Components and Outcomes of Internet-Based Interventions for Caregivers of Older Adults: Systematic Review.
Components and Outcomes of Internet-Based Interventions for Caregivers of Older Adults: Systematic Review.
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DOI：
10.2196/jmir.7896
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发表时间：
2017-09-19
影响因子：
7.4
通讯作者：
Ahmed S
中科院分区：
文献类型：
--
作者：
Guay C;Auger C;Demers L;Mortenson WB;Miller WC;Gélinas-Bronsard D;Ahmed S
当试图获得干预措施，以改善他们的福祉和生活质量，家庭照顾者面临着许多挑战。基于互联网的干预措施为远程支持他们提供了新的和可获得的机会，并有助于减轻他们的负担。然而，人们对这些组成部分之间存在的联系、行为改变技术的使用以及这些基于互联网的干预措施的结果知之甚少。本研究旨在提供有关基于互联网的干预措施对老年人照顾者的有效性的最佳现有证据的最新信息。具体而言，行为改变技术的组成部分和使用，以及它们如何影响干预的有效性。一项系统性综述检索了2000年至2015年间发表的主要来源研究。纳入的研究由独立评分员使用GRADE标准对高水平证据进行评分，并报告了通过互联网为50岁及以上人群的护理人员提供干预措施的特定结果。叙述性综合确定了干预成分（例如，内容，多媒体使用，互动在线活动和提供支持），行为改变技术和护理人员的结果（例如，对压力源，中介和心理健康的影响）。评估了纳入研究中的偏倚风险。共筛选了2338篇文章，确定了12项描述10种基于互联网的干预措施的研究。这些干预措施中有7项导致护理人员结局的统计学显著改善（例如，减少抑郁或焦虑，n=4）。这些有效的干预措施使用了互动的组成部分，如在线练习和家庭作业（n=4）或健康状况问卷（n=2），其中五项包括专业人员或同行的远程人力支持。有效干预措施中最常用的行为改变技术是提供社会支持（n=6）和指导行为改变和障碍识别的指导组合（n=5）。纳入研究的设计和目的不允许准确确定哪种成分和/或行为改变技术在照顾者中产生积极结果方面更有效。所有研究的选择偏倚风险均较低，表现偏倚、检测偏倚和损耗偏倚的风险从低到高。总之，基于互联网的干预措施，结合专业和社会的支持，并提供指示，以改变行为和解决问题的互动方式似乎导致积极的结果，在照顾者。需要研究分离组分的具体作用，以提高我们对潜在作用机制的理解。
When trying to access interventions to improve their well-being and quality of life, family caregivers face many challenges. Internet-based interventions provide new and accessible opportunities to remotely support them and can contribute to reducing their burden. However, little is known about the link existing between the components, the use of behavior change techniques, and the outcomes of these Internet-based interventions. This study aimed to provide an update on the best available evidence about the efficacy of Internet-based interventions for caregivers of older adults. Specifically, the components and the use of behavior change techniques and how they impact on the efficacy of the intervention were sought. A systematic review searched primary source studies published between 2000 and 2015. Included studies were scored with a high level of evidence by independent raters using the GRADE criteria and reported caregiver-specific outcomes about interventions delivered through the Internet for caregivers of people aged 50 years and older. A narrative synthesis identified intervention components (eg, content, multimedia use, interactive online activities, and provision of support), behavior change techniques, and caregiver outcomes (eg, effects on stressors, mediators, and psychological health). The risk of bias within the included studies was assessed. A total of 2338 articles were screened and 12 studies describing 10 Internet-based interventions were identified. Seven of these interventions led to statistically significant improvements in caregiver outcomes (eg, reducing depression or anxiety, n=4). These efficacious interventions used interactive components, such as online exercises and homework (n=4) or questionnaires on health status (n=2) and five of them incorporated remote human support, either by professionals or peers. The most frequently used behavior change techniques included in efficacious interventions were provision of social support (n=6) and combinations of instructions to guide behavior change and barrier identification (n=5). The design and aim of the included studies did not permit determining exactly which component and/or behavior change technique was more efficacious in producing positive outcomes in caregivers. The risk for selection bias was low for all the studies, and low to high for performance, detection, and attrition biases. In sum, Internet-based interventions that incorporate professional and social support, and provide instructions to change behavior and problem solve in an interactive manner appear to lead to positive outcomes in caregivers. Studies isolating the specific effect of components are needed to improve our understanding of the underlying mechanism of action.
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影响因子：
4.2
作者：
Abraham, Charles;Michie, Susan
通讯作者：
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