title: Psychosocial group intervention to enhance self-management skills of people with dementia and their caregivers: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  After diagnosis of a dementing illness, patients and their spouses have many concerns related to the disease and their future. This often leads to poor psychological well-being and reduced health-related quality of life (HRQoL) of the family. Support for self-management skills has been proven to be an effective method to improve prognosis of asthma, heart failure and osteoarthritis. However, self-management interventions have not been studied in dementia. Therefore, our aim was to examine, in an objective-oriented group intervention, the efficacy of self-management support program (SMP) on the HRQoL of dementia patients and their spousal caregivers as well as on the sense of competence and psychological well-being of caregivers.
  
  
  METHODS
  During the years 2011 to 12, 160 dementia patients and their spouses will be recruited from memory clinics and randomized into two arms: 80 patients for group-based SMP sessions including topics selected by the participants, 80 patients will serve as controls in usual community care. Sessions may include topics on dementia, community services, active lifestyle and prevention for cognitive decline, spousal relationship, future planning and emotional well-being. The patients and spouses will have their separate group sessions (ten participants per group) once a week for eight weeks. Main outcome measures will be patients' HRQoL (15D) and spousal caregivers' HRQoL (RAND-36), and sense of competence (SCQ). Secondary measures will be caregivers' psychological well-being (GHQ-12) and coping resources, patients' depression, cognition and signs of frailty. Data concerning admissions to institutional care and the use and costs of health and social services will be collected during a two-year follow-up.
  
  
  CONCLUSIONS
  This is a 'proof-of-concept' study to explore the efficacy of group support for self-management skills among dementia families. It will also provide data on cost-effectiveness of the intervention.
  
  
  BACKGROUND
  ACTRN12611001173987.
authors.affiliation: Department of General Practice, University of Helsinki, PO Box 20, Helsinki 00014, Finland. marja-liisa.laakkonen@kolumbus.fi
authors.forename: Marja-Liisa
authors.initials: ML
authors.lastname: Laakkonen
authors.forename: Eeva H
authors.initials: EH
authors.lastname: Hölttä
authors.forename: Niina
authors.initials: N
authors.lastname: Savikko
authors.forename: Timo E
authors.initials: TE
authors.lastname: Strandberg
authors.forename: Merja
authors.initials: M
authors.lastname: Suominen
authors.forename: Kaisu H
authors.initials: KH
authors.lastname: Pitkälä
mesh_terms: D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003152:Community Health Nursing / Q000379:methods / Q000458:organization & administration; D003704:Dementia / Q000451:nursing / Q000523:psychology* / Q000534:rehabilitation*; D005260:Female; D005851:Geriatric Nursing / Q000379:methods / Q000458:organization & administration; D005853:Geriatrics / Q000379:methods / Q000458:organization & administration; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011209:Power, Psychological; D015397:Program Evaluation; D011446:Prospective Studies; D011615:Psychotherapy, Group / Q000379:methods* / Q000458:organization & administration; D011788:Quality of Life; D012107:Research Design; D012648:Self Care / Q000379:methods*; D012657:Self-Help Groups