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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Factors associated with caregiver readiness to use nonpharmacologic strategies to manage dementia-related behavioral symptoms
International journal of geriatric psychiatry, v 29(1)
01 Jan 2014
PMID: 23653143
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BackgroundNonpharmacologic strategies to manage dementia-related behavioral symptoms depend upon caregiver implementation. Caregivers may vary in readiness to use strategies. We examined characteristics associated with readiness, extent readiness changed during intervention, and predictors of change in readiness.
MethodsData came from a randomized trial involving 119 caregivers in a nonpharmacologic intervention for managing behavioral symptoms. Baseline measures included caregiver, patient, and treatment-related factors. At initial (2weeks from baseline) and final (16weeks) intervention sessions, interventionists rated caregiver readiness as pre-action (precontemplation=1; contemplation=2; preparation=3) or action (=4). Ordinal logistic regression identified baseline characteristics associated with initial readiness. Mc Nemar-Bowker test of symmetry described change in readiness; binary logistic regression identified baseline predictors of change in readiness (initial to final sessions). One-way multivariate analysis of variance identified treatment factors (dose/intensity, number of strategies used, perceived benefits, and therapeutic engagement) associated with change in readiness.
ResultsAt initial intervention session, 67.2% (N=80) of caregivers were in pre-action and 32.8% (N=39) in action. Initial high readiness was associated with better caregiver mood, less financial difficulty, lower patient cognition, and more behavioral symptoms. By final session, 72% (N=79) were in action and 28% (N=31) in pre-action; caregivers with less financial difficulty improved in readiness (B=-0.70, p=0.017); those in action were more therapeutically engaged (F[2,107]=3.61, p=0.030) and perceived greater intervention benefits (F[2, 88]=6.06, p=0.003).
ConclusionWhereas patient and caregiver-related factors were associated with initial readiness, financial stability, therapeutic engagement, and perceived benefits enhanced probability of change. Understanding caregiver readiness and factors associated with its change may be important considerations in nonpharmacologic interventions. Copyright (c) 2013 John Wiley & Sons, Ltd.
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Details
- Title
- Factors associated with caregiver readiness to use nonpharmacologic strategies to manage dementia-related behavioral symptoms
- Creators
- Laura N. Gitlin - Johns Hopkins UniversityKaren Rose - Widener University
- Publication Details
- International journal of geriatric psychiatry, v 29(1)
- Publisher
- Wiley
- Number of pages
- 10
- Grant note
- National Institute on Aging; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA) RO1 AG22254 / National Institute on Nursing Research; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Nursing Research (NINR) R01AG041781 / NATIONAL INSTITUTE ON AGING; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Nursing and Health Professions; Drexel University
- Web of Science ID
- WOS:000327823400010
- Scopus ID
- 2-s2.0-84890125895
- Other Identifier
- 991020111990504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Geriatrics & Gerontology
- Gerontology
- Psychiatry