网络干预在痴呆老年人居家照护中应用的范围综述

doi:10.3761/j.issn.0254-1769.2021.05.008

摘要/Abstract

摘要：

目的对网络干预在痴呆老年人居家照护中应用的研究进行范围审查,以识别网络干预的要素及应用现状,为未来该领域的研究提供指导。方法以乔安娜布里格斯研究所范围综述指南为方法学框架,检索PubMed、Embase、CINAHL、Web of Science、PsycINFO、Cochrane Library、中国知网、万方和中国生物医学文献数据库中相关研究。检索时限为建库至2020年3月31日。对纳入文献进行汇总和分析。结果纳入31篇文献,网络干预的要素涵盖提供信息和照护技能指导、同伴支持、与专业人员联系、决策支持、心理支持和自我照护指导。结局类型主要为对居家照护者和痴呆老年人的干预效果及可行性指标。结论网络干预对痴呆照护者起到了积极影响,且多要素结合的个性化网络干预更受居家照护者欢迎。未来研究需结合分级诊疗模式和人工智能决策技术,探究在“互联网+护理服务”背景下实现个性化支持的策略。

关键词: 痴呆, 居家照护者, 网络干预, 社区保健护理, 范围综述

Abstract:

Objective To identify the core components and application status of internet-based interventions for family care of older people with dementia,so as to provide guidance for future research.Methods This scoping review was conducted under the Joanna Briggs Institute guidelines. A literature search was performed in the PubMed,Embase,CINAHL,Web of Science,PsycINFO,Cochrane Library,CNKI,Wanfang,and CBM databases to identify relevant studies. The included studies were summarized and analyzed.Results A total of 31 articles were included. The core components of internet-based interventions included the provision of information and care skills guidance,peer support,contact with professionals,decision-making support,psychological support,and self-care guidance. The outcome types were mainly the effect evaluation and feasibility evaluation of interventions.Conclusion Internet-based interventions have positive effects on family caregivers of dementia patients,and the personalized internet-based interventions combined with multiple components are more favored by family caregivers. Future research should combine the hierarchical medical system and artificial intelligence decision-making technology,explore the strategy of realizing personalized support in the context of “Internet + nursing service”.

Key words: Dementia, Family Caregivers, Internet-Based Interventions, Community Health Nursing, Scoping Review

冷敏敏,赵雅洁,李立玉,李策,肖红梅,王志稳. 网络干预在痴呆老年人居家照护中应用的范围综述[J]. 中华护理杂志, 2021, 56(5): 694-698.

LENG Minmin,ZHAO Yajie,LI Liyu,LI Ce,XIAO Hongmei,WANG Zhiwen. Internet-based interventions for family care of older people with dementia：a scoping review[J]. Chinese Journal of Nursing, 2021, 56(5): 694-698.

