Implementation of START (STrAtegies for RelaTives) for dementia carers in the third sector: Widening access to evidence-based interventions.
Implementation of START (STrAtegies for RelaTives) for dementia carers in the third sector: Widening access to evidence-based interventions.
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DOI：
10.1371/journal.pone.0250410
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Livingston G
中科院分区：
文献类型：
--
作者：
Amador S;Rapaport P;Lang I;Sommerlad A;Mukadam N;Stringer A;Hart N;Nurock S;Livingston G
家庭成员仍然是越来越多的痴呆症患者的主要护理提供者，他们往往变得抑郁或焦虑。在一个实施研究项目中，我们的目标是通过为在第三部门的实施奠定基础，扩大获得关系战略的机会，这是一种对家庭照顾者心理健康的临床和成本效益高的干预措施。我们使用了综合促进行动研究实施卫生服务（i-PARIHS）框架，以指导实施START，手动为基础的，单独交付，多组件的八届应对策略干预。我们采访了一个最大的变化样本的27个利益相关者从英国阿尔茨海默氏症协会（AS），关于可能的困难，在管理，培训和交付的开始。我们在不同的地点培训和监督三名AS痴呆症支持工作者，每人向三名家庭护理人员提供START。两名研究人员独立编码干预前的采访主题。我们评估干预的可行性，通过监测交付的保真度，评级录音从1-5（5为高）和采访主持人，家庭照顾者和AS管理人员对他们的经验。我们使用医院焦虑和抑郁量表（HADS）在接受START之前和之后（得分0-42）评估家庭照顾者心理健康的有效性。我们通过更多地反映照顾者的多样性和增加照顾者故事的突出性来改变START的格式，但核心内容或交付过程没有改变。所有护理人员都接受了START，并参加了每一次会议。平均忠诚度评分为4.2。平均HADS总分从基线18.4（标准差7.4）降低至随访15.8（9.7）。6名（67%）护理人员在基线HADS和2名（22%）随访时评分为临床抑郁。主持人和照顾者积极评价START。有适当经验的第三部门工作人员可以接受培训和监督，以执行《裁减战略武器条约》，而且该条约仍然有效。这有可能扩大大规模的访问。
Family members remain the main care providers for the increasing numbers of people with dementia, and often become depressed or anxious. In an implementation research project, we aimed to widen access to Strategies for RelaTives (START), a clinically and cost-effective intervention for the mental health of family carers, by laying the foundations for its implementation in the third sector. We used the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to guide implementation of START, a manual-based, individually-delivered, multicomponent eight-session coping strategy intervention. We interviewed a maximum variation sample of twenty-seven stakeholders from the English Alzheimer’s Society (AS), about possible difficulties in management, training, and delivery of START. We trained and supervised three AS dementia support workers in different locations, to each deliver START to three family carers. Two researchers independently coded pre-intervention interviews for themes. We assessed intervention feasibility through monitoring delivery fidelity, rating audio-recordings from 1–5 (5 being high) and interviewing facilitators, family carers and AS managers about their experiences. We assessed effectiveness on family carers’ mental health using the Hospital Anxiety and Depression Scale (HADS) before and after receiving START (scores 0–42). We changed START’s format by reflecting carer diversity more and increasing carer stories prominence, but core content or delivery processes were unchanged. All carers received START and attended every session. The mean fidelity score was 4.2. Mean HADS-total score reduced from baseline 18.4 (standard deviation 7.4) to follow-up 15.8 (9.7). Six (67%) carers scored as clinically depressed on baseline HADS and 2 (22%) at follow-up. Facilitators and carers rated START positively. Appropriately experienced third sector workers can be trained and supervised to deliver START and it remains effective. This has the potential for widened access at scale.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
DOI：
10.1136/bmj.h1258
发表时间：
2015-03-19
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moore GF;Audrey S;Barker M;Bond L;Bonell C;Hardeman W;Moore L;O'Cathain A;Tinati T;Wight D;Baird J
通讯作者：
Baird J
影响因子：
0.7
作者：
Barry, Teresa L.;Kaiser, Katherine Laux;Atwood, Jan R.
通讯作者：
Atwood, Jan R.
影响因子：
7.2
作者：
Mahoney, R;Regan, C;Livingston, G
通讯作者：
Livingston, G
影响因子：
7.2
作者：
Harvey, Gill;Kitson, Alison
通讯作者：
Kitson, Alison