Content Validity and Acceptability of the Daily Enhancement of Meaningful Activity Program

Abstract

Persons with mild cognitive Impairment (PwMCI) are at greater risk for developing Alzheimer’s disease and they experience various difficulties that decrease their quality of life. Very few interventions focus on helping PwMCI improve or maintain functional performance and enhance quality of life through meaningful activity engagement. The purpose of the study was to explore PwMCI and their spouses’ perspectives on the content validity, usefulness, and acceptability of the daily enhancement of meaningful activity (DEMA) program, which included 6 bi-weekly face-to-face sessions, between session assignments, and a self-management tool kit of written educational handouts. Nine PwMCI-care partner dyads participated in three focus groups (PwMCI alone, spouses alone, couples) to capture their perspectives on DEMA. The transcribed focus group data were analyzed through content analysis. The three groups provided support for content validity and acceptability of the program, and they suggested additional content areas important to couples experiencing MCI. They also attested to the usefulness of the tool kit and gave suggestions for its further improvement. The findings provide evidence of the content validity and acceptability of the DEMA program. A pilot study to assess feasibility and preliminary efficacy of the DEMA on health-related outcomes is the recommended next research step for this program.

Pilot Testing a Couples-Focused Intervention for Mild Cognitive Impairment

“…Content validity and preliminary evidence of acceptability of DEMA are described elsewhere (Lu & Haase, 2011). …”

Cost Template for Meaningful Activity Intervention for Mild Cognitive Impairment

“…Content validity of the DEMA intervention is described elsewhere. 17 Following approval from an institutional review board for the protection of human subjects, we recruited PwMCI-caregiver dyads from the university hospital, Alzheimer Center, and Health Aging Brain Center. PwMCI were diagnosed by an interdisciplinary team based on Winblad et al’s criteria.…”

Mild Cognitive Impairment and Caregiver Burden: A Critical Review and Research Agenda

“…Viewed as a predementia clinical stage bridging between normal aging and dementia, 29 MCI poses considerable challenges not only for the individuals with MCI, but also for their family members. 13 Indeed, we have witnessed a growing body of literature on the topic of caregiver burden in MCI. Expanding our knowledge on the strengths and pitfalls of these developments may allow us to more accurately estimate the societal costs along the entire spectrum of cognitive deterioration and to develop more effective interventions tailored to the specific needs of caregivers of persons at different stages of this spectrum.…”

“…This is surprising given that the assessment of objective burden is of utmost importance to the family caregiver, who often must take on new responsibilities in order to help the individual with MCI continue to function as long as possible. 13 These responsibilities include housework, driving, financial management, supervision of daily activities, assistance in decision-making, and provision of psychological support, 8,34 as well as some nursing tasks, such as administration of medications. 17 However, only Garand and her colleagues 16,17 assessed objective and subjective burden of care separately, showing that, similar to the area of AD, 35 both aspects of burden are differentially associated with outcome variables, and that subjective burden (meaning the perceptions of the caregivers regarding their role) was more clearly associated with outcome variables such as depression and marital satisfaction.…”

“…For example, a recent review covering the literature up to July 2011, indicated that the most commonly experienced emotions reported by caregivers of individuals with MCI were frustration, guilt, and anger. 8 Other consequences associated with caring for a person with MCI are a strong sense of loss 13 and deprivation in the caregiver relationship with the patient, 14 including less effective communication, a loss of intimacy, 8,15 and decreased marital satisfaction 16 among spouses. Finally, the new responsibilities facing caregivers as a result of the need to compensate for the memory decline in those with MCI take a toll on the caregivers' own lifestyle, for example by reducing the amount of time they have to themselves 17 or for participating in their own recreational activities.…”