研究啟發創新思維 推動業界持續發展
耆智園重視腦退化症護理的優質發展,我們相信要持續優化服務和緊貼腦退化症人士的需要,必須投入資源和心思進行研究,以了解不同護理方案的成效。因此,耆智園的研究團隊憑藉豐富經驗,以專業及專注的態度進行腦退化症相關的研究,期望藉著具前瞻性的研究結果,和業界一起探索創新的護理模式,並予以實踐。
自2005年起,耆智園已完成及發布超過30項統計調查及成效研究,探討的範疇包括:大眾對腦退化症的誤解、腦退化症服務前線員工壓力、減少約束對腦退化症人士的益處、社區腦退化症人士的走失情況、腦退化症日間服務的效能、認知訓練效能、電話心理教育支援成效、針灸療法等,研究結果為推動優質腦退化症護理服務之發展提供實證及發展方向。
進行中的研究
iSupport 是由世界衛⽣組織 (WHO) 開發的針對腦退化症照顧者的網上教育和技能培訓計畫。它包括五個學習模組:(1)有關腦退化症的⼀般資訊;(2)與照顧者有關的資訊;(3)⾃我保健;(4)照顧腦退化症⼈⼠;(5)解決腦退化症狀。
我們現正招募初至中期腦退化症人士的同住家屬照顧者就iSupport 網站提供使用者意見,從以使網站更符合照顧者的需求並方便其使用。家屬照顧者會隨機分派至 (1) 網站測試組: 瀏覽iSupport網站及参加每月參加1次45分鐘的網上會談(共6次)或 (2) 對照組: 每月收到研究員發出的有關腦退化資訊的訊息(共6次)。
所有參加者均會在研究開始時、6個月後、9個月後填寫1份(每次約30分鐘)網上問卷。此外,參加者會每月 (每次約5分鐘) 自行填寫有關使用醫療服務的記錄。
參加者會收到總值最多150港元的超巿禮券酬謝。
[研究招募已完結]
為了讓腦退化症人士能安在家中接受訓練活動,賽馬會耆智園推出為期24節的網上訓練課程,以延緩腦退化症人士的認知能力衰退、提升他們的生活滿意度及社交能力。研究將收集腦退化症人士及其照顧者在開始參與和完成課程時在認知、心理健康、社交生活及照顧者壓力的數據以作分析。
研究指出腦退化症人士住院時因陌生及嘈吵的環境和身體受約束而有機會變得混亂和身心功能轉差。面對這些入院導致的急劇轉變,家屬照顧者或會感到無所適從而在腦退化症人士出院後將他們送往安老院舍。得到香港賽馬會慈善信託基金的捐助,賽馬會耆智園推出為期十二星期的「回家易」離院康復計劃,以促進腦退化症人士的復康,令他們可繼續居家安老。本計劃的成效研究探討計劃如何改善離院後的腦退化症人士的功能和改善照顧者心理健康。二百位參與本計劃的腦退化症人士及其家屬照顧者在開始參與和離開計劃時、計劃結束三個月及六個月後會接受訪問,以收集有關腦退化症人士的活動能力、認知能力、營養、心理健康、照顧者壓力、及計劃後居住情況的數據。透過與香港中文大學醫學院那打素護理學院合作,本成效研究亦會探討其成本與社會效益。
研討會 (初步結果) Wong, B., Chan, H., Mo, M., Ho, F., Cheng, T., & Kwok, T. (2023). Effects of Transitional Care Program on Reducing Nursing Home Placement in People with Dementia. Presented at the 2023 IPA International Congress, Lisbon, Portugal.
