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A pilot randomized controlled trial of a self-management group intervention for people with early-stage dementia (The SMART study)

Published online by Cambridge University Press:  17 December 2015

Catherine Quinn
Affiliation:
REACH: The Centre for Research in Ageing and Cognitive Health, Department of Psychology, College of Life and Environmental Sciences, Exeter University, Exeter, EX4 4QG, UK
Gill Toms
Affiliation:
School of Psychology, Bangor University, Bangor, Gwynedd, LL57 2AS, UK
Carys Jones
Affiliation:
Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, Gwynedd, LL57 2PZ, UK
Andrew Brand
Affiliation:
North Wales Organization for Randomized Trials in Health, College of Health and Behavior Sciences (CoHABS), Bangor University, Bangor, Gwynedd, LL57 2PZ, UK
Rhiannon Tudor Edwards
Affiliation:
Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, Gwynedd, LL57 2PZ, UK
Fiona Sanders
Affiliation:
Glan Traeth Community Team, Glan Traeth CPN office, Royal Alexandra Hospital, Betsi Cadwaladr University Health Board, Denbighshire, LL18 3AS, UK
Linda Clare
Affiliation:
REACH: The Centre for Research in Ageing and Cognitive Health, Department of Psychology, College of Life and Environmental Sciences, Exeter University, Exeter, EX4 4QG, UK
Corresponding
E-mail address:

Abstract

Background:

Self-management equips people to manage the symptoms and lifestyle changes that occur in long-term health conditions; however, there is limited evidence about its effectiveness for people with early-stage dementia. This pilot randomized controlled trial (RCT) explored the feasibility of a self-management intervention for people with early-stage dementia.

Methods:

The participants were people with early-stage dementia (n = 24) and for each participant a caregiver also took part. Participants were randomly allocated to either an eight-week self-management group intervention or treatment as usual (TAU). Assessments were conducted at baseline, three months and six months post-randomization by a researcher blind to group allocation. The primary outcome measure was self-efficacy score at three months.

Results:

Thirteen people with dementia were randomized to the intervention and 11 to TAU. Two groups were run, the first consisting of six people with dementia and the second of seven people with dementia. There was a small positive effect on self-efficacy with the intervention group showing gains in self-efficacy compared to the TAU group at three months (d = 0.35), and this was maintained at six months (d = 0.23). In terms of intervention acceptability, attrition was minimal, adherence was good, and satisfaction ratings were high. Feedback from participants was analyzed with content analysis. The findings suggest the positive aspects of the intervention were that it fostered independence and reciprocity, promoted social support, offered information, and provided clinician support.

Conclusions:

This study has provided preliminary evidence that self-management may be beneficial for people with early-stage dementia.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2015 

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