OBJECTIVES Describe the state of the science in intervention - PDF document

APNA 30th Annual Conference Session 3013: October 21, 2016 Effectiveness of Resourcefulness Training for Women Dementia Caregivers Jaclene A. Zauszniewski, PhD, RN-BC, FAAN Nirmala Lekhak, BSN, PhD student Mary Variath, MSN, PhD student Christopher J. Burant, PhD, FGSA Diana L. Morris, PhD, RN, FAAN, FGSA Funded by the National Institute * The research team of Nursing Research has NO conflicts of (R21-NR010368) interest to disclose OBJECTIVES  Describe the state of the science in intervention research with dementia caregivers in terms of the extent of the problem and interventions needed.  Discuss differences among methods for reinforcing resourcefulness skills in women dementia caregivers and the implications of having them choose among available reinforcement methods.  Evaluate the effectiveness of two methods used during resourcefulness training for practicing and reinforcing resourcefulness skills. Resourcefulness Training Effectiveness PROBLEM  Increasing number of women providing care to elders with dementia  Potential deleterious effects on health  Need to test self-management interventions to promote caregiver health  Potential benefit of resourcefulness training  Effectiveness of resourcefulness in women dementia caregivers is unknown Resourcefulness Training Effectiveness Zauszniewski 1

APNA 30th Annual Conference Session 3013: October 21, 2016 PURPOSE  To examine the effectiveness of two randomly assigned methods of resourcefulness training (RT) versus having a choice between them:  Journaling  Digital voice recording Resourcefulness Training Effectiveness METHODS  Design:  Modified Partially Randomized Preference Trial  Random assignment - 8 conditions (next slide)  Longitudinal data – repeated measures  Sample:  Community-based; convenience  138 women dementia caregivers  For 6 months - same household  Procedure:  3 interviews - 6 weeks apart  Structured and open-ended questions Resourcefulness Training Effectiveness DESIGN RT-Journal (N = 16) RT (N = 32) RT-Recorder (N = 16) Random (N = 64) Journal (N = 16) No RT (N = 32) Recorder (N = 16) Total Sample (N = 138) RT-Journal (N = 20) RT (N = 31) RT-Recorder (N = 11) Choice (N = 62) Dropped (N = 12) Journal (N = 24) No RT (N = 31) Random Recorder (N = 7) Choice Resourcefulness Training Effectiveness Zauszniewski 2

APNA 30th Annual Conference Session 3013: October 21, 2016 INSTRUMENTATION Variables Items Measures Demographics 5 Caregiver self-report Perceived Stress 14 Perceived Stress Scale Depressive Cognitions 8 Depressive Cognition Scale Negative Emotions 10 Negative Emotions Checklist Resourcefulness Training Intervention Acronym “RESOURCE” reference card Chunking Personal (self-help skills) = 5 Social (help-seeking skills) = 3 Practice / Reinforcement Journaling once a day for 4 weeks Voice recording once a day for 4 weeks Resourcefulness Training Effectiveness RESULTS: RT vs. No-RT 30 Perceived stress RT F (1,124) = 4.36 p < .05 20 No ‐ RT RT effect size: D = .55 T1 T2 T3 10 Negative emotions RT F (1,124) = 20.48 p < .001 0 No ‐ RT RT effect size: D = .62 T1 T2 T3 10 Depressive cognitions RT F (1,124) = 10.92 p < .001 0 No ‐ RT RT effect size: D = .53 T1 T2 T3 Resourcefulness Training Effectiveness RESULTS: RANDOM vs. CHOICE 28 Perceived stress Random F (1,124) = 0.49 p = .59 Random RT effect size: D = .43 23 Choice T1 T2 T3 Choice RT effect size: D = .70 Negative emotions 6 Random F (1,124) = 1.23 p = .29 4 Choice Random RT effect size: D = .56 T1 T2 T3 Choice RT effect size: D = .69 9 Depressive cognitions 7 Random F (1,124) = 1.31 p = .27 5 Choice Random RT effect size: D = .45 T1 T2 T3 Choice RT effect size: D = .60 Resourcefulness Training Effectiveness Zauszniewski 3

APNA 30th Annual Conference Session 3013: October 21, 2016 RESULTS: JOURNAL vs. RECORDER 28 Perceived stress 26 Journal F (1,124) = 0.10 p = .88 Journal RT effect size: D = .57 Recorder 24 Recorder RT effect size: D = .53 T1 T2 T3 Negative emotions 6 Journal F (1,124) = 0.09 p = .87 4 Recorder Journal RT effect size: D = .68 T1 T2 T3 Recorder RT effect size: D = .59 Depressive cognitions 8 Journal F (1,124) = 0.05 p = .98 6 Recorder Journal RT effect size: D = .62 T1 T2 T3 Recorder RT effect size: D = .46 Resourcefulness Training Effectiveness CONCLUSION  Preliminary effectiveness of RT for women dementia caregivers  Better effects possible with choice of method to reinforce RT skills  Journaling superior to voice recording  Further testing is recommended Resourcefulness Training Effectiveness THANK YOU Resourcefulness Training Effectiveness Zauszniewski 4