SupportingCaregiversbyMobileTechnology:AFeasibilityStudyoftheE-paintingMobileApp透過流動(dòng)科技支援照顧者：電子繪畫流動(dòng)應(yīng)用程序的可行性研究Outline目錄Background背景StudyAims&Objectives

研究目的Methods

研究方法Results

研究結(jié)果Discussion&Conclusion

研究討論及總結(jié)Background背景Sourcesofcaregivers’stress…Personswithdementia’s(PWD)dependencyinactivitiesofdailylivingSeverityandfrequencyofbehaviouralsymptomsPWDoftenperformedproblematicbehaviorsthatmightaffectothersCaregivers’feelingofoverload(subjectivestressor)照顧者壓力來源……患者于日常生活的依賴嚴(yán)重及頻繁的行為癥狀患者經(jīng)常表演出奇怪或讓人煩擾的行為照顧者覺得自己負(fù)擔(dān)太重（主觀的壓力來源）(Kangetal.,2006;Leeetal.,2017;Sonetal.,2007)Areview(Slaytonetal.,2010)summarizedthatabriefperiodofpaintingsignificantlyreduced…anxietyscore

(Sandmireetal.,2012;Curry&Kasser,2005)

distress

(Franks&Whitaker,2007)

depression(Gussak,2006)butincreasedmentalalertnessandsociability(Rusted,Sheppard,&Waller,2006)

一篇評(píng)論(Slaytonetal.,2010)

總結(jié)出短暫的繪畫時(shí)段可顯著縮短......焦慮評(píng)分(Sandmireetal.,2012;Curry&Kasser,2005)

憂慮(Franks&Whitaker,2007)

抑郁(Gussak,2006)但提高了精神警覺性和社交能力(Rusted,Sheppard,&Waller,2006)

Background背景Aims&Objectives研究目的Thisstudyaimstoassessthefeasibilityofthise-paintingmobileappamongthecaregiverswhofrequentlyprovidecaretopersonswithdementia.本研究旨在評(píng)估認(rèn)知障礙癥患者的恒常照顧者于使用這種電子繪畫流動(dòng)應(yīng)用程序的可行性。Objectives目的:Toassesstheprocessoftheuseofthee-paintingappfor8weeks;Tocollecttheappusers’viewsontheappaftertheintervention.Topreliminarilyassesstheeffectoftheapponsocialandpsychologicalaspects.評(píng)估使用電子繪畫應(yīng)用程序(8周)的情況;收集使用者對(duì)電子繪畫應(yīng)用程序的評(píng)價(jià);初步評(píng)估干預(yù)后心理及情緒的變化。StudyDesign研究設(shè)計(jì)Thisisamixed-methodstudywithquantitativecomponent(apre-test&post-testsurvey)andqualitativecomponent(focusgroupinterviews,FGI)Pre-interventionFocusGroupInterviews(pre-FGI)Post-interventionFocusGroup/individualInterviews(post-FGI)Datacollection:fromJan2018toMay2018

這是一個(gè)具有質(zhì)性和量性的混合研究量性成分（使用程序前后的問卷調(diào)查）質(zhì)性部分（干預(yù)前后的焦點(diǎn)小組/個(gè)人訪談）數(shù)據(jù)收集：2018年1月至2018年5月Subjects對(duì)象Quantitative&Qualitativecomponent質(zhì)性和量性部分Inclusioncriteria:aged18oraboveprovidedirectcaretoapersonwithdementiaabletoreadChineseorcommunicateinCantoneseorPutonghua

abletotraveltothedesignedinterviewvenueindependently(forqualitativecomponentonly)

納入條件：年滿18歲或以上為患有認(rèn)知障礙癥的人提供直接護(hù)理能夠閱讀中文或以粵語或普通話交流能夠獨(dú)立前往設(shè)計(jì)的面試場(chǎng)所（僅限質(zhì)性部分）Exclusioncriteria:havingfever,influenzasymptomsbeinghospitalizedlivinginresidentialcarehomes排除條件：有發(fā)燒，流感癥狀正在住院住在安老院PrimaryOutcome主要目標(biāo)：

Caregivers’levelofstress照顧者壓力水平measuredbya11-itemZaritBurdenInterview,CZBI-Short(Tangetal.,2015)SecondaryOutcomes次要目標(biāo)：

Self-ratedhealthstatus自評(píng)健康measuredbythe1-itemSelf-ratedHealthscale

Depressivesymptoms抑郁癥狀measuredbya9-itemPatientHealthQuestionnaire(PHQ-9)(Cheng&Cheng,2007)

