Background: Integrating evidence-based music-with-movement into routine practices for people with dementia requires effective implementation strategies. The objectives of this study were to evaluate the clinical efficacy of the intervention and to examine the effectiveness of the implementation strategies in promoting home-based adoption.
Methods: This was a cluster randomized controlled trial adopting a clinical effectiveness-implementation hybrid design. The 12-week music-with-movement intervention aims to promote the well-being of people with dementia and their caregivers. Clinical outcomes were assessed to evaluate the efficacy of the intervention. These included the symptoms of anxiety and depression of people with dementia; caregivers’ perception of their stress and the positive aspects of caregiving; and the quality of the dyadic relationship. Caregivers, staff, and volunteers were interviewed and objective figures on reach and adoption were collected to reflect the outcomes of the implementation.
Results: Compared to the waitlist control, there was a significant reduction in the anxiety and the symptoms of depression of those in the intervention group. There was also a significant reduction in the perceived stress level of the caregivers. Six focus group interviews were conducted. The intervention and the appropriateness of the implementation strategies were perceived positively by the dyad participants, the staff of the centres, and volunteers. Of the collaborating centres, 57% continued to use the intervention and, after six months, served six times more people than were recruited in this study. Over half of the participating families continued to use the intervention for at least six more months.
Conclusion: Music-with-movement interventions showed promise for improving the well-being of people with dementia and their caregivers. Effective strategies facilitated the implementation process, such as integrating communication technology to provide instant support and involving volunteers in engaging the collaborating centres and families. This study sheds light on perceptions of the intervention, and on its scalability for a broader population.
Trial Registration: NCT03575026, Registered 2 July 2018.



中文翻译：

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针对痴呆症患者和护理人员的基于家庭的二元音乐运动干预：混合类型 2 集群随机有效性实施设计

背景：将循证音乐与动作结合到痴呆症患者的常规实践中需要有效的实施策略。本研究的目的是评估干预的临床疗效，并检查实施策略在促进家庭收养方面的有效性。
方法：这是一项采用临床有效性-实施混合设计的整群随机对照试验。为期 12 周的运动音乐干预旨在促进痴呆症患者及其护理人员的福祉。评估临床结果以评估干预的有效性。这些包括痴呆症患者的焦虑和抑郁症状；看护者对其压力的看法和看护的积极方面；以及二元关系的质量。对护理人员、工作人员和志愿者进行了访谈，并收集了关于覆盖面和采用率的客观数据，以反映实施的结果。
结果：与候补名单对照组相比，干预组的焦虑和抑郁症状显着减少。护理人员的感知压力水平也显着降低。进行了六次焦点小组访谈。双人组参与者、中心工作人员和志愿者对实施策略的干预和适当性给予了积极评价。在合作中心中，57% 的人继续使用该干预措施，六个月后，服务的人数是本研究招募人数的六倍。超过一半的参与家庭继续使用干预至少六​​个月。
结论：音乐配合运动干预措施有望改善痴呆症患者及其护理人员的福祉。有效的策略促进了实施过程，例如整合通信技术以提供即时支持以及让志愿者参与合作中心和家庭。这项研究阐明了人们对干预的看法，以及它对更广泛人群的可扩展性。
试用注册： NCT03575026，2018 年 7 月 2 日注册。