Life Story Work for Promoting Relationship Between Older Adults and live-in Migrant Caregivers: a Randomized Controlled Feasibility Trail
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 100
- 主要终点
- The change in quality of migrant caregiver-older adults relationship as assessed by 4-item Lawrence quality of the caregiver-care recipient relationship scale
研究概览
简要总结
The relationship between older adults and live-in migrant caregivers is always challenged by weak emotional connectedness, ineffective communication, power struggling and unmet needs of both, that may lead to poor care quality and negatively influence their well-being. The aim of this study is to explore the feasibility to train live-in migrant caregivers to adopt Life Story Work for promoting the dyadic relationship with the older adults, through communication and negotiation, mutual understanding and expression of needs. This is a two-arm randomized controlled trial. The caregivers of the intervention group will receive training on life story work. Then they will be asked to create a life storybook of the older adult at home individually, with the support from the team. The caregivers in the control group will receive training on communication skills only, and will be asked to conduct social activities at home. Outcomes such as quality of relationship; well-being, depressive symptoms and level of loneliness of the older adults; and job satisfaction of the caregivers will be assessed at baseline, post-intervention and 3 months follow up. Focus group interviews will be conducted with the caregivers of the intervention group for soliciting their comments regarding to the intervention.
详细描述
There are approximately 21.5 million live-in migrant workers, and around 41% of them are employed in Asia. Among the 352 thousand live-in migrant workers in Hong Kong, at least 21% of them are caregivers of older adults. The 2016 Policy Address suggested a pilot scheme for training live-in migrant caregivers to take care of the older people in Hong Kong to meet the trend of Ageing in Place, and cope with the dreadful shortage of formal long-term care services. As such, Social Welfare Department of Hong Kong is now implementing an 18-month pilot scheme to train live-in migrant workers to care for older adults in order to improve the well-being of the older adults. However, there is no effective evidence-based intervention available for such caregiving arrangement, not only locally but also internationally. The common training for live-in migrant workers is about instrumental training, such as feeding and bathing. According to the Relationship-Centred Care Model, relationship is the core for good quality of care. Life story work have been tested effective in various settings for promoting the psychological well-being of older adults with/out dementia, as well as proven useful in promoting mutual understanding and communication between caregivers and care-recipients.
The project is of value in that:
- It is a pioneer study, which aims to promote relationship between live-in migrant caregivers and older adults to support good quality of care.
- The life story work is a skill that is easily learnt and adopted for promoting and sustaining good relationship that may impact on the well-being of caregivers and care-recipients.
- Reduce the needs of formal long-term care services by retaining the older adults to be cared at home.
- The life story work has a potential to be adopted by all types of caregivers (including formal and informal caregivers; live-in and live-out) for promoting the caregiver-care recipient dyadic relationship through communication and negotiation between the dyads, mutual understanding and expression of needs.
Objectives:
- Explore the feasibility to train live-in migrant caregivers to adopt life story work;
- Explore the feasibility of trained live-in migrant caregivers to produce a life story book with the older adult at home; and
- Provide preliminary evidence of efficacy of the life story work on improving dyadic relationship, psychosocial outcomes of the older adults, and satisfaction of caregivers.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Single (Outcomes Assessor)
盲法说明
A trained research assistant will be responsible to collect demographic data and assessing the outcomes at T0, T1, T2. The research assistant will be blinded to the grouping of participants.
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Older adults:
- •Inclusion Criteria:
- •aged 60 or above
- •community dwelling
- •being cared by participating migrant caregivers
排除标准
- •unwilling to create life story book with the migrant caregivers
- •not verbally communicable
- •diagnosed with serious psychiatric illnesses or terminal illnesses
- •Migrant caregivers:
- •Inclusion Criteria:
- •have been working for the older adutls for more than 6 months
- •at least completed primary education
- •be communicable in either English or Cantonese.
研究组 & 干预措施
Life story book training
The migrant caregivers will receive training (six weekly 1.5-hour sessions) about life story approach by a part-time trained interventionist with psychology or social work background with at least three years of working experience working with older people and have basic knowledge about the life story work. After training, the migrant caregivers will be asked to produce the life story book individually at home with the older adults
干预措施: Life Story Book (Behavioral)
Communication skills training
The migrant caregivers who have randomly assigned into the control group will receive communication skills training (two 1.5-hour sessions) offered by another trained interventionist with psychology or social work background with at least three years of working experience working with older people. They would not receive any additional training on life story work.
干预措施: Self-selected social activities (Behavioral)
结局指标
主要结局
The change in quality of migrant caregiver-older adults relationship as assessed by 4-item Lawrence quality of the caregiver-care recipient relationship scale
时间窗: basline (T0), immediately post-intervention (T1), 3-month follow up (T2)
General closeness, communication, similarity of views about life, and degree of getting along will be captured. Total score of the scale ranges from 4-16. Higher values represent a better quality of relationship. The cronhach's alpha for this scale was 0.85.
次要结局
- The change in loneliness of the older adults as assessed by the Chinese version of 6-item De Jong Gierveld Loneliness Scale(basline (T0), immediately post-intervention (T1), 3-month follow up (T2))
- The change in well-being of the dyad as assessed by the 12-item General Health Questionnaire(basline (T0), immediately post-intervention (T1), 3-month follow up (T2))
- The change in depressive symptoms of the older adults as assessed by the Chinese version of 15-item Geriatric Depression Scale(basline (T0), immediately post-intervention (T1), 3-month follow up (T2))
- The change in satisfaction of caregiver as assessed by the 6-item Care Work Satisfaction Scale(basline (T0), immediately post-intervention (T1), 3-month follow up (T2))
研究者
Ken HM HO
Assistant Professor
Tung Wah College