monica Patrascu, Heather Allore, Bettina S Husebo, Egil Kjerstad, Marie H Gedde, Line I Berge\",\"doi\":\"10.1093/geroni/igae020\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objectives: </strong>Proper symptom management, informal caregiver support, and service innovation are required to reduce dementia care burden. The objective of this study is to investigate the effect of the multicomponent LIVE (Learning, Innovation, Volunteering, Empowerment) intervention on caregiver experience of the self-perceived care situation, coordinator performance, and informal care time.</p><p><strong>Research design and methods: </strong>We conducted a 24-month multicomponent, stepped-wedge randomized control trial including dyads of people ≥65 years with mild-to-moderate dementia with minimum weekly contact with their informal caregivers in Norway. The intervention was implemented by municipal coordinators over a 6-month period. This study investigates the first 6-month period (September 2019-March 2020) of the trial, due to the coronavirus disease 2019 (COVID-19) pandemic. Primary outcomes are changes in provision of informal care time assessed by Resource Utilization in Dementia Care (RUD) and informal caregiver experience assessed by the Clinical Global Impression of Change (CGIC). We use logistic regression and feedback system analysis to assess the reach of the multicomponent intervention.</p><p><strong>Results: </strong>A total of 280 dyads were included at baseline, mean age of the person with dementia was 81.8 years, and 62.5% were female. After 6 months, the feedback system analysis reveals that the caregivers randomized to the intervention period reported improved caregiver situation (CGIG-T: intervention 0.63 (<i>SD</i> 2.4) vs control -0.43 (<i>SD</i> 1.7), <i>p</i> < .01), even though informal care time for activities of daily living was not reduced (<i>p</i> = .31). Informal caregivers registered a positive change for the Learning, Innovation, and Empowerment components, while no change was found for Volunteer support.</p><p><strong>Discussion and implications: </strong>Findings illustrate the usefulness of dementia care coordinators that provide regular follow-up. 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Feedback System Analysis of a Multicomponent Intervention on Dyads of Home-Dwelling Persons With Dementia and Their Caregivers: Results From the LIVE@Home.Path Trial.
Background and objectives: Proper symptom management, informal caregiver support, and service innovation are required to reduce dementia care burden. The objective of this study is to investigate the effect of the multicomponent LIVE (Learning, Innovation, Volunteering, Empowerment) intervention on caregiver experience of the self-perceived care situation, coordinator performance, and informal care time.
Research design and methods: We conducted a 24-month multicomponent, stepped-wedge randomized control trial including dyads of people ≥65 years with mild-to-moderate dementia with minimum weekly contact with their informal caregivers in Norway. The intervention was implemented by municipal coordinators over a 6-month period. This study investigates the first 6-month period (September 2019-March 2020) of the trial, due to the coronavirus disease 2019 (COVID-19) pandemic. Primary outcomes are changes in provision of informal care time assessed by Resource Utilization in Dementia Care (RUD) and informal caregiver experience assessed by the Clinical Global Impression of Change (CGIC). We use logistic regression and feedback system analysis to assess the reach of the multicomponent intervention.
Results: A total of 280 dyads were included at baseline, mean age of the person with dementia was 81.8 years, and 62.5% were female. After 6 months, the feedback system analysis reveals that the caregivers randomized to the intervention period reported improved caregiver situation (CGIG-T: intervention 0.63 (SD 2.4) vs control -0.43 (SD 1.7), p < .01), even though informal care time for activities of daily living was not reduced (p = .31). Informal caregivers registered a positive change for the Learning, Innovation, and Empowerment components, while no change was found for Volunteer support.
Discussion and implications: Findings illustrate the usefulness of dementia care coordinators that provide regular follow-up. We also show that complex intervention studies benefit from applying feedback system analysis. Meeting the needs of persons with dementia and their caregivers is a complex process that requires coordinated input from health services and user communities.
期刊介绍：
Innovation in Aging, an interdisciplinary Open Access journal of the Gerontological Society of America (GSA), is dedicated to publishing innovative, conceptually robust, and methodologically rigorous research focused on aging and the life course. The journal aims to present studies with the potential to significantly enhance the health, functionality, and overall well-being of older adults by translating scientific insights into practical applications. Research published in the journal spans a variety of settings, including community, clinical, and laboratory contexts, with a clear emphasis on issues that are directly pertinent to aging and the dynamics of life over time. The content of the journal mirrors the diverse research interests of GSA members and encompasses a range of study types. These include the validation of new conceptual or theoretical models, assessments of factors impacting the health and well-being of older adults, evaluations of interventions and policies, the implementation of groundbreaking research methodologies, interdisciplinary research that adapts concepts and methods from other fields to aging studies, and the use of modeling and simulations to understand factors and processes influencing aging outcomes. The journal welcomes contributions from scholars across various disciplines, such as technology, engineering, architecture, economics, business, law, political science, public policy, education, public health, social and psychological sciences, biomedical and health sciences, and the humanities and arts, reflecting a holistic approach to advancing knowledge in gerontology.
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