成人日间项目及其对痴呆症患者及其照顾者的影响(ADAPT-DemCare):一项现实主义综合研究,旨在就如何以及为何开展项目提出理论。

IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Hung Nguyen, Atiqur Rahman, Andrea Ubell, Zahra Goodarzi, Colleen J Maxwell, Saleema Allana, Kaitlyn Tate, Holly Symonds-Brown, Lori Weeks, Sienna Caspar, Jim Mann, Matthias Hoben
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引用次数: 0

摘要

背景:成人日间项目旨在通过支持痴呆症患者的健康和福祉,并为其照顾者提供喘息机会,从而促进居家养老。然而,有关日间项目效果的研究尚无定论,我们尤其缺乏对日间项目背景条件和机制的深入了解,而这些条件和机制可能会对不同群体的痴呆症患者及其照顾者产生不同的效果。我们的目标是进行一次现实主义综述,综合有关日间项目的研究,发展项目理论,解释日间项目如何以及为何对不同群体的痴呆症患者及其照护者产生或积极或消极的结果:我们确定了 14 篇关于成人日间项目的文献综述(包括 1975 年至 2021 年间发表的 329 篇参考文献)。从这些初步研究中,我们将纳入那些以患有痴呆症或严重认知障碍的日间项目参加者和/或其照顾者为研究对象的研究,并报告日间项目的环境(C)和机制(M)如何为参加者和照顾者带来结果(O)。我们将提取 CMO 声明(即解释日间项目如何以及为什么在什么情况下为谁带来或没有带来某些结果的叙述)。通过额外的重点搜索、引文映射、引文跟踪以及与我们的研究人员和专家团队成员的讨论,我们将确定更多的参考文献。我们将对 CMO 的陈述进行综合,将其转化为假设,并将其联系起来,形成可视化的计划理论。我们将利用焦点小组和詹姆斯-林德联盟优先事项设定合作方法,与 32 位专家(老年人、护理人员、阿尔兹海默病协会、护理人员组织、日间项目工作人员和管理人员以及卫生系统和政策决策者)讨论 CMO 声明并确定其优先次序,完善我们的项目理论:通过确定日间项目的基本要素和流程以及相关的知识差距,本研究将产生急需的知识,以充分发挥日间项目的潜力,使其能够提供适当的护理,防止过早入院以及不必要的急性病和初级保健的使用。这最终将改善痴呆症患者及其护理者的生活质量,减轻护理者的负担,并降低社会成本:系统综述注册:PREMCORD42024504030。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Adult day programs and their effects on individuals with dementia and their caregivers (ADAPT-DemCare): a realist synthesis to develop program theories on the how and why.

Background: Adult day programs aim to facilitate aging in place by supporting the health and well-being of persons with dementia and providing respite to their caregivers. However, studies on the effects of day programs are inconclusive, and we especially lack insights into the context conditions and mechanisms of day programs that may produce different outcomes for different groups of persons with dementia and their caregivers. Our objective was to conduct a realist review, synthesizing research on day programs to develop program theories explaining how and why day programs do or do not produce positive or negative outcomes for different groups of persons with dementia, and caregivers.

Methods: We identified 14 literature reviews (including 329 references published between 1975 and 2021) on adult day programs. From this initial pool of studies, we will include those that focused on day program attendees with dementia or meaningful cognitive impairment, and/or their caregivers, and that report how day program contexts (C) and mechanisms (M) bring about outcomes (O) for attendees and caregivers. We will extract CMO statements (i.e., narratives that explain how and why day programs do or do not bring about certain outcomes for whom and under what circumstances). Using additional focused searches, citation mapping, citation tracking, and discussions with our researcher and expert team members, we will identify additional references. CMO statements will be synthesized, transformed into hypotheses, and linked and visualized to form program theories. Using focus groups and the James Lind Alliance Priority Setting Partnership method, we will discuss and prioritize our CMO statements and refine our program theories with 32 experts (older adults, caregivers, Alzheimer societies, caregiver organizations, day program staff and managers, and health system and policy decision makers).

Discussion: By identifying essential elements and processes of day programs and related knowledge gaps, this study will generate much-needed knowledge to leverage the full potential of day programs so they can provide appropriate care, preventing premature institutionalization, and unnecessary acute and primary care use. This will ultimately improve the quality of life of persons with dementia and their caregivers, alleviate caregiver burden, and reduce social costs.

Systematic review registration: PROSPERO CRD42024504030.

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来源期刊
Systematic Reviews
Systematic Reviews Medicine-Medicine (miscellaneous)
CiteScore
8.30
自引率
0.00%
发文量
241
审稿时长
11 weeks
期刊介绍: Systematic Reviews encompasses all aspects of the design, conduct and reporting of systematic reviews. The journal publishes high quality systematic review products including systematic review protocols, systematic reviews related to a very broad definition of health, rapid reviews, updates of already completed systematic reviews, and methods research related to the science of systematic reviews, such as decision modelling. At this time Systematic Reviews does not accept reviews of in vitro studies. The journal also aims to ensure that the results of all well-conducted systematic reviews are published, regardless of their outcome.
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