Wai-Kit Tang
.
Title: How to improve caregiving self-efficacy on managing disruptive behavior of dementia client? ARCT study on an evidence-based psychosocial intervention.
Biography
Biography: Wai-Kit Tang
Abstract
Background: Caregivers (CGs) of people with dementia (PWD) often experience role overload and a high level of perceived burden during caregiving. The American Psychiatric Association has recommended using a psychosocial intervention as a quality practice to enhance the self-efficacy (SE) of CGs in dementia caregiving. Methodology: Critically compare the program design through a literature review and adopting Bandura’s (1997) theoretical framework of self-efficacy, an evidence-based psychosocial intervention for dementia caregiver (PSI-CG) was worked out which aimed at enhancing the caregiving SE and reduce the perceived burden of the CG. The intervention focused on providing four types of information to bolster the caregivers’ self-efficacy. They include mastery experience, vicarious learning, verbal persuasion, and physiological and psychological feedback. The intervention consisted of three face-to-face group sessions that included knowledge and skills training, group sharing, and relaxation exercises. After each group session, a telephone call was provided to each CG by the program assistant for knowledge checking and consolidating strengths and gains in the previous sessions. After validation on the intervention, an RCT study was conducted to examine the effectiveness. A total of 115 CG of PWD were recruited while follow-up visit in the Mental Health Centre in Hong Kong. Upon three intervention groups, block randomization and a block size of eight was used to randomize the CGs to receive either the PSI-CG (n=56) or the control intervention (n=59) by using a ratio of 1:1.Results: The GEE results indicated the intervention effectiveness that compared with the control group who received the information booklet, those who received the PSI-CG had significantly greater improvements in overall caregiving SE (p=0.045), particularly on the SE in handling disruptive behaviors (p=0.005). The particular favorable effect on handling disturbing symptoms may be related to the education on the communication skills by modifying the CG mindset towards PWD behaviors, and peer-led discussions over symptom management. For further improvements, future study may consider adding components, for example, a social break and additional booster sessions, to facilitate peer support among the CG.