Development and Initial Evaluation of the Web-Based Self-Management Program “Partner in Balance” for Family Caregivers of People With Early Stage Dementia: An Exploratory Mixed-Methods Study

Boots, Lizzy; Vugt, Marjolein E. de; Withagen, Hanneke Ej; Kempen, Gertrudis I. J. M.; Verhey, Frans R.J.

doi:10.2196/resprot.5142

Cited by 69 publications

(146 citation statements)

References 65 publications

(86 reference statements)

Supporting

Mentioning

131

Contrasting

Unclassified

Order By: Relevance

“…The completers did not differ from non-completers at baseline in terms of age (t=0. Results on caregiver self-efficacy, mastery, and quality of life are in line with previous results in an uncontrolled study [22] and results of previous e-health interventions for dementia caregivers [19]. Furthermore, the results of the present study fit the Stress and Coping paradigm by Lazarus and Folkman [36] and the Social Learning theory by Bandura [7], suggesting that taking charge of the changes in one's life increases self-efficacy and general wellbeing.…”

Section: User Involvementsupporting

confidence: 91%

See 1 more Smart Citation

Effectiveness of a Blended Care Self-Management Program for Caregivers of People With Early-Stage Dementia (Partner in Balance): Randomized Controlled Trial (Preprint)

Boots¹,

Vugt²,

Kempen³

et al. 2018

Preprint

Self Cite

View full text Add to dashboard Cite

BACKGROUND The benefits of electronic health support for dementia caregivers are increasingly recognized. Reaching caregivers of people with early-stage dementia could prevent high levels of burden and psychological problems in the later stages. OBJECTIVE The current study evaluates the effectiveness of the blended care self-management program, Partner in Balance, compared to a control group. METHODS A single-blind randomized controlled trial with 81 family caregivers of community-dwelling people with mild dementia was conducted. Participants were randomly assigned to either the 8-week, blended care self-management Partner in Balance program (N=41) or a waiting-list control group (N=40) receiving usual care (low-frequent counseling). The program combines face-to-face coaching with tailored Web-based modules. Data were collected at baseline and after 8 weeks in writing by an independent research assistant who was blinded to the treatment. The primary proximal outcome was self-efficacy (Caregiver Self-Efficacy Scale) and the primary distal outcome was symptoms of depression (Center for Epidemiological Studies Depression Scale). Secondary outcomes included mastery (Pearlin Mastery Scale), quality of life (Investigation Choice Experiments for the Preferences of Older People), and psychological complaints (Hospital Anxiety and Depression Scale-Anxiety and Perceived Stress Scale). RESULTS A significant increase in favor of the intervention group was demonstrated for self-efficacy (care management, P=.002; service use P=.001), mastery (P=.001), and quality of life (P=.032). Effect sizes were medium for quality of life (d=0.58) and high for self-efficacy care management and service use (d=0.85 and d=0.93, respectively) and mastery (d=0.94). No significant differences between the groups were found on depressive symptoms, anxiety, and perceived stress. CONCLUSIONS This study evaluated the first blended-care intervention for caregivers of people with early-stage dementia and demonstrated a significant improvement in self-efficacy, mastery, and quality of life after receiving the Partner in Balance intervention, compared to a waiting-list control group receiving care as usual. Contrary to our expectations, the intervention did not decrease symptoms of depression, anxiety, or perceived stress. However, the levels of psychological complaints were relatively low in the study sample. Future studies including long-term follow up could clarify if an increase in self-efficacy results in a decrease or prevention of increased stress and depression. To conclude, the program can provide accessible preventative care to future generations of caregivers of people with early-stage dementia. CLINICALTRIAL Netherlands Trial Register NTR4748; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4748 (Archived by WebCite at http://www.webcitation.org/6vSb2t9Mg)

show abstract

Section: User Involvementsupporting

confidence: 91%

“…The iterative development and pilot evaluation of Partner in Balance as recommended by the MRC framework is described elsewhere [22]. The burden of the intervention was assessed in a process evaluation.…”

Section: User Involvementmentioning

confidence: 99%

Effectiveness of a Blended Care Self-Management Program for Caregivers of People With Early-Stage Dementia (Partner in Balance): Randomized Controlled Trial (Preprint)

Boots¹,

Vugt²,

Kempen³

et al. 2018

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…As one participant said, 'people experience emotions, whilst a computer is just an object'. 61 The assumption was that personal contact could increase motivation and adherence, although the mechanism for achieving this was not identified in the paper. This is supported by an evaluation of web-based appointments for people with diabetes in Newham, East London.…”

