Pilot Evaluation of Technology-enhanced Horticultural Activities Among the People With Dementia and Their Family Caregivers

Dementia Clinical Trial

Official title:

Pilot Evaluation of Technology-enhanced Horticultural Activities Among the People With Dementia and Their Family Caregivers

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05577975
• Other study ID #: HSEARS20220801002
• Status: Recruiting
• Phase: N/A
• Start date: September 1, 2022
• Est. completion date: August 30, 2024

Study information

• Verified date: October 2022
• Source: The Hong Kong Polytechnic University
• Contact: Patrick Kor, PhD
• Phone: 27665622
• Email: patrick.kor[@]polyu.edu.hk
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Horticultural therapy is one of the effective interventions for the person with dementia(PWD) which could increase their time engaging in leisure activities and decrease their time doing nothing. However, there are some limitations and constraints for PWD to participate in the horticultural therapy especially in the high-density cities (e.g. Hong Kong). This study aims to investigate the feasibility and preliminary effects of adopting home-based technology-enhanced horticultural activities. The program will consist of three face-to-face (F-T-F) horticultural activity training session for a group of 6-8 participants and then biweekly telephone follow-up for 8-week home-based horticultural intervention. Program evaluation will be conducted through focus groups with 15 participants with different levels of stress reduction after the intervention. It is hypothesized that the PWD and their caregiver will have a significant improvement in the cognitive function and behavioral symptoms of the PWD, an increase in the positive caregiving experience in the family caregivers, a reduction of the caregivers' level of stress and depressive symptoms, and enhancement of the quality of life of the family caregivers after the intervention.

Description:

Objective This study aims to investigate the feasibility and preliminary effects of adopting home-based technology-enhanced horticultural activities to: a) improve the cognitive function and behavioral symptoms of the PWD; b) promote the positive caregiving experience in the family caregivers; c) reduce the caregivers' level of stress and depressive symptoms; and d) improve the quality of life of the family caregivers. To the best of our knowledge, it is the first program adopting Smart Grower for horticultural intervention among the PWD and their family caregivers in Hong Kong. Method The home-based technology-enhanced horticultural activities will be delivered for the people with dementia and their family caregivers through a smart grower. The smart grower is a hydroponic indoor grower that builds a controllable environment with auto optimization for growing healthy plants, fresh vegetables, herbs, and fruits. A mobile app will be connected to the grower for controlling the growing environment (e.g. lighting, watering), tracking the progress of the plants, guiding the older people with dementia and their family caregiver to conduct the horticulture activities. The program will consist of three face-to-face (F-T-F) horticultural activity training session for a group of 6-8 participants and then biweekly telephone follow-up for 8-week home-based horticultural intervention. The home-based program contains different horticultural, cognitive and multisensory stimulation activities such asking the PWD and the family caregiver to record the sense of touch and odor when taking care of the plant and the various changes of the plants by using the smart grower. Program evaluation will be conducted through focus groups with 15 participants with different levels of stress reduction after the intervention. The aims of the focus groups is to identify the strengths, limitations, and difficulties of the home-based technology-enhanced horticultural program. Significance and Value In this project, we would like to collaborate with the elderly center to deliver the technology-enhanced horticultural activities for PWD in the community and make this program sustainable in the community. Meanwhile, we will collect the users' feedback and further modify the program to fit the needs of the people with dementia and the family caregivers. In the future, we hope that the program will not only benefit the community-dwelling older people but also those receiving service in the respite center, day care center, hospice and nursing home as they are also facing the challenges of manpower shortage, issues of loneness and poor psychological health. We will base on the data and results collected from this proposed study and further revise the program and software for servicing the older people in nursing through a group-based approach.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 60
• Est. completion date: August 30, 2024
• Est. primary completion date: December 30, 2023
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. The PWD

1. Aged 65 or above who had been diagnosed with any type of dementia at the early to moderate stage

2. Are Community-dwelling (i.e., non-institutionalized),

3. Are Able to understand Cantonese and follow simple instruction

2. The family caregivers

1. Aged 18 years or above;

2. the blood or by-marriage relatives (e.g. spouses, siblings, children, and grandchildren) of a person who has been clinically diagnosed with dementia, regardless of its types and these relatives are taking up the caring responsibilities ranging from physical aids to emotional supports, in the form of transportation, financial assistance, personal hygiene, and decision-making.;

3. Providing most of the daily care and support for PWD (daily contact for at least four hours); and

4. Able to speak Cantonese Exclusion Criteria: The PWD and the family caregivers

1. Are diagnosed with a mental disorder such as bipolar disorder, schizophrenia, dementia, or depression; and/or,

2. Are taking anticonvulsants, or any kind of psychotropic drugs, and/or identified with a self-reported suicidal thought or drug abuse in the past 6 months.

Related Conditions & MeSH terms

• Dementia

Intervention

Device:
• The Aspara @ smart grower
The program will consist of three face-to-face (F-T-F) horticultural activity training session for a group of 6-8 participants and then biweekly telephone follow-up for 8-week home-based horticultural intervention. The home-based program contains different horticultural, cognitive and multisensory stimulation activities such asking the PWD and the family caregiver to record the sense of touch and odor when taking care of the plant and the various changes of the plants by using the smart grower. Program evaluation will be conducted through focus groups with 15 participants with different levels of stress reduction after the intervention.

