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

APNA 30th Annual Conference Session 3013: October 21, 2016 Zauszniewski 1

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

* The research team has NO conflicts of interest to disclose

Funded by the National Institute

• f Nursing Research

(R21-NR010368) Resourcefulness Training Effectiveness

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.

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

APNA 30th Annual Conference Session 3013: October 21, 2016 Zauszniewski 2

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

Resourcefulness Training Effectiveness

Dropped (N = 12) RT-Journal (N = 16) Recorder (N = 16) RT-Recorder (N = 16) Recorder (N = 7) Journal (N = 24) Journal (N = 16) RT-Recorder (N = 11) RT-Journal (N = 20) Total Sample (N = 138) Random (N = 64) Choice (N = 62) RT (N = 31) No RT (N = 32) No RT (N = 31) RT (N = 32) Random Choice

APNA 30th Annual Conference Session 3013: October 21, 2016 Zauszniewski 3

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 Effectiveness 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

RESULTS: RT vs. No-RT

Resourcefulness Training Effectiveness 20 30 T1 T2 T3 RT No‐RT 10 T1 T2 T3 RT No‐RT 10 T1 T2 T3 RT No‐RT

Perceived stress F (1,124) = 4.36 p < .05 RT effect size: D = .55 Negative emotions F (1,124) = 20.48 p < .001 RT effect size: D = .62 Depressive cognitions F (1,124) = 10.92 p < .001 RT effect size: D = .53

RESULTS: RANDOM vs. CHOICE

Resourcefulness Training Effectiveness 23 28 T1 T2 T3 Random Choice 4 6 T1 T2 T3 Random Choice 5 7 9 T1 T2 T3 Random Choice

Perceived stress F (1,124) = 0.49 p = .59 Random RT effect size: D = .43 Choice RT effect size: D = .70 Negative emotions F (1,124) = 1.23 p = .29 Random RT effect size: D = .56 Choice RT effect size: D = .69 Depressive cognitions F (1,124) = 1.31 p = .27 Random RT effect size: D = .45 Choice RT effect size: D = .60

APNA 30th Annual Conference Session 3013: October 21, 2016 Zauszniewski 4

RESULTS: JOURNAL vs. RECORDER

Resourcefulness Training Effectiveness 24 26 28 T1 T2 T3 Journal Recorder 4 6 T1 T2 T3 Journal Recorder 6 8 T1 T2 T3 Journal Recorder

Perceived stress F (1,124) = 0.10 p = .88 Journal RT effect size: D = .57 Recorder RT effect size: D = .53 Negative emotions F (1,124) = 0.09 p = .87 Journal RT effect size: D = .68 Recorder RT effect size: D = .59 Depressive cognitions F (1,124) = 0.05 p = .98 Journal RT effect size: D = .62 Recorder RT effect size: D = .46

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