腦退化症人士的親人在照顧腦退化症人士的過程中會遇到各種挑戰,例如不知道該如何處理與腦退化症有關的徵狀,或決定是否送親人去院舍等;這些挑戰會令照顧者的身體和心理承受各種負面影響。為此,耆智園推行一個照顧者支援服務,由專業人士向腦退化症人士的家屬照顧者提供各種照顧上的支援。
本項目的成效研究結果顯示照顧者因對腦退化症診斷和進展缺乏認知,及因為親人的健康狀況感到壓力。許多照顧者也沒有得到社區支援。在本項目中,專業人士提供了有關腦退化症和未來照顧計劃的資料,及為照顧者提供適合他們情況的照顧方案以便紓緩照顧困難。
照顧者表示滿意本項目的服務。他們覺得本項目能夠協助照顧者為親人安排診斷諮詢,並使照顧者在接受服務後能更主動尋求社區支援。
賽馬會耆智園聯同聖雅各福群會和香港科技大學推行賽馬會「友里蹤跡」社區計劃,希望透過藍牙群眾外包技術協助尋找走失的腦退症人士,並透過公眾教育建立腦退化症友善社區。計劃的成效評估集中兩個範疇:本計劃推行的技術能否降低照顧者因腦退化症人士走失產生的焦慮,及本計劃的公眾教育能否增加大眾對腦退化症的認識和正面態度。本研究邀請參加計劃的腦退化症人士的主要照顧者在開始參與時、參與後半年、和參與後一年完成問卷,問卷內容包括照顧者面對被照顧者走失時的焦慮程度、參加計劃前和過程中被照顧者走失時的情況以及對本計劃研發的技術提供用家意見。公眾教育講座的參加者會在講座後填寫問卷,來評估他們在參與講座後,在腦退化症的知識和態度的變化,以及是否願意幫助腦退化症走失人士。
研討會 (初步結果) Wong, B., Ho, F., & Kwok, T. (2022). Development of tracking technology to facilitate the development of dementia friendly community. Presented at the 35th Global Conference of Alzheimer’s Disease International, London.
已完成的研究
文獻 Chan, H. Y. L., Ho, F. K. Y., Chui, K. C. M., Wong, B. P. S., Chui, M. Y. P., Zhao, Y., ... & Kwok, T. C. Y. (2022). Evaluation of a multicomponent restraint reduction intervention in care homes. Collegian, 29(6), 837-842.
研究會 Wong, B., Xiao, L., Cheng, T., Leung, P., Ho, F., & Kwok, T. (2024). Development of Culturally Sensitive Dementia Caregiving Psychoeducation Intervention: Views from Chinese Care Partners on iSupport Adaptation. Presented at the 36th Global Conference of Alzheimer’s Disease International, Krakow.
閱讀《健康由我管─輕度認知障礙自我管理課程計劃小冊子》
文獻 Wong, B., Kwok, T., Chui, K., Cheng, T., Ho, F., & Woo, J. (2021). The impact of dementia daycare service cessation due to COVID‐19 pandemic. International Journal Of Geriatric Psychiatry. doi: 10.1002/gps.5621
研究結果顯示腦退化症人士及家屬照顧者對這項介入感到滿意。當腦退化症人士能獨立地完成游戲,他們的社交參與度、自尊心、及自信心有所提升。家屬照顧者指出腦退化症人士的身體健康、認知能力、及心理健康在參與遊戲介入後有所提升。此外,他們表示這項介入讓他們有休息的機會。同工認為這項介入提升了他們的腦退化症服務護理技巧。
總括而言,遊戲介入是一項可在社區推行的介入模式,這項介入能協助同工在社區提供優質的腦退化症照顧,能使家屬照顧者行到休息,並能協助同工發展其腦退化照顧專業。我們建議(1)長者服務機構可將這介入納入為恆常服務;(2)家屬照顧者應鼓勵有腦退化症的家人參加這項介入。
文獻 Yan E, Wong A, Chan W, Kwok T. Misconceptions About Dementia and Its Implication for Willingness to Seek Treatment and Knowledge in Dementia Related Information. Hong Kong Practitioner. 2006;28(3):108-113.
研討會 Yan, E, Kwok, T, Ho, F, Li, J. Misconception about dementia and its effects on treatment seeking tendency. Paper presented at the 13th Annual Congress of Gerontology; November 2005; Hong Kong.
