Strength-Based Intervention for Dyads with Mild Dementia

针对轻度痴呆症二人组的基于力量的干预

• 批准号: 7101483
• 负责人: KATHERINE S JUDGE
• 金额: $ 6.44万
• 依托单位: BENJAMIN ROSE INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-01 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7101483
• 关键词: aging; behavioral /social science research tag; caregivers; coping; dementia; dyadic interaction; early /brief intervention /therapy; education evaluation /planning; functional ability; health care model; human old age (65+); human subject; human therapy evaluation; medical rehabilitation related tag; outcomes research; patient oriented research; problem solving; psychiatric patient care; psychological stressor; psychosocial rehabilitation; quality of life; training

DESCRIPTION (provided by applicant): Older adults and their families coping with mild dementia and memory loss face unique challenges in providing care and managing cognitive and functional symptoms. These challenges can result in negative psychosocial outcomes for both caregivers (CGs) and care receivers (CRs). For CRs, dementia deteriorates their cognitive abilities and functional capacities, leading to negative emotional, social, and behavioral outcomes (e.g., loss of self, depression, anxiety). For CGs, the stress of care giving increases depression, health problems, and role and intra-psychic strains (e.g., strained family relationships, emotional strain). Since family CGs provides the vast majority of daily home care for persons with dementia, it is imperative that interventions support their ability to continue providing care and effectively cope with their role. Interventions supporting CRs' remaining cognitive and functional skills are important in maximizing their abilities and improving psychosocial outcomes. The proposed 2-year pilot investigation is a randomized controlled study that tests the efficacy of an innovative intervention for care giving dyads dealing with mild dementia. The intervention "Acquiring New Skills While Enhancing Remaining Strengths (ANSWERS)" combines educational skills training (traditionally only used with family CGs) and cognitive rehabilitation skills training (traditionally only used with older CRs). ANSWERS is unique because it trains both members of care giving dyads to implement a core set of educational and cognitive rehabilitation techniques in the home. ANSWERS is grounded in a Strength-Based Approach that draws upon and enhances CRs' remaining cognitive and functional abilities, while serving as a low-cost resource to help CGs cope. The proposed study includes 70 care giving dyads comprised of a CR with mild dementia and his/her primary family CG. Dyads will be randomly assigned to the treatment group (n=35) or control group (n=35). The intervention protocol follows a set curriculum that includes three education skills components and three cognitive rehabilitation skills components: communication & redirection, problem-solving & reframing, and realistic goal setting (the educational skills); and spaced retrieval, cognitive task analysis, and external memory aids (the cognitive rehabilitation skills). The Stress Process Model is the conceptual framework that guides study hypotheses for how the ANSWERS intervention is expected to improve psychosocial outcomes for both CGs and CRs. Psychosocial outcomes include various dimensions of general well-being (e.g., depression, anxiety, quality of life) and intra-psychic and role strains (e.g., relationship strain, self-efficacy). If efficacious, findings from this controlled test will be used to refine the ANSWERS intervention, which will be tested for effectiveness in a larger, federally-funded trial.

描述（由申请人提供）：患有轻度痴呆和记忆丧失的老年人及其家人在提供护理和管理认知和功能症状方面面临着独特的挑战。这些挑战可能会给照顾者 (CG) 和被照顾者 (CR) 带来负面的心理社会结果。对于 CR 来说，痴呆症会损害他们的认知能力和功能能力，导致负面的情绪、社交和行为结果（例如丧失自我、抑郁、焦虑）。对于 CG 来说，护理压力会增加抑郁、健康问题以及角色和内心压力（例如，家庭关系紧张、情绪紧张）。由于家庭CG 为痴呆症患者提供绝大多数日常家庭护理，因此干预措施必须支持他们继续提供护理并有效应对其角色的能力。支持 CR 剩余认知和功能技能的干预措施对于最大限度地发挥其能力和改善心理社会结果非常重要。拟议的为期 2 年的试点调查是一项随机对照研究，旨在测试创新干预措施对治疗轻度痴呆症的护理双人组的功效。 “获取新技能，同时增强剩余优势 (ANSWERS)”干预措施结合了教育技能培训（传统上仅与家庭 CG 一起使用）和认知康复技能培训（传统上仅与老年 CR 一起使用）。 ANSWERS 是独一无二的，因为它训练护理二人组的两名成员在家中实施一套核心的教育和认知康复技术。 ANSWERS 基于基于优势的方法，利用并增强 CR 剩余的认知和功能能力，同时作为帮助 CG 应对的低成本资源。拟议的研究包括 70 个护理双人组，其中包括患有轻度痴呆的 CR 和他/她的主要家庭 CG。双人组将被随机分配到治疗组 (n=35) 或对照组 (n=35)。干预方案遵循一套课程，其中包括三个教育技能组成部分和三个认知康复技能组成部分：沟通和重定向、解决问题和重新构建以及现实的目标设定（教育技能）；间隔检索、认知任务分析和外部记忆辅助（认知康复技能）。压力过程模型是指导研究假设的概念框架，用于指导 ANSWERS 干预如何改善 CG 和 CR 的心理社会结果。社会心理结果包括总体幸福感的各个维度（例如抑郁、焦虑、生活质量）以及内心和角色压力（例如关系压力、自我效能）。如果有效，该对照测试的结果将用于完善 ANSWERS 干预措施，并将在一项更大规模的、联邦资助的试验中测试其有效性。