The goal of this study is to investigate whether the in-home respite service model is effective in relieving caregiver's burden and improving their mental wellbeing. Caregivers are triaged into four levels of needs using a self-developed screening tool. Those screened as mild and moderate levels are admitted to the study, while those in low or high-needs levels are referred to other services. Caregivers admitted in this study will receive either 12 or 36 hours of in-home respite services as the intervention. Trained volunteers or substitute caregivers will visit their home to take care the older adults, providing several hours of free time for the caregivers. Assessments are conducted before and immediate after the intervention, and 3, 6, 12 months after the completion of intervention, to measure the changes in mental wellbeing of the caregivers. A control group with no respite service provided is recruited to compare the effects in the changes of mental wellbeing.
All participants will provide informed consent at the time of enrolment. Both caregivers and their care recipients will complete assessment before the respite service period. Care recipients are assessed for their self-dependent ability in daily activities and their physical health condition. Caregivers are screened for their overall needs level using a self-developed multidimensional screening tool. Those screened as High Needs level will be referred professional services. Those screened as Low will be recommended to join centre-based services. Caregivers who are in Mild or Moderate needs levels will be admitted to this project. They are also assessed using standard tests for measuring changes in mental health (using Depression Anxiety Stress Scales - Short Form (DASS-21)), caregiving burden (using Chinese Version of the Zarit Caregiver Burden Interview) and quality of life (using EQ-5D-5L). As the intervention, caregivers in Mild-needs level will receive 12 hours of in-home respite service, whereas those in Moderate-level will receive 36 hours of service. Volunteer or substitute caregivers will provide in-home elderly-sitting service so that the caregivers can have some private time for themselves. At the end of the intervention, caregivers and care recipients will complete the assessment again to measure the changes of their physical and mental health. All participants will be contacted again for follow-up assessment 3, 6 and 12 months after the completion of intervention. A control group with no respite service provided is recruited to compare the effects in the changes of mental wellbeing. They are contacted 3, 6 and 12 months after baseline measurement.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
5,166
12 hours of respite service within 3 months will be provided by volunteers. Volunteers will provide elderly-sitting service (accompany the care recipient) during the service session, and provide cognitive training or physical training to the care recipient if situation allows.
36 hours of respite service within 3 months will be provided by substitute caregivers. Substitute caregivers will provide elderly-sitting service (accompany the care recipient) during the service session, and provide cognitive training or physical training to the care recipient if situation allows.
Sau Po Centre on Ageing
Hong Kong, Hong Kong
RECRUITINGChange from baseline in score in caregiving needs measured by Multidimensional screening tool after the intervention
The Multidimensional screening tool is a self-developed tool that measures different aspects of caregiving needs over the past 1 week period. It is a 22-item scale, with 8 items that determines the overall needs level and the others for four aspects of needs: physical health, mental health, social support and care needs. Possible score is from 8 to 32 with lower score indicates lower caregivers' needs. Change in score = Immediate after intervention - baseline
Time frame: Baseline and Immediate after intervention
Change from baseline in score in mental wellbeing measured by DASS-21 scale after intervention
The DASS-21 comprises 21 items that assess symptoms of depression, anxiety, and stress over the past week. Each item is rated on a 4-point Likert scale, with higher scores indicating greater symptom severity. The total scores for each subscale (Depression, Anxiety, Stress) are calculated by summing the relevant item scores. Possible score for each subscale ranged from 0 to 42, with 0 indicates best outcome and 42 the worst outcome. Reductions in DASS-21 scores indicate improvements in symptoms of depression, anxiety, and stress following the intervention. Change in score = Immediate after intervention- baseline
Time frame: Baseline and Immediate after intervention
Change in score from baseline in caregiving burden measured by CZBI after intervention
The Chinese version of Zarit Caregiver Burden Inventory (CZBI) is a widely used tool designed to assess caregiver burden and distress experienced by individuals caring for a loved one with a chronic illness or disability. It comprises of 12 items, and each item is rated on a 5-point Likert scale. Possible score ranged from 0 to 48, with higher scores indicating greater levels of caregiver burden. Change in score= Immediate after intervention - baseline
Time frame: Baseline and Immediate after intervention
Change in score from baseline in quality of life measured by EQ-5D-5L after intervention
The EQ-5D-5L is a standardized instrument used to assess health-related quality of life across five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The responses are converted into a single index value representing overall health status using Hong Kong's normative value. The primary outcome measure in this study is the change in EQ-5D-5L index scores from baseline to post-intervention/follow-up assessments. 1 equals to perfect health and more negative numbers indicates worse health. Change in health index = Immediate after intervention - baseline
Time frame: Baseline and Immediate after intervention
Retention of changes of Primary outcome 1 to 4 after the end of intervention
Caregivers will complete the primary outcome measurements (1 to 4) again 3, 6 and 12 months after the end of the intervention. They will not receive any in-home respite service from the project in between the measurement periods. Changes in score of each scale in Primary Outcome 1 to 4 will be measured. Participants with improved/sustained score indicates better retention.
Time frame: Baseline, immediate after service, 3, 6 and 12 months after the intervention
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