The Dementia Caregiver Care Planning Tool: Development and Pilot Implementation

描述（由申请人提供）：与阿尔茨海默病（AD）的基础和临床研究的增长相一致，AD或相关痴呆症患者的家庭护理研究在过去三十年中取得了相当大的进展。有一系列的心理社会干预措施可以帮助家庭照顾者管理和科普痴呆症的各种挑战。这些战略包括支助小组、技能培训、教育、心理治疗模式和多成分方案。虽然痴呆症照顾者干预效果的证据基础已经扩大，但对于家庭来说，哪种特定的干预模式最适合他们的不同护理需求，仍然没有什么指导。的 拟议的项目旨在通过开发和试行一种基于网络的交互式工具（痴呆症护理者护理规划工具，或DCCPT）来填补科学探究和临床实践之间的这一空白，该工具可以促进痴呆症护理家庭的护理规划过程，这些家庭仍然充满了潜在的破坏性护理过渡（例如，发病、残疾、收容等），未回答的问题，或不知情的服务选择。本研究的具体目标如下：1）综合现有的荟萃分析和系统评价以及更新的荟萃分析，以确定特定的干预策略，这些策略对减轻特定类型痴呆照顾者的压力和延迟入住疗养院最为有效; 2）使用在线情景策略，从200名临床和研究专家那里获得建议，以更充分地确定最适合各种痴呆症护理人员的干预措施; 3）为家庭开发基于网络的DCCPT门户网站，以帮助确定潜在的有益服务;以及4）与40名痴呆症护理人员一起完成DCCPT的可行性研究，收集有关治疗交付（DCCPT介绍的准确性），治疗接收（如何使用DCCPT）和治疗制定（DCCPT如何影响日常痴呆症护理）的信息。预计DCCPT将为家庭提供个性化的干预建议，并为在亲属痴呆症进展过程中寻求适当服务的照顾者提供充分的支持。 公共卫生相关性：虽然痴呆症照顾者干预效果的证据基础已经扩大，但对于家庭来说，哪种特定的干预模式最适合他们的特定护理需求，仍然很少有指导。拟议的项目旨在通过开发和试行一种基于网络的交互式工具（痴呆症护理者护理规划工具，或DCCPT）来填补科学探究和临床实践之间的这一差距，该工具可以促进痴呆症护理家庭的护理规划过程，这些家庭仍然充满了潜在的破坏性护理过渡（例如，发病、残疾、收容等），没有答案的问题，或不知情的服务选择。预计DCCPT将为家庭提供个性化的干预建议，并为在亲属痴呆症进展过程中寻求适当服务的照顾者提供充分的支持。

DESCRIPTION (provided by applicant): Coinciding with the growth of basic and clinical research on Alzheimer's disease (AD), the study of family care for persons with AD or associated dementias has advanced considerably in the last three decades. A range of psychosocial interventions exists to help family caregivers manage and cope with the various challenges of dementia. These strategies include support groups, skills-based training, education, psycho- therapeutic models, and multi-component protocols. Although the evidence base of dementia caregiver intervention efficacy has expanded, there remains little guidance for families as to which particular intervention model is best suited for their diverse care needs. The proposed project aims to fill this gap between scientific inquiry and clinical practice by developing and piloting an interactive web-based tool (the Dementia Caregiver Care Planning Tool, or DCCPT) that can facilitate the care planning process for dementia care giving families which remains fraught with potentially disruptive care transitions (e.g., onset, disability, institutionalization, etc.), unanswered questions, or ill-informed selection of service. The Specifc Aims of this project are as follows: 1) Conduct a synthesis of existing meta-analyses and systematic reviews as well as an updated meta-analysis to identify specific intervention strategies that are most effective in reducing stress and delaying nursing home admission for particular types of dementia caregivers; 2) Use an online scenario strategy to obtain recommendations from 200 clinical and research experts to more fully identify interventions that are most appropriate for various dementia caregivers; 3) Develop the web-based DCCPT portal for families to help identify potentially beneficial services; and 4) Complete a [feasibility study of the DCCPT with 40 dementia caregivers that collects information on treatment delivery (accuracy of DCCPT presentation), treatment receipt (how the DCCPT is utilized), and treatment enactment (how the DCCPT influences everyday dementia care). It is anticipated the DCCPT will result in individualized intervention recommendations for families and provide ample support to caregivers who are searching for appropriate services throughout the progression of a relative's dementia. PUBLIC HEALTH RELEVANCE: Although the evidence base of dementia caregiver intervention efficacy has expanded, there remains little guidance for families as to which particular intervention model is best suited for their particular care needs. The proposed project aims to fill this gap between scientific inquiry and clinical practice by developing and piloting a interactive web-based tool (the Dementia Caregiver Care Planning Tool, or DCCPT) that can facilitate the care planning process of dementia care giving families which remains fraught with potentially disruptive care transitions (e.g., onset, disability, institutionalization, etc.), unanswered questions, or ill- informed selection of service. It is anticipated the DCCPT will result in individualized intervention recommendations for families and provide ample support to caregivers who are searching for appropriate services throughout the progression of a relative's dementia.