Experiences of Caregivers of Dementia Patients with an Integrated Primary Care Model
Review TypeNone: Sigma Grant Recipient Report
Repository Posting Date2019-04-22T18:52:44Z
Author(s)Kovaleva, Mariya; Carolyn, Clevenger; Patricia, Griffiths; Bonnie, Jennings; Mi-Kyung, Song; Kenneth, Hepburn
Author DetailsStudent who completed the dissertation: Mariya Kovaleva, RN, PhD, MS, AGPCNP-BC (the study was completed for the requirements for the dissertation in nursing). email@example.com, firstname.lastname@example.org, (612) 300-9066 Dissertation Committee Chair and Academic Advisor: Kenneth Hepburn, PhD, FGSA Dissertation Committee Faculty Members: Carolyn Clevenger, RN, DNP, AGPCNP-BC, GNP-BC, FAANP Patricia Griffiths, PhD, MS, FGSA Bonnie Mowinski Jennings, PhD, RN, FAAN Mi-Kyung Song, PhD, RN, FAAN
Lead Author Sigma AffliationNon-member
Lead Author AffliationNell Hodgson Woodruff School of Nursing, Emory University
Level of EvidenceCohort
Research ApproachMixed/Multi Method Research
Keywordscaregivers; dementia; Alzheimer's disease; advanced practice registered nurses; collaborative dementia care models; primary care; dementia care; aging
CINAHL HeadingsCaregivers; Dementia; Dementia--Therapy; Alzheimer's Disease; Caregiver Attitudes; Caregivers--Psychosocial Factors; Primary Health Care--Evaluation; Advanced Practice Nurses; Registered Nurses
Few U.S. dementia care programs are led by advanced practice registered nurses (APRNs), including a dementia patient-centered medical home, the Integrated Memory Care Clinic (IMCC) at Emory Healthcare. To our best knowledge, the IMCC is the only U.S. dementia care program where primary care and dementia care are provided simultaneously. This study aimed to explore the experiences of caregivers of persons living with dementia (PLWD) and PLWD (as reported by their caregivers) at the IMCC. This prospective longitudinal cohort study employed quantitative and qualitative methods. The study began with a scoping review of the U.S. dementia care programs. Caregivers participated in three assessments that evaluated caregivers’ health status and psychological well-being and PLWDs’ dementia-related symptoms and quality of life. Forty-nine caregivers completed the baseline assessment. Mixed linear models were used to evaluate changes in client-centered outcomes. A sub-sample of 12 caregivers participated in telephone qualitative interviews six months post-baseline. Five outcomes decreased significantly (signifying improvements) with time as the only predictor: caregivers’ distress regarding their PLWDs’ delusions (p=0.048) and their PLWDs’ anxiety (p=0.018), and severity of PLWDs’ delusions (p=0.032), depressive symptoms (p<0.001), and total symptom severity (p=0.013). When accounting for the total number of clients’ visits to the clinic, time no longer significantly predicted changes in caregivers’ distress regarding their PLWDs’ delusions. When accounting for the total number of visits to the clinic or PLWDs’ total number of comorbidities besides dementia, time no longer significantly predicted changes in PLWDs’ total symptom severity. Two features characterizing caregivers’ experience of the clinic were discovered: the IMCC as the wished-for model of dementia care and ways to improve the IMCC. This study provides quantitative and qualitative descriptive data on caregivers’ experience within the IMCC. Since this study did not have a comparison group, the outcomes cannot be attributed to the IMCC.
DescriptionThis study was prepared in a format of three publishable articles (scoping review, quantitative outcomes, qualitative outcomes), with an introduction and conclusion (first and last chapters) required for the submission of this dissertation to Emory graduate school. Since three articles are prepared separately, a reference list follows each of the articles.
Degree GrantorEmory University
NotesThe Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.
Dr. Kovaleva is a 2016-2017 Sigma Theta Tau International Grant Recipient.
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