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
{"title":"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","authors":"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","doi":"10.1016/j.ijnurstu.2024.104868","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>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.</p></div><div><h3>Objectives</h3><p>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.</p></div><div><h3>Design</h3><p>A multicentre randomised controlled trial.</p></div><div><h3>Settings and participants</h3><p>Participants were family carers in Australia and greater China. We recruited participants to the study from 1st November 2021 to 30th June 2022.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusion</h3><p>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.</p></div><div><h3>Trial registration</h3><p>This study is registered in the Australia New Zealand Clinical Trials Registry on 12th March 2021 (ACTRN12621000276853).</p></div><div><h3>Tweetable abstract</h3><p>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.</p></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"159 ","pages":"Article 104868"},"PeriodicalIF":7.5000,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0020748924001810/pdfft?md5=c2aa0b185f1c78650e77667db910d419&pid=1-s2.0-S0020748924001810-main.pdf","citationCount":"0","resultStr":"{\"title\":\"The effects of a facilitator-enabled online multicomponent iSupport for dementia programme: A multicentre randomised controlled trial\",\"authors\":\"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\",\"doi\":\"10.1016/j.ijnurstu.2024.104868\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>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.</p></div><div><h3>Objectives</h3><p>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.</p></div><div><h3>Design</h3><p>A multicentre randomised controlled trial.</p></div><div><h3>Settings and participants</h3><p>Participants were family carers in Australia and greater China. We recruited participants to the study from 1st November 2021 to 30th June 2022.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusion</h3><p>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.</p></div><div><h3>Trial registration</h3><p>This study is registered in the Australia New Zealand Clinical Trials Registry on 12th March 2021 (ACTRN12621000276853).</p></div><div><h3>Tweetable abstract</h3><p>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.</p></div>\",\"PeriodicalId\":50299,\"journal\":{\"name\":\"International Journal of Nursing Studies\",\"volume\":\"159 \",\"pages\":\"Article 104868\"},\"PeriodicalIF\":7.5000,\"publicationDate\":\"2024-08-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S0020748924001810/pdfft?md5=c2aa0b185f1c78650e77667db910d419&pid=1-s2.0-S0020748924001810-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Nursing Studies\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0020748924001810\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Nursing Studies","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0020748924001810","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
The effects of a facilitator-enabled online multicomponent iSupport for dementia programme: A multicentre randomised controlled trial
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.
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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