为居家老年痴呆症患者提供听力和视力支持:欧洲 SENSE-Cog 试验干预发展计划的成果

Iracema Leroi, JP Connelly, W. Yeung, Catherine Molony
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引用次数: 0

摘要

背景 听力和视力丧失是痴呆症最常见的致残性并发症之一,可能会加重病情的恶化。改善感官功能可能是提高痴呆症患者(PwD)生活质量(QoL)和其他成果的一种方便且具有成本效益的方法。在此,我们介绍了一项多步骤干预开发计划的成果,该计划旨在为社区环境中的痴呆症患者提供听力和视力支持,其组成部分包括跨国干预措施的开发和实施。方法 我们采用了 "干预映射 "流程和一套混合方法子研究来开发针对听力和/或视力受损的残疾人的干预措施。这包括对理解、认识和服务提供方面的差距进行调查,模拟干预原型,将原型改进为干预草案,最后对干预草案的可行性、可接受性和耐受性进行实地试验。来自 "患者和公众之声"(PPV)的意见与开发计划的每一步都相互关联(Miah 等人,2017 年)。本文综合了各项子研究的结果,得出了干预措施的描述和逻辑模型,然后在一项完全有效的确定性试验中对其进行了评估。该计划的子研究在四个欧盟国家的参与者家中、大学或诊所环境中进行:塞浦路斯、法国、希腊和英国。专家咨询小组会议在希腊雅典举行。我们采用定量和定性的方法来分析不同子研究的数据。结果 一项由多部分组成的以家庭为基础的心理社会 "感官干预 "旨在优化残疾人的听力和视力,从而改善其生活质量以及其他与痴呆症和护理伙伴相关的结果。结论 该干预措施是一项复杂干预措施的迭代开发成果,旨在满足残疾人和感官缺失者尚未得到满足的需求。
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Hearing and vision support in people with dementia living at home: Outcomes  from the intervention development programme for the European SENSE-Cog Trial
Background Hearing and vision loss are among the most common and disabling comorbidities in dementia and may worsen the trajectory of decline. Improving sensory function may be an accessible and cost-effective means of improving quality of life (QoL) and other outcomes for people with dementia (PwD). Here we describe the outcome of a multi-step intervention development programme for the components and implementation of a cross-national intervention to support hearing and vision in PwD in community settings. Methods We used the process of ‘intervention mapping’ and a set of mixed method sub-studies to develop the intervention for PwD with hearing and/or vision loss. This involved scoping the gaps in understanding, awareness, and service provision, modelling a prototype intervention, refining the prototype into a draft intervention, and finally field trialling the draft intervention for feasibility, acceptability, and tolerability. Input from the ‘patient and public voice’ (PPV) was interlinked with each step of the development programme (Miah et al., 2017). This paper synthesises the results of sub-studies leading to a description and logic model of the intervention which was then evaluated in a fully powered definitive trial. The sub-studies of the programme took place in participants’ own homes and in university or clinic settings in four EU countries: Cyprus, France, Greece, and the UK. The Expert Reference Group took place in Athens, Greece. We used quantitative and qualitative approaches to analyse the data from the different sub-studies. Results A multi-component psychosocial home-based ‘sensory intervention’ designed to optimise hearing and vision in PwD to improve QoL and other dementia-related and care partner-related outcomes. Conclusion This intervention represents the output of the iterative development of a complex intervention to fulfil an unmet need for PwD and sensory loss.
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