Development and Initial Evaluation of the Web-Based Self-Management Program "Partner in Balance" for Family Caregivers of People With Early Stage Dementia: An Exploratory Mixed-Methods Study.
Development and Initial Evaluation of the Web-Based Self-Management Program "Partner in Balance" for Family Caregivers of People With Early Stage Dementia: An Exploratory Mixed-Methods Study.
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DOI：
10.2196/resprot.5142
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发表时间：
2016-03-01
影响因子：
1.7
通讯作者：
Verhey FR
中科院分区：
文献类型：
--
作者：
Boots LM;de Vugt ME;Withagen HE;Kempen GI;Verhey FR
痴呆症患者越来越依赖非正式的照顾者。基于互联网的自我管理干预措施有望以较低的成本满足早期痴呆症照顾者(EDCs)的教育和支持需求。本研究的目的是(1)为幼儿发展中心开发一个在线自我管理项目，以提高自我效能感和目标成就感；(2)评估该项目的可行性，并报告其有效性的初步数据。基于医学研究理事会(MRC)开发和评估复杂干预措施的框架，采用循序渐进的方法，通过(1)与痴呆症护理人员进行焦点小组讨论(N=28)，(2)采访痴呆症护理专业人员(N=11)，以及(3)与EDC(N=2)和专家(N=2)进行个人有声思考可用性测试，来探索潜在的用户需求并开发和验证内容。对EDC(N=17)进行了初步评估，以测试其可行性并建立初步效果。干预结束后完成可行性自我报告措施。干预前后进行自我效能感和目标成就感评定。不同的步骤提供了关于潜在用户在节目内容和交付方面的需求的有用信息。这导致了新开发的“平衡中的合伙人”计划。在开始时，系统故障导致高不完成率(7/17，41%)，但在结束时，可接受的可行性得分为209(范围54-234)。在家完成节目的便利性、量身定制的内容和指导(面对面和在线)都得到了积极的评价。初步影响照顾者的自我效能(P<；0.05)和目标实现(T>；50)是有希望的。对程序进行了调整，以限制系统故障的数量，并防止高不完全率。正如MRC框架所建议的那样，确认可行性和初步有效性是检查这一新开发的干预措施有效性的宝贵一步。荷兰试验登记：NTR4217；http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4217(由http://www.webcitation.org/6f6B8lvRP).网站存档
People with dementia increasingly depend on informal caregivers. Internet-based self-management interventions hold considerable promise for meeting the educational and support needs of early stage dementia caregivers (EDCs) at a reduced cost. This study aimed to (1) develop an online self-management program for EDC to increase self-efficacy and goal attainment, and (2) evaluate the program’s feasibility and report preliminary data on effectiveness. Based on the Medical Research Council (MRC) framework for the development and evaluation of complex interventions, a stepwise approach was adopted to explore potential user needs and develop and validate the content by means of (1) focus group discussions with dementia caregivers (N=28), (2) interviews with dementia care professionals (N=11), and (3) individual think-aloud usability tests with EDC (N=2) and experts (N=2). A pilot evaluation was conducted with EDC (N=17) to test the feasibility and establish preliminary effects. Self-report measures of feasibility were completed after the completion of intervention. Self-efficacy and goal attainment were evaluated before and after the intervention. The different steps provided useful information about the needs of potential users regarding the content and delivery of the program. This resulted in the newly developed “Partner in Balance” program. At the start, system failures resulted in a high noncompleter rate (7/17, 41%), but at the end, an acceptable feasibility score of 209 (range 54-234) was found. The convenience of completing the program at home, the tailored content, and the guidance (face-to-face and online) were appraised positively. Preliminary effects on caregiver self-efficacy (P<.05) and goal attainment (T>50) were promising. Adaptations were made to the program to limit the amount of system failures and prevent high noncompleter rates. As recommended by the MRC framework, confirming the feasibility and preliminary effectiveness is a valuable step toward examining the effectiveness of this newly developed intervention. Dutch Trial Register (NTR): NTR4217; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4217 (Archived by WebCite at http://www.webcitation.org/6f6B8lvRP).