Translating an Evidence-based Multicomponent Intervention for Older Adults With Dementia and Caregivers
Translating an Evidence-based Multicomponent Intervention for Older Adults With Dementia and Caregivers
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DOI：
10.1093/geront/gny122
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发表时间：
2020-04-01
期刊：
影响因子：
5.7
通讯作者：
McGough, Ellen L.
中科院分区：
文献类型：
--
作者：
Teri, Linda;Logsdon, Rebecca G.;McGough, Ellen L.
背景和目的：需要有效的以社区为基础的计划，以维持成年痴呆症患者的健康和福祉。这篇文章描述了由地区老龄机构(AAA)的工作人员进行的多成分锻炼加上行为/心理社会干预(减少阿尔茨海默病西北地区的残疾[RDAD-NW])的翻译、实施和有效性。研究设计和方法：采用交错多基线设计；10名AAA、20名病例管理人员和255名居住在社区的痴呆症患者(PWD)和家庭照顾者被纳入研究。RDAD-NW在家中进行了6周多的有氧/耐力、力量和平衡/柔韧性练习，痴呆症教育，增加愉快事件的训练，以及激活者-行为-后果问题解决方法。结果：RDAD-NW由AAA机构的工作人员通过他们通常的服务提供机制成功地翻译和实施。工作人员积极响应，以高度的保真度交付了节目。照顾者/PWD夫妇也对参与该计划的锻炼和行为/心理社会部分的反应积极。共有207人(81%)完成了干预，140人(55%)完成了13个月的随访。在治疗前和治疗后13个月，PWD的体力活动显著增加(P<；.001，ES=.54)(P<；.01，ES=.21)。治疗前PWD患者的生活质量显著提高(p<；.001，ES=.29)；照顾者抑郁在治疗前后得到改善(p=.01，ES=-.18)。讨论和启示：RDAD-NW由AAA病例经理成功翻译和实施，并导致照顾者/残疾人的体力活动增加和行为和情绪结果改善。结果支持RDAD-NW的继续传播和实施。
Background and Objectives: Effective community-based programs to maintain health and well-being of adults with dementia are needed. This article describes the translation, implementation, and effectiveness of a multicomponent exercise plus behavioral/psychosocial intervention (Reducing Disability in Alzheimer's Disease-NorthWest [RDAD-NW]) conducted by staff in regional Area Agencies on Aging (AAAs).Research Design and Methods: Staggered multiple baseline design was used; 10 AAAs, 20 case managers, and 255 community-residing persons with dementia (PWDs), and family caregivers were enrolled. RDAD-NW was conducted in-home over 6 weeks with aerobic/endurance, strength, and balance/flexibility exercises, dementia education, training to increase pleasant events, and activator-behavior-consequence problem-solving approach. Outcomes included case manager treatment fidelity, and caregiver/PWD physical activity, restricted activity days, physical functioning, quality of life, and affect.Results: RDAD-NW was successfully translated and implemented by AAA agency staff through their usual service provision mechanisms. Staff responded positively and delivered the program with a high degree of fidelity. Caregiver/PWD dyads also responded favorably engaging in both exercise and behavioral/psychosocial portions of the program. A total of 207 dyads (81%) completed the intervention and 140 (55%) completed the 13-month follow-up. PWD physical activity increased significantly pre- to posttreatment (p < .001, ES = .54), and 13 months (p < .01, ES = .21). Quality of life of PWD increased significantly pre- to posttreatment (p < .001, ES = .29); caregiver depression improved pre- to posttreatment (p = .01, ES = -.18).Discussion and Implications: RDAD-NW was successfully translated and implemented by AAA case managers and resulted in increased physical activity and improved behavioral and emotional outcomes of caregiver/PWDs. Results support continued dissemination and implementation of RDAD-NW.