The effects of a dyadic strength-based empowerment program on the health outcomes of people with mild cognitive impairment and their family caregivers: a randomized controlled trial

Abstract

Doris Sau-Fung Yu,1 Polly Wai-chi Li,1 Fan Zhang,2 Sheung-Tak Cheng,2 Tsz Kwan Ng,3 Katherine S Judge4 1The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong; 2Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, Hong Kong; 3Fong Shu Chuen District Elderly Community Centre, Tung Wah Group Hospital, Sheung Wan, Hong Kong; 4Department of Psychology, College of Sciences and Health Professions, Cleveland State University, Cleveland, OH, USACorrespondence: Doris Sau-Fung YuThe Nethersole School of Nursing, The Chinese University of Hong Kong, Rm. 729, Esther Lee Building, Shatin, New Territories, Hong KongTel [phone]Fax [phone]Email [email protected]: As an intermediate prodromal stage of dementia, mild cognitive impairment (MCI) causes functional, emotional, and social challenges for both of the person with MCI (PwMCI) and their family caregiver. However, major attention has only been placed on the PwMCI’s for cognitive training. This study evaluated a more comprehensive intervention, which integrated both strength-based and empowerment approaches, to address their complex needs in a dyadic fashion.Patients and methods: This randomized controlled trial allocated 103 MCI patient-caregiver dyads to receive a 14-week dyadic strength-based empowerment program (D-StEP-MCI, n=52) or usual care (n=51). The D-StEP-MCI program consisted of group-based session to the PwMCI, home-based dyadic sessions, and telephone follow-up, with the activities supported the care dyads to navigate their own strengths and resources for integration, together with the trained skills, to optimize role and social engagement in everyday life. Dyadic health outcomes in terms of subjective and objective cognitive function, and neuro-psychiatric symptoms of PwMCI, stress in symptom management of their family caregivers, and depression of the dyads were evaluated at baseline, after the D-StEP-MCI and at 3 months thereafter.Results: By using general estimating equation, the D-StEP-MCI significantly improved the cognitive function, subjective memory, and mood status of the PwMCI, and the positive changes were maintained at the 3-month endpoints. It also has significantly positive effects on caregivers’ stress in symptom management and level of depression.Conclusion: Our findings showed the health benefit of combining strength-based and empowerment approach in supporting the disease adaptation of PwMCI and caregiver in a dyadic fashion. This study also supports the use of a social interaction approach to optimize the everyday engagement of the PwMCI.Keywords: mild cognitive impairment, caregiving, empowerment, strength-based, dyadic approach

Keywords

• mild cognitive impairment
• caregiving
• empowerment
• strength-based
• dyadic approach.