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参考文献 37

[1]	Alzheimer’s Disease International. World Alzheimer Report 2018:the state of the art of dementia research:new frontiers[EB/OL]. (2018-09-21)[2020-05-27]. https://www.alz.co.uk/research/world-report-2018.
[2]	陈丽丽, 李红, 金爽, 等. 老年痴呆患者异常进食行为特征及潜在需求分析[J]. 中华护理杂志, 2017,52(11):1304-1309.
	Chen LL, Li H, Jin S, et al. Analysis of characteristics of abnormal eating behaviors and potential needs in patients with Alzheimer’s disease[J]. Chin J Nurs, 2017,52(11):1304-1309.
[3]	马冬飞, 孙皎, 赵英男, 等. 痴呆患者精神行为症状相关护理模式的研究进展[J]. 中华护理杂志, 2019,54(7):1017-1022.
	Ma DF, Sun J, Zhao YN, et al. Nursing care mode of behavioral and psychological symptoms in patients with dementia:a literature review[J]. Chin J Nurs, 2019,54(7):1017-1022.
[4]	郝薇, 王志稳, 张晖, 等. 居家痴呆老年人照护问题评估单的构建研究[J]. 中华护理杂志, 2016,51(12):1504-1508.
	Hao W, Wang ZW, Zhang H, et al. Development of care problems assessment indicator system for community-dwelling patients with dementia[J]. Chin J Nurs, 2016,51(12):1504-1508.
[5]	田双月, 刘帅, 王志稳. 中重度失智老人居家照护者困扰问题及需求调研[J]. 中国护理管理, 2019,19(10):1502-1507.
	Tian SY, Liu S, Wang ZW. Study on the problems and needs of home caregivers of elderly with moderate to severe dementia[J]. Chin Nurs Manag, 2019,19(10):1502-1507.
[6]	Lockwood C, dos Santos KB, Pap R. Practical guidance for knowledge synjournal:scoping review methods[J]. Asian Nurs Res, 2019,13(5):287-294. DOI PMID
[7]	Beauchamp N, Irvine AB, Seeley J, et al. Worksite-based Internet multimedia program for family caregivers of persons with dementia[J]. Gerontol, 2005,45(6):793-801. DOI URL
[8]	Blom MM, Zarit SH, Groot Zwaaftink RBM, et al. Effectiveness of an Internet intervention for family caregivers of people with dementia:results of a randomized controlled trial[J]. PLoS One, 2015,10(2):e0116622. DOI URL
[9]	Brennan PF, Moore SM, Smyth KA. The effects of a special computer network on caregivers of persons with alzheimer’s disease[J]. Nurs Res, 1995,44(3):166-172. PMID
[10]	Chiu T, Marziali E, Colantonio A, et al. Internet-based caregiver support for Chinese canadians taking care of a family member with alzheimer disease and related dementia[J]. Can J Aging, 2009,28(4):323-336. DOI URL
[11]	Cristancho-Lacroix V, Wrobel J, Cantegreil-Kallen I, et al. A web-based psychoeducational program for informal caregivers of patients with Alzheimer’s disease:a pilot randomized controlled trial[J]. J Med Internet Res, 2015,17(5):e117. DOI URL
[12]	Dam AEH, van Boxtel MPJ, Rozendaal N, et al. Development and feasibility of Inlife:a pilot study of an online social support intervention for informal caregivers of people with dementia[J]. PLoS One, 2017,12(9):e0183386. DOI URL
[13]	Duggleby W, Ploeg J, McAiney C, et al. Web-based intervention for family carers of persons with dementia and multiple chronic conditions(my tools 4 care):pragmatic randomized controlled trial[J]. J Med Internet Res, 2018,20(6):e10484. DOI URL
[14]	Finkel S, Czaja SJ, Martinovich Z, et al. E-care:a telecommunications technology intervention for family caregivers of dementia patients[J]. Am J Geriatr Psychiatry, 2007,15(5):443-448. DOI URL
[15]	Griffiths PC, Kovaleva M, Higgins M, et al. Tele-savvy:an online program for dementia caregivers[J]. Am J Alzheimers Dis Other Demen, 2018,33(5):269-276. DOI PMID
[16]	Gustafson DH, Gustafson DH, Cody OJ, et al. Pilot test of a computer-based system to help family caregivers of dementia patients[J]. J Alzheimer’s Dis, 2019,70(2):541-552.
[17]	Hattink B, Meiland F, van der Roest H, et al. Web-based STAR E-learning course increases empathy and understanding in dementia caregivers:results from a randomized controlled trial in the Netherlands and the United Kingdom[J]. J Med Inter-net Res, 2015,17(10):e241.
[18]	Hattink BJJ, Meiland FJM, Overmars-Marx T, et al. The electronic,personalizable Rosetta system for dementia care:exploring the user-friendliness,usefulness and impact[J]. Disabil Rehabilitation:Assist Technol, 2016,11(1):61-71. DOI URL
