作者
Lily Dongxia Xiao,Shahid Ullah,Rujun Hu,Li Wang,Huali Wang,Chia‐Chi Chang,Timothy Kwok,Zhu Ming-xia,Julie Ratcliffe,Henry Brodaty,Bianca Brijnath,Hui‐Chen Chang,Bel Wong,Yunrui Zhou,Jinjie He,Mengmeng Xia,Jhih-Yang Hong,Shirley Che,Rachel Milte
摘要
Multicomponent interventions with carers of people with dementia demonstrate positive effects on the health and quality of life for carers and care recipients. The World Health Organisation's iSupport for Dementia is an evidence-based online psychoeducation program for carers. However, the program was mainly implemented as a self-learning tool which might have limited its positive effects on carers and care recipients. Evidence for online multicomponent interventions with carers that incorporates the iSupport program remains unknown. This study aimed to partner with health and social care organisations to evaluate the effects of a facilitator-enabled online multicomponent Chinese iSupport program, which included psychoeducation using the iSupport program, facilitator-enabled carer support groups and access to care services. a multicentre randomised controlled trial. Participants were family carers in Australia and greater China. We recruited participants to the study from 1st November 2021 to 30th June 2022. The intervention group received the Chinese iSupport program delivered online. The intervention lasted for 6 months. Our primary outcome was carers' quality of life. Our secondary outcomes were carers' self-efficacy, social support, distress reactions to changed behaviours, care recipients' frequency of changed behaviours, quality of life, unplanned hospital admissions, emergency department presentations and permanent admissions to nursing homes. The outcomes were measured at baseline (T0), 6 months (T1) and 9 months (T2). We applied a multivariate mixed effect linear regression model to capture the group effect, time effect and their interaction. In total, 266 eligible family carers agreed to participate and were randomly assigned to an intervention group (n = 131) or a usual care group (n = 135). Most carers were women with a mean age of 53 years. The intervention group showed a statistically significant higher score of mental-health-related quality of life (mean difference = 4.1, 95 % CI: 1.5, 6.8, p = 0.002), self-efficacy in controlling upsetting thoughts (mean difference = 7.1, 95 % CI: 2.2, 12.0, p = 0.005) and lower score of distress reactions to changed behaviours (mean difference = − 0.1, 95 % CI: − 0.3, − 0.03, p = 0.012) than the usual care group at T1. The facilitator-enabled online multicomponent Chinese iSupport program demonstrated positive effects for carers on mental health-related quality of life, controlling upsetting thoughts and distress reactions to changed behaviours of people with dementia. This study is registered in the Australia New Zealand Clinical Trials Registry on 12th March 2021 (ACTRN12621000276853). The facilitator-enabled online multicomponent Chinese iSupport program improved family carers' mental health-related quality of life, controlling upsetting thoughts and distress reactions to changed behaviours of people with dementia.