Instrumentalandemotionalsocialsupport

社會(huì)情感支持measuredbya8-itemModifiedMedicalOutcomeStudySocialSupportSurvey(mMOS-SS)(Moseretal.,2012)Measuresusedinsurvey問卷測(cè)量工具Quantitativedata:Descriptiveanalysis(frequency,means,standarddeviation)Pairedt-testswereusedtocomparetheoutcomesbeforeandafterthe8-weekinterventionQualitativedata:Contentanalysiswasused量性數(shù)據(jù)：敘述統(tǒng)計(jì)分析（頻率，均值，標(biāo)準(zhǔn)差）配對(duì)檢定(Pairedt-tests)用于比較使用8周電子繪畫應(yīng)用程序前后的結(jié)果質(zhì)性數(shù)據(jù)：使用內(nèi)容分析法Dataanalysis數(shù)據(jù)分析E-painting:Allowingcaregiverstoexpresstheirfeelings

電子繪畫：讓照顧者表達(dá)自己的感受Chatroom聊天室Painting畫畫Fivefeatures:PaintingSharingthePicturesAnnouncementChatroomMoodSelf-AssessmentEightPaintingTopics:APersonIlikeAPlantIlikeAplaceIlikeAnAnimalIlikeAtaskIoftendoSomethingIwanttodowhenIamfreeAplaceIwanttogo

whenIamfreeSomefoodIwanttoeatE-PaintingGuidelines電子繪畫指南八周畫畫主題:我喜愛的人物我喜愛的植物我喜愛的地方我喜愛的動(dòng)物一件我恒常會(huì)做的事當(dāng)我空閑時(shí)會(huì)想做的事當(dāng)我空閑時(shí)會(huì)想去的地方一些我想吃的食物Examplesofdrawingssharedbyappusers電子繪畫程序用戶畫作分享例子Topic:AplaceIwanttogo

whenIamfree當(dāng)我空閑時(shí)會(huì)想去的地方Topic:AplantIlike我喜愛的植物Demographics照顧者背景Outofthe32recruitedsubjects,28caregiversusedtheapp.Only22completedthe8-weektrial.28名照顧者使用了該應(yīng)用程序，但只有22名完成了為期8周的試驗(yàn)。Dropoutrate:21.4%EngagementinE-PaintingApp

使用電子繪畫程序的參與度Figure1.Frequencyofloginandpicturesharinginthee-paintingapp.Notes.*FrequencyofLoginwerecountedevery24hours.**Photoswerealsocountedaspictures.Replicatedsharingwereexcluded.圖1.電子繪畫應(yīng)用程序中用戶登錄和圖片共享的頻率(每24小時(shí)紀(jì)錄)Accumulatedcountofpicturessharing

累計(jì)畫作上傳紀(jì)錄Figure2.Timeforpaintingandsharinginaday.Notes.Photoswerealsocountedaspictures.Replicatedsharingwereexcluded.圖2.照顧者繪畫并分享畫作的時(shí)間Usageofthee-paintingapp

使用電子繪畫應(yīng)用程序LoginfrequencyPaintingfrequencyPicturesharingFavouritefunctionsintheappReasonsfornotusingtheappDifficultyinappusageCaregiversbelievedthattherewasstressalleviationaftertheuseofthee-paintingapp.Afterpainting,itwouldmakeyourselfbecomemorepositive,andmymoodisbetter.(26May2018CGPWD_Epainting_PostFGI;line23-24)Well,Ithinkoneofthebestthings(oftheapp)isthateveryonecouldsee(picturesof)…eachother.Andeventhoughotherappusersmightnot‘like’orrespondtoyourpictures,youcouldstillseeothers’(pictures)…youmightsee,ohthepicturesdrawnwerequitesimilar,or….Stillitcouldhaveamotivationeffectoneachother,thattheinteractionisquitegood,thatis…h(huán)elpful,ishelpful.

(26May2018CGPWD_Epainting_PostFGI;line26-30)照顧者認(rèn)為使用電子繪畫程序后可以減輕壓力。

Caregivers’FeedbackafterAppUsage

使用電子繪畫應(yīng)用程序用戶的意見Changesinoutcomesaftertheappintervention

使用應(yīng)用程序前后的變化Discussion討論Non-frequentappusersseemedtoexperiencemoreburdenbeforetheyusedtheapp.AlthoughtheCGPWDreportedtheincreasedburdenovertime,theirdepressivesymptomswerenotexaggerated.TheappseemedtohelptobreakthegeographicdistanceforconnectionsandsocialsupportAfairlyincreaseininstrumentalandemotionalsocialsupportscores非頻繁用戶使用應(yīng)用程序后遇到更多負(fù)擔(dān)。雖然照顧者反映隨著時(shí)間的推移他們的負(fù)擔(dān)會(huì)相應(yīng)增加，但他們的抑郁癥狀并沒有明顯變化。該應(yīng)用程序似乎有助于打破地理界限社會(huì)情感支持度有相當(dāng)增幅。IsE-paintingApp