Virtual Patient Behavioral Response Training for Family Caregivers

项目概述：阿尔茨海默病（AD）患者行为症状的主要原因是 脑细胞的退化导致个体理解世界的能力下降。应对 对于许多照顾者来说，这种困难的行为是具有挑战性的，它与许多痛苦的 situations.尽管目前对痴呆症对家庭的不利影响的了解，痴呆症照顾者仍然 隐性患者中应激（59%）和抑郁（30%）发生率较高。身体和情感 在美国，痴呆症的影响估计为97亿美元的医疗保健费用（2014年）。“在 单独的研究，住院和急诊室访问更有可能为痴呆症的照顾者 帮助那些抑郁、功能低下或有行为障碍的受照顾者。” 痴呆症患者的应激受几个因素的影响，如痴呆症状的严重程度， 照顾者如何看待具有挑战性的痛苦情况，以及可用的资源。虽然 关于痴呆症的信息和计划是向公众提供的，一个重要的缺失工具是如何处理 以有效的方式与痴呆症患者的困难行为，因为他们是非常常见和苛刻的。 该第二阶段项目将完成虚拟患者行为反应（VPBR）培训的开发 提高应对痴呆症行为问题的技能，并加强照顾者的应对能力。这 培训在移动的应用程序（关怀响应应用程序，CRA）中实施。预期收益包括： 心理健康的照顾者和减少压力有关的AD患者的行为障碍。 主要创新包括：（1）将虚拟患者技术集成到痴呆症护理人员的移动的应用程序中; (2)匿名分享护理人员在日常情况下使用的真实的反应和技术;以及（3） 通过先进的知识共享“众包”（在 由项目人员“策划”），以促进照顾者认为有帮助的最佳做法。 第一阶段证明了可行性，并达到了所有里程碑。结果显示，照顾者准备 使用移动的应用程序，它实际上减少了他们的心理压力。事实上，除了展示可用性， 接受和感知的好处，第一阶段的研究表明，照顾者的显着积极成果， 减轻他们的压力、抑郁症状和由于患者的问题行为而造成的护理负担。 在第二阶段，我们将最终确定VPBR课程，开发完整的应用程序，并评估其有效性， 随机临床试验;导致一种新的干预，整合虚拟患者行为反应， 社区共享经验的汇总、关于困难痴呆行为的有效培训以及移动的 应用程序将部署到数百万与阿尔茨海默氏症作斗争的家庭。 商业机会：VPBR培训将提供给痴呆症护理人员（美国1600多万人）， 一个移动的应用程序订阅。这种模式在我们目前的应用商店中的移动的应用程序中非常成功。

Project Summary: The main cause of behavioral symptoms in patients with Alzheimer's disease (AD) is the deterioration of brain cells which causes a decline in the individual's ability to make sense of the world. Coping with such difficult behaviors is challenging for many caregivers, and it is associated with many distressful situations. Despite current knowledge of adverse effects of dementia on families, dementia caregivers remain the hidden patients with high incidence of stress (59%) and depression (30%). The physical and emotional impact of dementia caregiving is estimated to $9.7 billion in health care costs in the United States (2014). “In separate studies, hospitalization and emergency department visits were more likely for dementia caregivers who helped care recipients who were depressed, had low functional status, or had behavioral disturbances.” The stress of dementia caregiving is influenced by several factors, such as severity of dementia symptoms, how challenging distressful situations are perceived by caregivers, and available resources. Although information and programs about dementia are available to the public, an essential missing tool is how to deal with difficult behaviors of dementia patients in an effective manner, as they are very common and demanding. This Phase II project will complete the development of the Virtual Patient Behavioral Response (VPBR) training to improve skills on how to respond to dementia behavioral problems and enhance caregiver coping. This training is implemented in a mobile app (Caring Response App, CRA). The expected benefits include improved psychological health in caregivers and reduced stress related to behavioral disturbances of AD patients. Key innovations consist of: (1) integration of virtual patient techniques in a mobile app for dementia caregivers; (2) anonymous sharing of real responses and techniques used by caregivers in day-to-day situations; and (3) automated content update to users through an advanced “crowdsourcing” of caregiving knowledge (after being “curated” by project personnel) to promote best practices that caregivers found helpful. Phase I demonstrated the feasibility and met all milestones. Results showed that caregivers were prepared to use the mobile app and it actually reduced their psychological stress. In fact, besides demonstrating usability, acceptance and perceived benefits, Phase I study showed significant positive outcomes for caregivers on reducing their stress, depressive symptoms, and burden of care due to patients’ problem behaviors. In Phase II, we will finalize the VPBR curriculum, develop the complete app, and evaluate its effectiveness in a randomized clinical trial; resulting in a novel intervention that integrates virtual patient behavioral response, aggregation of community shared experience, effective training on difficult dementia behaviors, and a mobile app to be deployed to millions of families struggling with Alzheimer’s. Commercial Opportunity: VPBR training will be available to dementia caregivers (16+ Million people in US) as a mobile app subscription. This model has been very successful with our current mobile apps in App Stores.