文獻 Lam LC, Lee JS, Chung JC, Lau A, Woo J, Kwok TC. A Randomized Controlled Trial to Examine the Effectiveness of Case Management Model for Community Dwelling Older Persons with Mild Dementia in Hong Kong. International Journal of Geriatric Psychiatry.
文獻 Kwok T, Twinn S, Yan E. The Attitudes of Chinese Family Caregivers of Older People with Dementia towards Life Sustaining Treatments. Journal of Advanced Nursing. 2007;58(3):256-262.
文獻 Yan E, Kwok T, Lee D, Tang C. The Prevalence and Correlates of the Use of Restraint and Force on Hospitalised Older People. Journal of Nursing and Healthcare of Chronic Illness. 2009;1(2):147-155.
研討會 Yan E, Kwok T, Ho F, Li J. Nurses' Attitudes towards Restraint-use among Dementia Elderly Patients. Oral presentation at the 14th Annual Congress of Gerontology; November 2006; Hong Kong.
文獻 Kwok T, Yuen K, Ho F, Chan W. Getting Lost in the Community: a Phone Survey on the Community‐dwelling Demented People in Hong Kong. International Journal of Geriatric Psychiatry. 2010;25(4):427-432.
研討會 Yuen K, Kwok T, Ho F, Li J. Getting Lost in the Community: A Phone Survey on the Aged Population in Hong Kong. Oral presentation at the 15th Annual Congress of Gerontology; November 2007; Hong Kong.
文獻 Yan E, Ho F, Kwok T, Tang C. Factors Associated with Life Satisfaction of Personal Care Workers Delivering Dementia Care in Day Care Centers. Social Work in Health Care. 2007;46(1):37-45.
文獻 Kwok T, Chau WW, Yuen K, et al. Who Would Benefit from Memory Training? A Pilot Study Examining the Ceiling Effect of Concurrent Cognitive Stimulation. Clinical Interventions in Aging. 2011;6:83.
文獻 Kwok T, Wong A, Chan G, et al. Effectiveness of Cognitive Training for Chinese Elderly in Hong Kong. Clinical Interventions in Aging. 2013;8:213.
研討會 Ting K, Yuen K, Chung E, Li J, Ho F, Kwok T. Effectiveness of Physical Exercise in the Ageing Population. Oral presentation at the 16th Annual Congress of Gerontology; November 2008; Hong Kong.
文獻 Kwok T, Lam K, Yip A, Ho F. Knowledge of Dementia among Undergraduates in the Health and Social Care Professions in Hong Kong. Social Work in Mental Health. 2011;9(4):287-301.
研討會 Lam K, Yip A, Kwok T, Ho, F. Knowledge of Dementia Among Undergraduates in the Health and Social Care Professions in Hong Kong. Paper Presented at the 17th Annual Congress of Gerontology; November 2009; Hong Kong.
文獻 Kwok T, Ho D, Chan G, Ip I, Wong B, Ho F. Evaluation of Day Care Services for Demented Clients in Hong Kong. Asian J Gerontol Geriatr. 2014;9:5-9.
研討會 Lam KC, Hui E, Yip A, Kwok T, Ho, F. Usage of Day Care Service by Persons with Dementia in Hong Kong. Poster presented at the 18th Annual Congress of Gerontology; 2010; Hong Kong.
文獻 Kwok T, Young D, Yip A, Ho F. Effectiveness of Day Care Services for Dementia Patients and Their Caregivers. Asian J Gerontol Geriatr. 2013;8:9-15.
研討會 Yip A, Kwok T, Ho F, Li J. The Effectiveness of Day Care for People with Dementia and Their Family Caregivers: The JCCPA Experience. Paper Presented at the 17th Annual Congress of Gerontology; November 2009; Hong Kong.
文獻 Kwok T, Wong A, Chan G, et al. Effectiveness of Cognitive Training for Chinese Elderly in Hong Kong. Clinical Interventions in Aging. 2013;8:213.
文獻 Bai X, Kwok T, Chan N, Ho F. Determinants of Job Satisfaction in Foreign Domestic Helpers Caring for People with Dementia in Hong Kong. Health & Social Care in the Community. 2013;21(5):472-479.
