ABSTRACT

Background

The Structured External Memory Aid Treatment (SEMAT) is a recently developed compensatory cognitive intervention that systematically teaches external memory aids (EMAs) and strategies to older adults with mild cognitive impairment (MCI). Preliminary efficacy evidence for the SEMAT is encouraging and suggests that treatment effects (i.e., using EMAs) may persist over a year after treatment. However, it is unknown which component(s) of the SEMAT are most contributory to long-term adherence and sustained treatment effects.

Aims

The aims of this study were to conduct a thematic analysis of interviews conducted with adults with MCI who completed the SEMAT 18 months prior to explore the factors that influenced participants’: 1) long-term adherence to the EMAs taught during the SEMAT and 2) treatment acceptability.

Methods & Procedures

Six female participants, ages 74–90, with MCI participated in the present study. Participants completed semi-structured interviews 18 months following the six-week SEMAT. We used a reflexive thematic framework for data collection and analysis.

Outcomes & Results

Our thematic analysis revealed seven major themes related to adherence: (1) multiple types of EMAs used, (2) idiosyncratic modifications to the EMAs, (3) EMA use enhanced the completion of everyday tasks, (4) EMAs were used for reassurance, (5) EMA use supported independence and safety, (6) EMA location and use within daily routine, and (7) difficulties with features of the EMAs. Four major themes emerged regarding treatment acceptability: (1) metamemory skills, (2) appropriate length of treatment, (3) eased memory concerns, and (4) group dynamic.

Conclusions

Findings from the present study, along with the associated quantitative and qualitative SEMAT studies, provide preliminary evidence for the SEMAT as a novel, person-centered, semi-structured, and functional treatment that aims to promote lasting treatment effects for older adults with MCI up to 18 months after treatment. These findings reinforce the importance of implementing compensatory interventions early during cognitive decline that are designed to promote independence. Future research should investigate the effectiveness of the SEMAT with a larger and more rigorous clinical trial design.

中文翻译：

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针对轻度认知障碍的老年人的结构化外部记忆辅助治疗 (SEMAT)：长期依从性和治疗的可接受性

摘要

背景

结构化外部记忆辅助治疗 (SEMAT) 是最近开发的一种补偿性认知干预，它系统地向患有轻度认知障碍 (MCI) 的老年人教授外部记忆辅助 (EMA) 和策略。SEMAT 的初步疗效证据令人鼓舞，并表明治疗效果（即使用 EMA）可能在治疗后持续一年以上。然而，尚不清楚 SEMAT 的哪些成分对长期依从性和持续治疗效果最有贡献。

目标

本研究的目的是对在 18 个月前完成 SEMAT 的 MCI 成年人进行的访谈进行主题分析，以探索影响参与者的因素：1）长期遵守 SEMAT 期间教授的 EMA 和 2）治疗可接受性。

方法和程序

六名年龄在 74-90 岁的 MCI 女性参与者参与了本研究。在为期六周的 SEMAT 之后的 18 个月，参与者完成了半结构化访谈。我们使用反思性主题框架进行数据收集和分析。

结果和结果

我们的主题分析揭示了与依从性相关的七个主要主题：（1）使用多种类型的 EMA，（2）对 EMA 的特殊修改，（3）EMA 的使用增强了日常任务的完成，（4）EMA 用于保证， (5) EMA 使用支持的独立性和安全性，(6) EMA 在日常生活中的位置和使用，以及 (7) EMA 功能的困难。关于治疗可接受性出现了四个主要主题：（1）元记忆技能，（2）适当的治疗时间，（3）缓解记忆问题，以及（4）群体动态。

结论

本研究的结果，连同相关的定量和定性 SEMAT 研究，为 SEMAT 作为一种新颖的、以人为本、半结构化和功能性的治疗方法提供了初步证据，旨在促进对患有 MCI 的老年人的持久治疗效果。至治疗后18个月。这些发现强化了在认知衰退早期实施旨在促进独立的补偿性干预措施的重要性。未来的研究应该通过更大、更严格的临床试验设计来调查 SEMAT 的有效性。