题名

An Outpatient-Based Training Program Improves Family Caregivers' Preparedness in Caring for Persons With Mild Cognitive Impairment: A Randomized Controlled Trial

DOI

10.1097/jnr.0000000000000541

作者

Yi-En TUNG;Li-Min KUO;Min-Chi CHEN;Wen-Chuin HSU;Yea-Ing Lotus SHYU

关键词

mild cognitive impairment ; family caregiver training program ; preparedness ; health-related quality of life ; depressive symptoms

期刊名称

The Journal of Nursing Research

卷期/出版年月

31卷1期(2023 / 02 / 01)

页次

1 - 11

内容语文

英文

中文摘要

Background: Little is known regarding the effects of training programs on family caregivers of older persons with mild cognitive impairment because of the significant differences in outcome variables measured in the various studies in the literature. Purpose: This study was designed to examine the effects of an outpatient-based caregiver training program on the preparedness, health-related quality of life, and depressive symptoms of participants responsible for caring for older persons with mild cognitive impairment. Methods: A randomized clinical trial was implemented. Of the 54 family caregiver participants who provided complete and valid data, 28 and 26 were assigned to the experimental and control groups, respectively. The experimental group participated in a researcher-developed training program that provided information on mild cognitive impairment, strategies for maintaining and promoting cognitive function in persons with mild cognitive impairment, managing their own and their care recipients' healthcare, and managing their own emotional support and stress. Outcomes (caregiver preparedness, health-related quality of life, and depressive symptoms) were assessed before the start of the training program (baseline) and at 1, 3, and 6 months after completion of the program. Results: After controlling for baseline cognitive function of the care recipients and of caregiver preparedness, the experimental group was shown to be significantly less prepared than the control group at baseline (β = -1.41, p = .031) and better prepared than the control group at all three posttests (group differences: 1.3, 1.53, and 4.24, respectively), with the difference at the third posttest (6 months) reaching statistical significance (p = .008). No impact of the intervention on caregiver depressive symptoms or health-related quality of life was found at posttest. Conclusions: The training intervention in this study was found to increase the perceived preparedness of the family caregiver participants to handle various aspects of providing care to persons with mild cognitive impairment. However, no changes were found in depressive symptoms or health-related quality of life.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. Sakanashi, S.,Fujita, K.,Konno, R.(2021).Components of empowerment among family caregivers of community-dwelling people with dementia in Japan: A qualitative research study.The Journal of Nursing Research,29(3),e155.
    連結:
  2. Shyu, Y. L.,Yang, C.,Huang, C.,Kuo, H.,Chen, S.,Hsu, W.(2010).Influences of mutuality, preparedness, and balance on caregivers of patients with dementia.Journal of Nursing Research,18(3),155-163.
    連結:
  3. Tseng, H. M.,Lu, J. R.,Tsai, Y. J.(2003)。Assessment of health-related quality of life (II): Norming and validation of SF-36 Taiwan version。Taiwan Journal of Public Health,22(6),512-518。
    連結:
  4. Andrade, C.(2021).The ceiling effect, the floor effect, and the importance of active and placebo control arms in randomized controlled trials of an investigational drug.Indian Journal of Psychological Medicine,43(4),360-361.
  5. Archbold, P. G.,Stewart, B. J.,Greenlick, M. R.,Harvath, T.(1990).Mutuality and preparedness as predictors of caregiver role strain.Research in Nursing & Health,13(6),375-384.
  6. Carlozzi, N. E.,Sherman, C.W.,Angers, K.,Belanger, M. P.,Austin, A. M.,Ryan, K. A.(2018).Caring for an individual with mild cognitive impairment: A qualitative perspective of health-related quality of life from caregivers.Aging & Mental Health,22(9),1190-1198.
  7. Chen, Y. J.,Dai, Y. T.,Yang, C. T.,Wang, T. C.,Cheng, Y. H.(1995).A review and proposal on patient classification in long-term care system.Department of Health, Taiwan, ROC.
  8. Connors, M. H.,Seeher, K.,Teixeira-Pinto, A.,Woodward, M.,Ames, D.,Brodaty, H.(2019).Mild cognitive impairment and caregiver burden: A 3-year-longitudinal study.American Journal of Geriatric Psychiatry,27(11),1206-1215.
  9. Domingues, N. S.,Verreault, P.,Hudon, C.(2018).Reducing burden for caregivers of older adults with mild cognitive impairment: A systematic review.American Journal of Alzheimer's Disease and Other Dementias,33(7),401-414.
  10. Fu, C. C.,Lee, Y. M.,Chen, J. D.(2003)。Association between depressive symptoms and twelve-year mortality among elderly in a rural community in Taiwan。Journal of the Formosan Medical Association,102(4),234-239。
  11. Garand, L.,Morse, J. Q.,ChiaRebecca, L.,Barnes, J.,Dadebo, V.,Lopez, O. L.,Dew, M. A.(2019).Problem-solving therapy reduces subjective burden levels in caregivers of family members with mild cognitive impairment or early-stage dementia: Secondary analysis of a randomized clinical trial.International Journal of Geriatric Psychiatry,34(7),957-965.
  12. Granger, C. V.,Hamilton, B. B.,Gresham, G. E.(1988).The stroke rehabilitation outcome study part1: General description.Archives of Physical Medicine and Rehabilitation,69(7),506-509.
  13. Huang, H. L.,Kuo, L. M.,Chen, Y. S.,Liang, J.,Huang, H. L.,Chiu, Y. C.,Chen, S. T.,Sun, Y.,Hsu, W. C.,Shyu, Y. I.(2013).A home-based training program improves caregivers' skills and dementia patients' aggressive behaviors: A randomized controlled trial.The American Journal of Geriatric Psychiatry,21(11),1060-1070.
  14. Junquera, A.,García-Zamora, E.,Olazarán, J.,Parra, M. A.,Fernández-Guinea, S.,Junquera Fernández, A.,Olazarán Rodríguez, J.,Parra Rodríguez, M. A.(2020).Role of executive functions in the conversion from mild cognitive impairment to dementia.Journal of Alzheimer's Disease,77(2),641-653.
  15. Kuo, L.-M.,Huang, H.-L.,Huang, H.-L.,Liang, J.,Chen, S.-T.,Kwok, Y.-T.,Hsu, W.-C.,Shyu, Y.-I. L.(2013).A home-based training program improves Taiwanese FCGs' quality of life and decreases their risk for depression: A randomized controlled trial.International Journal of Geriatric Psychiatry,28(5),504-513.
  16. Liang, K. Y.,Zeger, S. L.(1986).Longitudinal data analysis using generalized linear models.Biometrika,73(1),13-22.
  17. Lu, Y. F.,Austrom, M. G.,Perkins, S. M.,Bakas, T.,Farlow, M. R.,He, F.,Jin, S.,Gamst, A.(2007).Depressed mood in informal caregivers of individuals with mild cognitive impairment.American Journal of Alzheimer's Disease and Other Dementias,22(4),273-285.
  18. Mavounza, C.,Ouellet, M.-C.,Hudon, C.(2020).Caregivers' emotional distress due to neuropsychiatric symptoms of persons with amnestic mild cognitive impairment or Alzheimer's disease.Aging & Mental Health,24(3),423-430.
