Investigation of the implementation, take-up and use of an online personalised platform for those who care for people with dementia

[简介]这个博士项目的中心是调查沃里克郡地区痴呆症患者护理人员的在线资源，名为关怀伴侣。护理伴侣是由华威大学医学院开发的，根据每个护理人员的情况提供个性化的指导，目的是提高痴呆症护理的质量。该项目的主要目的是调查护理伴侣对接受和持续使用护理伴侣的影响，以及它对护理人员、痴呆症患者和英国国民健康保险制度的影响。确定资源的优势和局限性对于改进和增加关怀伴侣满足职业需求并产生重大和长期影响的可能性非常重要。一旦护理伴侣的好处和覆盖范围得到确立和优化，获得护理伴侣的机会可能会在英国其他地方提供，并在改善痴呆症服务方面发挥很大作用[护理伴侣的好处]据估计，NHS每年为痴呆症付出的费用超过260亿英镑，随着痴呆症患病率的上升，资源日益紧张。由于NHS资源过度紧张，许多护理人员感到没有得到足够的支持，这已被证明会导致护理接受者的负面结果，以及由于更高的住院率和疗养院入院等因素而导致NHS的成本更高。这也会对照顾者自身的健康和韧性产生不利影响，再次导致更高的医疗成本。因此，找到具有成本效益的方法来支持照顾者并提高家庭护理质量是减轻NHS负担的首要任务。更多的焦点小组积极参与护理伴侣的开发，以确定照顾者认为他们需要但目前缺乏哪些类型的支持，这为资源的内容和特征提供了信息。例如，痴呆症护理人员对缺乏关于痴呆症是什么以及如何照顾痴呆症患者的知识表示担忧。关怀伙伴试图通过获得相关的、可理解的和经过广泛筛选的资源来促进教育，从而支持照顾者。这对于那些照顾患有罕见痴呆症的人来说可能尤其关键，因为全科医生或其他医护人员可能没有专业知识来提供这方面的具体建议。因此，护理伙伴可能成为医疗培训的一种具有成本效益的资源，以进一步改善当地服务。护理伙伴还强调护理者使用情绪跟踪器、日记、帮助热线和联系支持小组来维持自己的心理健康和福祉的重要性。它受益于在线免费提供，这对于那些由于流动性差或因为来自低收入背景而难以获得支持的人来说很方便。这将确保以前没有获得支持的照顾者有知识和信心找到支持，例如，学习如何向政府申请照顾者津贴。[结论]护理伴侣有潜力改善照顾者和痴呆症患者的健康、福祉和生活质量。护理人员的支持在减轻NHS负担方面也显示出积极的结果。如果护理伙伴被发现是有效的，它可能是一种宝贵的资源，目前的工作将研究如何通过几项成果衡量标准确保它对所有人口有用和可获得。

[Introduction]This PhD project centres around investigating an online resource for carers of people with dementia in the Warwickshire area called Care Companion. Care Companion was developed by Warwick University Medical School and offers personalised guidance which is tailored to each carer's situation with the goal of improving the quality of dementia care.The primary aim of the project is to investigate the influences on uptake and sustained use of Care Companion and its impact on carers, people living with dementia and the NHS. Identifying the resource's strengths and limitations is important for making improvements and increasing the likelihood that Care Companion will meet the needs of careers and have a significant and long-lasting effect. Once the benefit and reach of Care Companion is established and optimised, access to Care Companion could potentially be made available elsewhere in the UK and play a large role in improving dementia services[Benefits of Care Companion]The annual cost of dementia to the NHS is estimated at over 26 billion pounds a year and there is a growing strain on resources the rising prevalence of dementia. As NHS resources are overstretched many carers feel inadequately supported, which has been shown to result in negative outcomes for the care recipient and higher costs for the NHS due to factors like higher rates of hospitalisation and care home admission. There is also a detrimental effect on the carer's own health and resilience, again resulting in higher healthcare costs. Finding cost effective ways to support carers and improve homecare quality is therefore a top priority to reduce NHS burden.Carer focus groups were heavily involved in the development of Care Companion to establish what type of support carers felt they needed but are currently lacking, which informed the content and features of the resource. For example, dementia carers expressed concerns about a lack of knowledge about what dementia is and how to care for someone living with dementia. Care Companion attempts to support carers by promoting education via access to relevant, understandable and extensively screened resources. This could be especially crucial to those caring for someone with a rare dementia diagnosis, as GPs or other healthcare workers may not have the expertise to offer specific advice about this. Care Companion could therefore potentially become a cost-effective resource for healthcare training to further improve local services.Care Companion also emphasises the importance of carers maintaining their own mental health and wellbeing using mood trackers, journaling, help lines and access to support groups. It benefits from being available for free online, which is convenient for people who may have trouble accessing support due to poor mobility or because they are from a low-income background. This would ensure that carers who have not previously had access to support have the knowledge and confidence to find support, for example, learning how to claim carer's allowance from the government.[Conclusion]Care Companion has the potential to improve health, wellbeing and quality of life, both for carers and people living with dementia. Carer support has also shown positive outcomes for reducing NHS burden. If Care Companion is found to be effective it could be a valuable resource and the present work will investigate ways to ensure that it is useful and accessible for all populations through several outcome measures.