[19]	Hicken BL, Daniel C, Luptak M, et al. Supporting caregivers of rural veterans electronically(SCORE)[J]. J Rural Heal, 2017,33(3):305-313.
[20]	Huis JG, Willemse BM, van Asch IF, et al. Online self-management support for family caregivers dealing with behavior changes in relatives with dementia(part 2):randomized controlled trial[J]. J Med Internet Res, 2020,22(2):e13001. DOI URL
[21]	Kajiyama B, Fernandez G, Carter EA, et al. Helping hispanic dementia caregivers cope with stress using technology-based resources[J]. Clin Gerontol, 2018,41(3):209-216. DOI PMID
[22]	Kajiyama B, Thompson LW, Eto-Iwase T, et al. Exploring the effectiveness of an Internet-based program for reducing caregiver distress using the iCare Stress Management e-Training Program[J]. Aging Ment Heal, 2013,17(5):544-554.
[23]	Kales HC, Gitlin LN, Stanislawski B, et al. Effect of the WeCare Advisor^TM on family caregiver outcomes in dementia:a pilot randomized controlled trial [J]. BMC Geriatr, 2018,18:113. DOI URL
[24]	Kovaleva M, Blevins L, Griffiths PC, et al. An online program for caregivers of persons living with dementia:lessons learned[J]. J Appl Gerontol, 2019,38(2):159-182. DOI PMID
[25]	Kwok T, Au A, Wong B, et al. Effectiveness of online cognitive behavioral therapy on family caregivers of people with dementia[J]. Clin Interv Aging, 2014: 631.
[26]	McKechnie V, Barker C, Stott J. The effectiveness of an Internet support forum for carers of people with dementia:a pre-post cohort study[J]. J Med Internet Res, 2014,16(2):e68. DOI URL
[27]	Meichsner F, Theurer C, Wilz G. Acceptance and treatment effects of an Internet-delivered cognitive-behavioral intervention for family caregivers of people with dementia:a randomized-controlled trial[J]. J Clin Psychol, 2019,75(4):594-613. DOI URL
[28]	Metcalfe A, Jones B, Mayer J, et al. Online information and support for carers of people with young-onset dementia:a multi-site randomised controlled pilot study[J]. Int J Geriatr Psychiatry, 2019,34(10):1455-1464. DOI PMID
[29]	Núñez-Naveira L, Alonso-Búa B, de Labra C, et al. UnderstAID,an ICT platform to help informal caregivers of people with dementia:a pilot randomized controlled study[J]. Biomed Res Int, 2016,2016:1-13.
[30]	Pagán-Ortiz ME, Cortés DE, Rudloff N, et al. Use of an online community to provide support to caregivers of people with dementia[J]. J Gerontol Soc Work, 2014,57(6/7):694-709. DOI URL
[31]	Possin KL, Merrilees JJ, Dulaney S, et al. Effect of collaborative dementia care via telephone and Internet on quality of life,caregiver well-being,and health care use[J]. JAMA Intern Med, 2019,179(12):1658. DOI URL
[32]	Schaller S, Marinova-Schmidt V, Setzer M, et al. Usefulness of a tailored eHealth service for informal caregivers and professionals in the dementia treatment and care setting:the eHealth Monitor dementia portal[J]. JMIR Res Protoc, 2016,5(2):e47. DOI URL
[33]	Span M, Smits C, Jukema J, et al. An interactive web tool for facilitating shared decision-making in dementia-care networks:a field study[J]. Front Aging Neurosci, 2015,7:128.
[34]	Torkamani M, Mc Donald L, Aguayo IS, et al. A randomized controlled pilot study to evaluate a technology platform for the assisted living of people with dementia and their carers[J]. J Alzheimer’s Dis, 2014,41(2):515-523.
[35]	van der Roest HG, Meiland FJM, Jonker C, et al. User evaluation of the DEMentia-specific Digital Interactive Social Chart(DEM-DISC). A pilot study among informal carers on its impact,user friendliness and,usefulness[J]. Aging Ment Heal, 2010,14(4):461-470.
[36]	van Mierlo LD, Meiland FJM, van de Ven PM, et al. Evaluation of DEM-DISC,customized e-advice on health and social support services for informal carers and case managers of people with dementia;a cluster randomized trial[J]. Int Psy-chogeriatr, 2015,27(8):1365-1378.
[37]	Williams KN, Perkhounkova Y, Shaw CA, et al. Supporting family caregivers with technology for dementia home care:a randomized controlled trial[J]. Innov Aging, 2019,3(3):igz037. DOI URL