  19. Nunes, P. V.,Schwarzer, M. C.,Leite, R. E. P.,Ferretti-Rebustini, R. E. L.,Pasqualucci, C. A.,Nitrini, R.,Rodriguez, R. D.,Nascimento, C. F.,Oliveira, K. C.,Grinberg, L. T.,Jacob-Filho, W.,Lafer, B.,Suemoto, C. K.(2019).Neuropsychiatric inventory in community-dwelling older adults with mild cognitive impairment and dementia.Journal of Alzheimer's Disease,68(2),669-678.
  20. Ottenbacher, K. J.,Hsu, Y.,Granger, C. V.,Fiedler, R. C.(1996).The reliability of the functional independence measure: A quantitative review.Archives of Physical Medicine and Rehabilitation,77(12),1226-1232.
  21. Pearlin, L. I.,Mullan, J. T.,Semple, S. J.,Skaff, M. M.(1990).Caregiving and the stress process: An overview of concepts and their measures.Gerontologist,30(5),583-594.
  22. Schmitter-Edgecombe, M.,Dyck, D. G.(2014).Cognitive rehabilitation multi-family group intervention for individuals with mild cognitive impairment and their care-partners.Journal of the International Neuropsychological Society,20(9),897-908.
  23. Schober, P.,Vetter, T. R.(2019).Correct baseline comparisons in a randomized trial.Anesthesia & Analgesia,129(3),639.
  24. Schumacher, K. L.,Stewart, B. J.,Archbold, P. G.(2007).Mutuality and preparedness moderate the effects of caregiving demand on cancer family caregiver outcomes.Nursing Research,56(6),425-433.
  25. Shim, Y. S.,Park, K. H.,Chen, C.,Dominguez, J. C.,Kang, K.,Kim, H.-J.,Hong, Z.,Lin, Y.-T.,Chu, L.-W.,Jung, S.,Kim, S.(2021).Caregiving, care burden and awareness of caregivers and patients with dementia in Asian locations: A secondary analysis.BMC Geriatrics,21(1),230.
  26. Sun, Y.,Lee, H. J.,Yang, S. C.,Chen, T. F.,Lin, K. N.,Lin, C. C.,Wang, P. N.,Tang, L. Y.,Chiu, M. J.(2014).A nationwide survey of mild cognitive impairment and dementia, including very mild dementia, in Taiwan.PLOS ONE,9(6),e100303.
  27. Taiwan Alzheimer's Disease Association. (2021). Dementia prevention starting now (online). http://tada2002.ehosting.com.tw/eng/Default.htm (Original work published in Chinese)
  28. Wang, C.-L.,Kuo, L.-M.,Chiu, Y.-C.,Huang, H.-L.,Huang, H.-L.,Hsu, W.-C.,Lu, C.-H.,Huang, T.-H.,Huang, S.,Shyu, Y.-I. L.(2018).Protective preparation: A process central to family care givers of persons with mild cognitive impairment.International Psychogeriatrics,30(3),375-384.
  29. Wang, K. N.,Page, A. T.,Etherton, B. C. D.(2021).Mild cognitive impairment: To diagnose or not to diagnose.Australasian Journal on Ageing,40(2),111-115.
  30. Ware, J. E.,Kosinski, M. K.,Keller, S. D.(1994).SF-36 physical and mental health summary scales: A user's manual.The Health Institute, New England Medical Center.
  31. Yang, X. Q.,Vedel, I.,Khanassov, V.(2021).The cultural diversity of dementia patients and caregivers in primary care case management: A pilot mixed methods study.Canadian Geriatrics Journal,24(3),184-194.
  32. Yip, P. K.,Shyu, Y. I. L.,Liu, S. I.,Lee, J. Y.,Chou, C. F.,Chen, R. C.,Lin, S. H.,Chen, R. C.(1992)。An epidemiological survey of dementia among elderly in an urban district of Taipei。Acta Neurologica Sinica,1(4),347-354。
  33. Yu, D. S.,Li, P. W.,Zhang, F.,Cheng, S. T.,Ng, T. K.,Judge, K. S.(2019).The effects of a dyadic strength-based empowerment program on the health outcomes of people with mild cognitive impairment and their family caregivers: A randomized controlled trial.Clinical Interventions in Aging,14,1705-1717.