文獻 Kwok T, Leung PC, Wing YK, et al. The Effectiveness of Acupuncture on the Sleep Quality of Elderly with Dementia: a Within-subjects Trial. Clinical Interventions in Aging. 2013;8:923.
文獻 Kwok T, Wong B, Ip I, Chui K, Young D, Ho F. Telephone-delivered Psychoeducational Intervention for Hong Kong Chinese Dementia Caregivers: a Single-blinded Randomized Controlled Trial. Clinical Interventions in Aging. 2013;8:1191.
文獻 Kwok T, Bai X, Li J, Ho F, Lee T. Effectiveness of Cognitive Training in Chinese Older People with Subjective Cognitive Complaints: a Randomized Placebo‐controlled Trial. International Journal of Geriatric Psychiatry. 2013;28(2):208-215.
研討會 Kwok T, Yip A, Cheng S, Ho F. The Effects of Cognitive Training in Older Adults: A Randomized Controlled Trial. Presented at the 25th International Conference of Alzheimer's Disease International; March 2010; Thessaloniki, Greece.
文獻 Bai X, Kwok T, Ip I, Woo J, Chui M, Ho F. Physical Restraint Use and Older Patients' Length of Hospital Stay. Health Psychology and Behavioral Medicine. 2014;2(1):160-170.
Kwok T, Bai X, Chui M, et al. Effect of Physical Restraint Reduction on Older Patients' Hospital Length of Stay. Journal of the American Medical Directors Association. 2012;13(7):645-650.
文獻 Kwok T, Au A, Wong B, Ip I, Mak V, Ho F. Effectiveness of Online Cognitive Behavioral Therapy on Family Caregivers of People with Dementia. Clinical Interventions in Aging. 2014;9:631.
文獻 Bai X, Ho D, Fung K, et al. Effectiveness of a Life Story Work Program on Older Adults with Intellectual Disabilities. Clinical Interventions in Aging. 2014;9:1865.
文獻 Lee, EK-P, Wong, B, Chan, PHS, et al. Effectiveness of a Mindfulness Intervention for Older Adults to Improve Emotional Well-being and Cognitive Function in a Chinese Population: A Randomized Waitlist-controlled Trial. Int J Geriatr Psychiatry. 2021; 1-11.
文獻 Chan H, Ho F, Chui K, et al. Capacity Building for Dementia Care in Community Care Services: A Mixed Methods Approach. BMC Geriatrics. 2020;20:1-10.
文獻 Young D, Ng P, Kwok T, et al. The Effects of an Expanded Cognitive Stimulation Therapy Model on the Improvement of Cognitive Ability of Elderly with Mild Stage Dementia Living in a Community—a Randomized Waitlist Controlled Trial. Aging & Mental Health. 2019;23(7):855-862.
Young D, Ng P, Cheng D, et al. Outcomes of Expanded Cognitive Stimulation Therapy Group for Mild-Stage Dementia: Four-Month Follow-Up. Research on Social Work Practice. 2019:1049731519859432.
文獻 Kwok T, Bai X, Kao H, Li J, Ho F. Cognitive Effects of Calligraphy Therapy for Older People: A Randomized Controlled Trial in Hong Kong. Clinical Interventions in Aging. 2011;6:269.
研討會 Yip E, Yuen K, Li J, Ho F, Lam S, Kao S, Kwok T. Effectiveness of Calligraphy Groups in Retaining Cognitive Function During Ageing. Paper Presentation at the 16th Annual Congress of Gerontology; November 2008; Hong Kong.
文獻 Wong OL, Kwong PS, Ho C, et al. Living With Dementia: An Exploratory Study of Caregiving in a Chinese Family Context. Social Work in Health Care. 2015;54(8):758-776.
文獻 Chan W, Wong B, Kwok T, Ho F. Assessing Grief of Family Caregivers of People with Dementia: Validation of the Chinese Version of the Marwit–Meuser Caregiver Grief Inventory. Health & Social Work. 2017;42(3):151-158.