透过流动科技支援照顾者-电子绘画流动应用程序的可行性研究

SupportingCaregiversbyMobileTechnology:AFeasibilityStudyoftheE-paintingMobileApp透过流动科技支援照顾者：电子绘画流动应用程序的可行性研究Outline目录Background背景StudyAims&Objectives

研究目的Methods

研究方法Results

研究结果Discussion&Conclusion

研究讨论及总结Background背景Sourcesofcaregivers’stress…Personswithdementia’s(PWD)dependencyinactivitiesofdailylivingSeverityandfrequencyofbehaviouralsymptomsPWDoftenperformedproblematicbehaviorsthatmightaffectothersCaregivers’feelingofoverload(subjectivestressor)照顾者压力来源……患者于日常生活的依赖严重及频繁的行为症状患者经常表演出奇怪或让人烦扰的行为照顾者觉得自己负担太重（主观的压力来源）(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)

一篇评论(Slaytonetal.,2010)

总结出短暂的绘画时段可显著缩短......焦虑评分(Sandmireetal.,2012;Curry&Kasser,2005)

忧虑(Franks&Whitaker,2007)

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

Background背景Aims&Objectives研究目的Thisstudyaimstoassessthefeasibilityofthise-paintingmobileappamongthecaregiverswhofrequentlyprovidecaretopersonswithdementia.本研究旨在评估认知障碍症患者的恒常照顾者于使用这种电子绘画流动应用程序的可行性。Objectives目的:Toassesstheprocessoftheuseofthee-paintingappfor8weeks;Tocollecttheappusers’viewsontheappaftertheintervention.Topreliminarilyassesstheeffectoftheapponsocialandpsychologicalaspects.评估使用电子绘画应用程序(8周)的情况;收集使用者对电子绘画应用程序的评价;初步评估干预后心理及情绪的变化。StudyDesign研究设计Thisisamixed-methodstudywithquantitativecomponent(apre-test&post-testsurvey)andqualitativecomponent(focusgroupinterviews,FGI)Pre-interventionFocusGroupInterviews(pre-FGI)Post-interventionFocusGroup/individualInterviews(post-FGI)Datacollection:fromJan2018toMay2018

这是一个具有质性和量性的混合研究量性成分（使用程序前后的问卷调查）质性部分（干预前后的焦点小组/个人访谈）数据收集：2018年1月至2018年5月Subjects对象Quantitative&Qualitativecomponent质性和量性部分Inclusioncriteria:aged18oraboveprovidedirectcaretoapersonwithdementiaabletoreadChineseorcommunicateinCantoneseorPutonghua

abletotraveltothedesignedinterviewvenueindependently(forqualitativecomponentonly)

纳入条件：年满18岁或以上为患有认知障碍症的人提供直接护理能够阅读中文或以粤语或普通话交流能够独立前往设计的面试场所（仅限质性部分）Exclusioncriteria:havingfever,influenzasymptomsbeinghospitalizedlivinginresidentialcarehomes排除条件：有发烧，流感症状正在住院住在安老院PrimaryOutcome主要目标：

Caregivers’levelofstress照顾者压力水平measuredbya11-itemZaritBurdenInterview,CZBI-Short(Tangetal.,2015)SecondaryOutcomes次要目标：

Self-ratedhealthstatus自评健康measuredbythe1-itemSelf-ratedHealthscale

Depressivesymptoms抑郁症状measuredbya9-itemPatientHealthQuestionnaire(PHQ-9)(Cheng&Cheng,2007)

Instrumentalandemotionalsocialsupport

社会情感支持measuredbya8-itemModifiedMedicalOutcomeStudySocialSupportSurvey(mMOS-SS)(Moseretal.,2012)Measuresusedinsurvey问卷测量工具Quantitativedata:Descriptiveanalysis(frequency,means,standarddeviation)Pairedt-testswereusedtocomparetheoutcomesbeforeandafterthe8-weekinterventionQualitativedata:Contentanalysiswasused量性数据：叙述统计分析（频率，均值，标准差）配对检定(Pairedt-tests)用于比较使用8周电子绘画应用程序前后的结果质性数据：使用内容分析法Dataanalysis数据分析E-painting:Allowingcaregiverstoexpresstheirfeelings

电子绘画：让照顾者表达自己的感受Chatroom聊天室Painting画画Fivefeatures:PaintingSharingthePicturesAnnouncementChatroomMoodSelf-AssessmentEightPaintingTopics:APersonIlikeAPlantIlikeAplaceIlikeAnAnimalIlikeAtaskIoftendoSomethingIwanttodowhenIamfreeAplaceIwanttogo

whenIamfreeSomefoodIwanttoeatE-PaintingGuidelines电子绘画指南八周画画主题:我喜爱的人物我喜爱的植物我喜爱的地方我喜爱的动物一件我恒常会做的事当我空闲时会想做的事当我空闲时会想去的地方一些我想吃的食物Examplesofdrawingssharedbyappusers电子绘画程序用户画作分享例子Topic:AplaceIwanttogo

whenIamfree当我空闲时会想去的地方Topic:AplantIlike我喜爱的植物Demographics照顾者背景Outofthe32recruitedsubjects,28caregiversusedtheapp.Only22completedthe8-weektrial.28名照顾者使用了该应用程序，但只有22名完成了为期8周的试验。Dropoutrate:21.4%EngagementinE-PaintingApp

使用电子绘画程序的参与度Figure1.Frequencyofloginandpicturesharinginthee-paintingapp.Notes.*FrequencyofLoginwerecountedevery24hours.**Photoswerealsocountedaspictures.Replicatedsharingwereexcluded.图1.电子绘画应用程序中用户登录和图片共享的频率(每24小时纪录)Accumulatedcountofpicturessharing

累计画作上传纪录Figure2.Timeforpaintingandsharinginaday.Notes.Photoswerealsocountedaspictures.Replicatedsharingwereexcluded.图2.照顾者绘画并分享画作的时间Usageofthee-paintingapp

使用电子绘画应用程序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…helpful,ishelpful.

(26May2018CGPWD_Epainting_PostFGI;line26-30)照顾者认为使用电子绘画程序后可以减轻压力。

Caregivers’FeedbackafterAppUsage

使用电子绘画应用程序用户的意见Changesinoutcomesaftertheappintervention

使用应用程序前后的变化Discussion讨论Non-frequentappusersseemedtoexperiencemoreburdenbeforetheyusedtheapp.AlthoughtheCGPWDreportedtheincreasedburdenovertime,theirdepressivesymptomswerenotexaggerated.TheappseemedtohelptobreakthegeographicdistanceforconnectionsandsocialsupportAfairlyincreaseininstrumentalandemotionalsocialsupportscores非频繁用户使用应用程序后遇到更多负担。虽然照顾者反映随着时间的推移他们的负担会相应增加，但他们的抑郁症状并没有明显变化。该应用程序似乎有助于打破地理界限社会情感支持度有相当增幅。IsE-paintingApp