Stressor-Oriented MUlticomponent Intervention and the WeLl-Being of Patients with Alzheimer’s Disease: A Randomized Controlled Trial (SOUL-P)

Article type: Research Article

Authors: Yang, Bing^a | Yang, Siyuan^b | Zhang, Yunmei^a | Liu, Wentao^c | Gan, Yao^d | Li, Yaling^e | Jiang, Dengbi^f | Luo, Yetao^g | Zhao, Qinghua^{b; *}

Affiliations: [a] Nursing Department, Stomatological Hospital of Chongqing Medical University, Yubei District, Chongqing, China | [b] Nursing Department, the First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China | [c] Rehabilitation Department, the Affiliated Rehabilitation Hospital of Chongqing Medical University, Jiulongpo District, Chongqing, China | [d] Psychiatry Department, the First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China. | [e] Geriatric Department, the First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China | [f] Community Health Center of Daxigou, Yuzhong District, Chongqing, China | [g] Clinical Epidemiology and Biostatistics Department, Children’s Hospital affiliated with Chongqing Medical University, Chongqing, China

Correspondence: [*] Correspondence to: Professor Qinghua Zhao, Nursing Department, the First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, 400016 Chongqing, China. Tel.: +86 23 89012206; Fax: +86 23 89012206; E-mail: [email protected].

Abstract: Background:Patients with Alzheimer’s disease (AD) experience various stressors that negatively impact well-being. Most studies have, however, small effect size and are limited by the experiences of severe patients. Therefore, we conducted a single-blind, randomized controlled trial, which has included patients at different stages. Objective:The stressor-oriented multicomponent program was designed as an intervention for AD patients to enhance well-being. Methods:Patients were randomly assigned to control or SOUL-P conditions according to disease severity. The SOUL-P group received 15 intensive sessions over 6 months and 6 maintenance sessions over a 6-month follow-up by a multidisciplinary team comprising psychologists, occupational therapists, and community nurses. The control group received a similar number of sessions by community nurses. Stress-related outcomes (primary stressors and well-being outcomes) were obtained from in-person baseline and follow-up interviews conducted at 6- and 12-months post-baseline. A treatment compliance survey was conducted at the intervention endpoint for patients. Results:Of the 863 patients screened, 218 (25.3%) were eligible. At 6 months, compared to controls, SOUL-P patients had improved quality of life (QoL) (p < 0.001; Cohen d = 0.56), depression (p = 0.020; Cohen d = –0.33), neurobehavioral symptoms (p = 0.034; Cohen d = –0.30), perceived stress (p = 0.030; Cohen d = –0.31), and family conflict (p = 0.026; Cohen d = –0.32). QoL, depression, perceived stress, and family conflict were still significantly different at 12 months. Most patients were satisfied with SOUL-P, while caregivers in the SOUL-P group reported overloading tasks. Conclusion:SOUL-P may reduce perceived stress and improve psychological outcomes in AD patients. Stressor-based interventions, patient-oriented goals, and a multidisciplinary team are essential features for a successful SOUL-P.

Keywords: Alzheimer’s disease, multidisciplinary intervention, perceived stress, quality of life, stress-oriented

DOI: 10.3233/JAD-200652

Journal: Journal of Alzheimer's Disease, vol. 79, no. 1, pp. 141-152, 2021