TY - JOUR
T1 - Predictors of adherence to a skill-building intervention in dementia caregivers
AU - Yeon, Kyung Chee
AU - Gitlin, Laura N.
AU - Dennis, Marie P.
AU - Hauck, Walter W.
N1 - Funding Information:
ACKNOWLEDGMENTS The research reported in this article was supported by the National Institute on Aging Grant U01 AG13265 and by the Pennsylvania Department of Health Grant SAP 4100027298. We acknowledge Laraine Winter for her thoughtful comments on previous drafts. Walter W. Hauck is now with U.S. Pharmacopeia, Rockville, Maryland.
PY - 2007/6
Y1 - 2007/6
N2 - Background. Treatment adherence is a widely recognized problem in health services but understudied in caregiver intervention research. This study examines caregiver sociodemographic and psychological characteristics, patient illness severity, and treatment implementation factors as predictors of caregiver adherence to a skills training intervention to help families manage dementia care problems at home. Methods. The sample consisted of 105 caregivers randomized to the Home Environmental Skill-Building Program at the Philadelphia site of the National Institutes of Health (NIH) Resources for Enhancing Alzheimer's Caregiver Health (REACH I). The intervention, implemented by occupational therapists, consisted of education, problem solving, communication, environmental and task simplification techniques, and home modifications. Adherence was measured by a proportion score representing the percentage of strategies used by participants compared to the total number of strategies prescribed during intervention (Strategy Use). Results. Regression analysis with intraclass correlation adjustment for interventionist effects revealed that caregivers with better physical health (p < .001), greater treatment exposure (p < .001), more problem areas addressed (p = .012), and for whom more active therapeutic techniques (role play) were used (p = .004) demonstrated greater adherence. Other caregiver characteristics, patient cognitive impairment, and troublesome behaviors were not significantly related to caregiver adherence. Conclusions. Modifiable caregiver and treatment implementation factors, including active engagement of caregivers, were associated with adherence, whereas patient characteristics were not. Caregivers with poor health may be at risk for not benefiting from intervention, suggesting that efforts, including instruction in preventive care and allocating time to attend to their own health care needs, be directed towards improving their health.
AB - Background. Treatment adherence is a widely recognized problem in health services but understudied in caregiver intervention research. This study examines caregiver sociodemographic and psychological characteristics, patient illness severity, and treatment implementation factors as predictors of caregiver adherence to a skills training intervention to help families manage dementia care problems at home. Methods. The sample consisted of 105 caregivers randomized to the Home Environmental Skill-Building Program at the Philadelphia site of the National Institutes of Health (NIH) Resources for Enhancing Alzheimer's Caregiver Health (REACH I). The intervention, implemented by occupational therapists, consisted of education, problem solving, communication, environmental and task simplification techniques, and home modifications. Adherence was measured by a proportion score representing the percentage of strategies used by participants compared to the total number of strategies prescribed during intervention (Strategy Use). Results. Regression analysis with intraclass correlation adjustment for interventionist effects revealed that caregivers with better physical health (p < .001), greater treatment exposure (p < .001), more problem areas addressed (p = .012), and for whom more active therapeutic techniques (role play) were used (p = .004) demonstrated greater adherence. Other caregiver characteristics, patient cognitive impairment, and troublesome behaviors were not significantly related to caregiver adherence. Conclusions. Modifiable caregiver and treatment implementation factors, including active engagement of caregivers, were associated with adherence, whereas patient characteristics were not. Caregivers with poor health may be at risk for not benefiting from intervention, suggesting that efforts, including instruction in preventive care and allocating time to attend to their own health care needs, be directed towards improving their health.
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U2 - 10.1093/gerona/62.6.673
DO - 10.1093/gerona/62.6.673
M3 - Article
C2 - 17595426
AN - SCOPUS:34548127828
SN - 1079-5006
VL - 62
SP - 673
EP - 678
JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
IS - 6
ER -