Supporting Family Caregivers With Technology for Dementia Home Care: A Randomized Controlled Trial
Supporting Family Caregivers With Technology for Dementia Home Care: A Randomized Controlled Trial
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DOI：
10.1093/geroni/igz037
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发表时间：
2019-07-01
影响因子：
7
通讯作者：
Coleman, Carissa K.
中科院分区：
文献类型：
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作者：
Williams, Kristine N.;Perkhounkova, Yelena;Coleman, Carissa K.
背景和目标：到 2050 年，美国痴呆症患者 (PLWD) 人数将达到 1600 万。痴呆症的行为和心理症状给家庭护理人员带来挑战，并导致护理人员的负面后果，例如负担和抑郁。现有技术可以支持向在家提供痴呆症护理的家庭提供有效的干预措施。利用痴呆症家庭护理技术支持家庭护理人员 (FamTechCare) 随机对照试验评估了远程医疗干预对护理人员结果的影响。研究设计和方法：FamTechCare 干预措施根据护理人员提交的具有挑战性的护理情况的视频记录，为家庭护理人员提供量身定制的痴呆症护理策略。专家团队每周都会审核视频并为实验组提供个性化干预措施。在电话支持注意力对照组中，护理人员根据护理人员对护理挑战的回顾性回忆，通过电话接收干预专家的反馈。通过将线性混合回归模型拟合到第 1 个月和第 3 个月测量的结果的变化，评估了干预对护理人员结果的影响，包括负担、抑郁、睡眠障碍、能力、将 PLWD 制度化的愿望以及护理人员对行为症状的反应。结果：FamTechCare 护理人员 (n = 42) 的抑郁程度显着降低 (p = 0.012)，能力提高 (p) =.033) 3 个月后与注意力对照组 (n = 41) 相比。生活在农村地区与 FamTechCare 护理人员抑郁症的减少有关 (p =.002)。对于 FamTechCare 和注意力控制护理人员来说，较高的教育水平与负担、能力和对行为症状的反应的更大改善或更少下降有关。讨论和启示：这项研究证明了利用现有技术通过视频记录技术将家庭与痴呆症护理专家联系起来的好处。它为未来研究测试远程医疗干预措施奠定了基础，这些干预措施根据丰富的背景数据量身定制，以支持家庭，包括农村或偏远地区的家庭。
Background and Objectives: The number of persons living with dementia (PLWD) in the United States will reach 16 million by 2050. Behavioral and psychological symptoms of dementia challenge family caregivers and contribute to negative caregiver outcomes such as burden and depression. Available technology can support the delivery of effective interventions to families providing dementia care at home. The Supporting Family Caregivers with Technology for Dementia Home Care (FamTechCare) randomized controlled trial evaluated the effects of a telehealth intervention on caregiver outcomes.Research Design and Methods: The FamTechCare intervention provides tailored dementia-care strategies to in-home caregivers based on video recordings caregivers submit of challenging care situations. An expert team reviews the videos and provides individualized interventions weekly for the experimental group. In the telephone-support attention control group, caregivers receive feedback from an interventionist via the telephone based on caregiver retrospective recall of care challenges. Effects of the intervention on caregiver outcomes, including burden, depression, sleep disturbance, competence, desire to institutionalize the PLWD, and caregiver reaction to behavioral symptoms were evaluated by fitting linear mixed regression models to changes in the outcomes measured at 1 and 3 months.Results: FamTechCare caregivers (n = 42) had greater reductions in depression (p =.012) and gains in competence (p =.033) after 3 months compared to the attention control group (n = 41). Living in rural areas was associated with a reduction in depression for FamTechCare caregivers (p =.002). Higher level of education was associated with greater improvements or lesser declines in burden, competence, and reaction to behavioral symptoms for both the FamTechCare and attention control caregivers.Discussion and Implications: This research demonstrated benefits of using available technology to link families to dementia care experts using video-recording technology. It provides a foundation for future research testing telehealth interventions, tailored based on rich contextual data to support families, including those in rural or remote locations.