Locations

Country	Name	City	State
Hong Kong	The Hong Kong Polytechnic Univeristy	Hong Kong

Sponsors (1)

Lead Sponsor	Collaborator
The Hong Kong Polytechnic University

Country where clinical trial is conducted

Hong Kong, 

References & Publications (17)

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Lin Y, Lin R, Liu W, Wu W. Effectiveness of horticultural therapy on physical functioning and psychological health outcomes for older adults: A systematic review and meta-analysis. J Clin Nurs. 2022 Aug;31(15-16):2087-2099. doi: 10.1111/jocn.16095. Epub 2021 Oct 24. Review. — View Citation

Lou VW, Lau BH, Cheung KS. Positive aspects of caregiving (PAC): scale validation among Chinese dementia caregivers (CG). Arch Gerontol Geriatr. 2015 Mar-Apr;60(2):299-306. doi: 10.1016/j.archger.2014.10.019. Epub 2014 Nov 7. — View Citation

Lu LC, Lan SH, Hsieh YP, Yen YY, Chen JC, Lan SJ. Horticultural Therapy in Patients With Dementia: A Systematic Review and Meta-Analysis. Am J Alzheimers Dis Other Demen. 2020 Jan-Dec;35:1533317519883498. doi: 10.1177/1533317519883498. Epub 2019 Nov 5. — View Citation

Ng KST, Sia A, Ng MKW, Tan CTY, Chan HY, Tan CH, Rawtaer I, Feng L, Mahendran R, Larbi A, Kua EH, Ho RCM. Effects of Horticultural Therapy on Asian Older Adults: A Randomized Controlled Trial. Int J Environ Res Public Health. 2018 Aug 9;15(8). pii: E1705. doi: 10.3390/ijerph15081705. — View Citation

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Van't Leven N, Prick AE, Groenewoud JG, Roelofs PD, de Lange J, Pot AM. Dyadic interventions for community-dwelling people with dementia and their family caregivers: a systematic review. Int Psychogeriatr. 2013 Oct;25(10):1581-603. doi: 10.1017/S1041610213000860. Epub 2013 Jul 24. Review. — View Citation

Wong A, Cheng ST, Lo ES, Kwan PW, Law LS, Chan AY, Wong LK, Mok V. Validity and reliability of the neuropsychiatric inventory questionnaire version in patients with stroke or transient ischemic attack having cognitive impairment. J Geriatr Psychiatry Neurol. 2014 Dec;27(4):247-52. doi: 10.1177/0891988714532017. Epub 2014 Apr 24. — View Citation

Wong A, Nyenhuis D, Black SE, Law LS, Lo ES, Kwan PW, Au L, Chan AY, Wong LK, Nasreddine Z, Mok V. Montreal Cognitive Assessment 5-minute protocol is a brief, valid, reliable, and feasible cognitive screen for telephone administration. Stroke. 2015 Apr;46(4):1059-64. doi: 10.1161/STROKEAHA.114.007253. Epub 2015 Feb 19. — View Citation

Wong A, Xiong YY, Kwan PW, Chan AY, Lam WW, Wang K, Chu WC, Nyenhuis DL, Nasreddine Z, Wong LK, Mok VC. The validity, reliability and clinical utility of the Hong Kong Montreal Cognitive Assessment (HK-MoCA) in patients with cerebral small vessel disease. Dement Geriatr Cogn Disord. 2009;28(1):81-7. doi: 10.1159/000232589. Epub 2009 Aug 11. — View Citation

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* Note: There are 17 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The Chinese version of Positive Aspect of Caregiving scale (PAC)	The PAC scale demonstrates the acceptable levels of internal consistency Cronbach's alpha 0.85 among the family caregivers of PWD in Hong Kong. Higher scores indicating more positive self-perceptions of caregiving. Comparisons of changes of Positive Aspect of Caregiving scale (PAC)will be considered as follows: T0 - T1	At baseline (T0) and 11th week (immediately post- intervention; T1
Primary	The Chinese version of Perceived Stress Scale (PSS)	Perceived Stress Scale contains 10 items with 5-point Likert-type scale rating from 0 (never) to 4 (very often). The total score can range from 0 to 40 with higher scores indicating higher perceived stress. Comparisons of changes of Perceived Stress Scale will be considered as follows: T0 - T1	At baseline (T0) and 11th week (immediately post- intervention; T1
Primary	The WHOQOL-OLD BREF (HK)	The WHOQOL-OLD BREF (HK) comprised 28 items and each item is rated on a 5-point Likert-type scale that ranged from 1 (very dissatisfied) to 5 (very satisfied), with a higher score indicating a better QoL. Comparisons of changes of The WHOQOL-OLD BREF (HK) will be considered as follows: T0 - T1	At baseline (T0) and 11th week (immediately post- intervention; T1
Primary	The Chinese version of Center for Epidemiological Studies Depression scale(CESDS)	The Chinese version of Center for Epidemiological Studies Depression scale is a self-reported measure of depression containing 20 items. Comparisons of changes of Center for Epidemiological Studies Depression scale will be considered as follows: T0 - T1	At baseline (T0) and 11th week (immediately post- intervention; T1
Primary	MoCA-5-min	MoCA-5-min assess participants' cognitive function over the telephone. MoCA-5-min comprises four domains: attention, executive function/language, orientation, and memory.Comparisons of changes of MoCA-5-min will be considered as follows: T0 - T1	At baseline (T0) and 11th week (immediately post- intervention; T1
Primary	The Chinese version of the Neuropsychiatric Inventory-Questionnaire (NPI-Q)	The Neuropsychiatric Inventory-Questionnaire evaluates the frequency, severity, and caregiver distress of 12 neuropsychiatric symptoms by using a 5-point rating scale..Comparisons of changes of the Neuropsychiatric Inventory-Questionnaire will be considered as follows: T0 - T1	At baseline (T0) and 11th week (immediately post- intervention; T1