Section: Resmentioning

confidence: 97%

“…25,28,30,37,39,42,43,45,[57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73] These comprised 79 research papers and 10 guidelines or discussion pieces. Other papers cited in this chapter are for background information and did not undergo full data extraction.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…The importance of contact with a HCP was supported by a qualitative study 61 exploring the use of a SM programme for carers of people living with dementia; participants preferred blended care (face-to-face and online modules) as they valued personal contact with a professional. As one participant said, 'people experience emotions, whilst a computer is just an object'.…”

Section: Resmentioning

confidence: 99%

See 1 more Smart Citation

Managing diabetes in people with dementia: a realist review

Bunn

Goodman

Jones

et al. 2017

Health Technol Assess

View full text Add to dashboard Cite

BackgroundDementia and diabetes mellitus are common long-term conditions that coexist in a large number of older people. People living with dementia and diabetes may be at increased risk of complications such as hypoglycaemic episodes because they are less able to manage their diabetes.ObjectivesTo identify the key features or mechanisms of programmes that aim to improve the management of diabetes in people with dementia and to identify areas needing further research.DesignRealist review, using an iterative, stakeholder-driven, four-stage approach. This involved scoping the literature and conducting stakeholder interviews to develop initial programme theories, systematic searches of the evidence to test and develop the theories, and the validation of programme theories with a purposive sample of stakeholders.ParticipantsTwenty-six stakeholders (user/patient representatives, dementia care providers, clinicians specialising in dementia or diabetes and researchers) took part in interviews and 24 participated in a consensus conference.Data sourcesThe following databases were searched from 1990 to March 2016: MEDLINE (PubMed), Cumulative Index to Nursing and Allied Health Literature, Scopus, The Cochrane Library (including the Cochrane Database of Systematic Reviews), Database of Abstracts of Reviews of Effects, the Health Technology Assessment (HTA) database, NHS Economic Evaluation Database, AgeInfo (Centre for Policy on Ageing – UK), Social Care Online, the National Institute for Health Research (NIHR) portfolio database, NHS Evidence, Google (Google Inc., Mountain View, CA, USA) and Google Scholar (Google Inc., Mountain View, CA, USA).ResultsWe included 89 papers. Ten papers focused directly on people living with dementia and diabetes, and the rest related to people with dementia or diabetes or other long-term conditions. We identified six context–mechanism–outcome (CMO) configurations that provide an explanatory account of how interventions might work to improve the management of diabetes in people living with dementia. This includes embedding positive attitudes towards people living with dementia, person-centred approaches to care planning, developing skills to provide tailored and flexible care, regular contact, family engagement and usability of assistive devices. A general metamechanism that emerges concerns the synergy between an intervention strategy, the dementia trajectory and social and environmental factors, especially family involvement. A flexible service model for people with dementia and diabetes would enable this synergy in a way that would lead to the improved management of diabetes in people living with dementia.LimitationsThere is little evidence relating to the management of diabetes in people living with dementia, although including a wider literature provided opportunities for transferable learning. The outcomes in our CMOs are largely experiential rather than clinical. This reflects the evidence available. Outcomes such as increased engagement in self-management are potential surrogates for better clinical management of diabetes, but this is not proven.ConclusionsThis review suggests that there is a need to prioritise quality of life, independence and patient and carer priorities over a more biomedical, target-driven approach. Much current research, particularly that specific to people living with dementia and diabetes, identifies deficiencies in, and problems with, current systems. Although we have highlighted the need for personalised care, continuity and family-centred approaches, there is much evidence to suggest that this is not currently happening. Future research on the management of diabetes in older people with complex health needs, including those with dementia, needs to look at how organisational structures and workforce development can be better aligned to the needs of people living with dementia and diabetes.Study registrationThis study is registered as PROSPERO CRD42015020625.FundingThe NIHR HTA programme.

show abstract

The Difficult Distinction Between Affective Disorders and Mild Cognitive Deterioration

Ramakers

Verhey

2016

Neuropsychiatric Symptoms of Cognitive Impairment and Dementia

View full text Add to dashboard Cite

Development and Initial Evaluation of the Web-Based Self-Management Program “Partner in Balance” for Family Caregivers of People With Early Stage Dementia: An Exploratory Mixed-Methods Study

Cited by 69 publications

References 65 publications

Effectiveness of a Blended Care Self-Management Program for Caregivers of People With Early-Stage Dementia (Partner in Balance): Randomized Controlled Trial (Preprint)

Effectiveness of a Blended Care Self-Management Program for Caregivers of People With Early-Stage Dementia (Partner in Balance): Randomized Controlled Trial (Preprint)

Managing diabetes in people with dementia: a realist review

The Difficult Distinction Between Affective Disorders and Mild Cognitive Deterioration

Contact Info

Product

Resources

About