Testing Tele-Savvy, an On-line Psychoeducation Program for Informal Alzheimer's Caregivers

摘要 我们试图测试一个针对阿尔茨海默氏症家庭的网络心理教育项目的有效性 护理人员，Tele-Savvy，通过在一项使用注意力控制等待列表的随机试验中招募216名护理人员 设计该试验建立在四个由NIA支持的阿尔茨海默病研究中心之间建立的联系基础上 PAR-15-348（阿尔茨海默病的非正式和正式护理研究）。 对阿尔茨海默病患者的社区护理依靠家庭护理人员。我们 随着这些疾病的流行，对这种非正规资源的依赖只会增加。家庭 成员们被期望提供持续和复杂的护理-护理，如果不是在手中， 一般来说，非专业人士需要具备护士、职业治疗师、社会工作者和其他专业人员的技能。 一般来说，家庭成员没有接受过承担抚养责任的培训。照顾者也付出了很大的代价， 他们所做的工作和他们承受的持续压力。他们的身体健康和心理健康是 他们的家庭和社会世界经常被撕裂;甚至在经济上他们也变得脆弱。 他们的工作直接关系到阿尔茨海默病患者的健康。 在这种情况下，增强的技能、知识和熟练掌握可能是关键的调解人。 心理教育计划是最成功的照顾者干预措施之一。然而，对于所有 照顾者-农村，但也包括城市和郊区-在住院期间前往并安排对艾滋病毒/艾滋病感染者的照顾; 个人方案是参与的主要障碍。互联网越来越多地被中年和老年人使用 人，典型的照顾者的年龄。一些心理教育项目部分在线， 完全互联网交付，没有一个完全模拟他们所基于的亲自程序。远距离 Savvy（建立在Savvy Caregiver Program的循证平台上）提供了一个虚拟的面对面 通过简单易用的远程方式向小团体的照顾者提供心理教育计划（在他们自己的 家）。该计划包括7个每周小组视频会议，穿插每天异步 可用的视频课程。试点结果证明了Tele-Savvy的初步功效， 照顾者的痛苦，提高掌握，并减少PLWA的痛苦行为。参与者的 评估证明了积极的行为和情感结果以及与他人联系的感觉 照顾者这项拟议中的研究旨在确定远程智能的功效：（1）减少焦虑， (2)提高远程护理人员的PLWA生活质量，以及（3）提高护理人员的掌握程度， 自我管理行为作为这些结果的中介;在一个探索性的目标，它也试图检查 该计划在三个种族/民族群体（非洲裔美国人，高加索人， 拉丁裔/西班牙裔）。Tele-Savvy为各种赞助提供了一种新的高度灵活的方式 组织，以达到和保持有益的关系，与家庭成员。

Abstract We seek to test the efficacy of an internet-delivered psychoeducation program for Alzheimer’s family caregivers, Tele-Savvy, by enrolling 216 caregivers in a randomized trial that uses an attention control wait-list design. The trial builds on established links across four NIA-supported Alzheimer’s Disease Research Centers to respond to PAR-15-348 (Research on Informal and Formal Caregiving for Alzheimer's Disease). Community-based care of persons living with Alzheimer’s disease (PLWA) rests on family caregivers. Our reliance on this informal resource will only increase as the prevalence of these illnesses increases. Family members are expected to provide sustained and sophisticated care – care that, were it not in the hands of laypersons, would require the skills of nurses, occupational therapists, social workers and other professionals. Typically, family members are not trained to undertake the caregiving role. Caregivers also pay a big price for the work they do and the sustained stress they bear. Their physical health and psychological well-being is jeopardized; their family and social worlds are often rent apart; even economically they become vulnerable. The work they perform bears directly on the well-being of the persons living with Alzheimer’s disease. Enhanced skills, knowledge, and caregiving mastery may be key mediators in this situation. Psychoeducational programs are among the most successful of caregiver interventions. However, for all caregivers – rural, but also urban and suburban – traveling to and arranging care for the PLWA during in- person programs pose major barriers to participation. The internet is increasingly used by middle age and older persons, the age of typical caregivers. Some psychoeducation programs are partially on line, they are not completely internet-delivered and none fully simulates the in-person programs on which they are based. Tele- Savvy (built on the evidence-based platform of the Savvy Caregiver Program) provides a virtual in-person psychoeducation program through simple-to-use distance means to small groups of caregivers (in their own homes). The program involves 7 weekly group videoconferences, interspersed with daily asynchronously available video lessons. Pilot results demonstrate Tele-Savvy’s preliminary efficacy for significantly reducing caregiver distress, enhancing caregiving mastery, and reducing distressing behaviors in PLWA. Participants’ evaluations attest to positive behavioral and affective outcomes and a sense of being connected with the other caregivers. The proposed study seeks to establish Tele-Savvy’s efficacy for (1) reducing caregiving distress, (2) promoting the quality of life of PLWA of Tele-Savvy caregivers, and (3) enhancing caregiver mastery and self-management behaviors as mediators of those outcomes; in an exploratory aim, it seeks also to examine the comparability of the program’s efficacy across three racial/ethnic groups (African Americans, Caucasians, and Latino/Hispanics). Tele-Savvy offers a new and highly flexible way for a wide variety of sponsoring organizations to reach and maintain beneficial relationships with caregiving family members.