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The development of the potential of family leaders in dementia surveillance among the home elderly

Authors

Sakchai Pattra Lecturer of Faculty of Arts and Science, Chaiyaphum Rajabhat University
Warawut Mahamit Lecturer of Faculty of Arts and Science, Chaiyaphum Rajabhat University

Keywords:

Dementia, Family Leaders, Surveillance, Elderly

Abstract

Dementia is a critical public health issue severely impacting families of the elderly, particularly in Na Fai Subdistrict, Chaiyaphum Province, where family leaders lack capacity for surveillance and care. This research aimed to 1) investigate the situation and needs of family leaders 2) develop a capacity-building model, and 3) implement the model. The sample comprised 306 elderly persons, 35 family leaders, and 43 stakeholders. The model was developed through literature review, expert seminars using Nominal Group Technique, and pilot studies. Data were analyzed using descriptive statistics, content analysis, and paired t-test.

Phase 1 results revealed that 31.7% of elderly participants were suspected of having dementia, with family leaders having low knowledge, negative attitudes, and requiring skills training. Phase 2 developed the innovative 4C Model comprising (C1) Cognitive and Attitudinal Foundation, (C2) Comprehensive Surveillance, (C3) Competency-based Caregiving, and (C4) Connected Community through Technology. The 8-week program integrated peer learning, local technology utilization, and caregiver support. Phase 3 demonstrated significant improvements with knowledge increasing by 7.74 points (95% CI: 6.74, 8.73, d=2.66), attitudes improving by 1.49 points (95% CI: 1.23, 1.75, d=1.93), and skills enhancing by 1.61 points (95% CI: 1.34, 1.88, d=2.05). Skills remained at good levels after 3 months, with 100% stakeholder satisfaction.

This research yielded highly satisfactory results in the development of the 4C Model innovation, demonstrating a very large effect size (d=1.93-2.66), which is 2 to 5 times greater than previous studies. Characterized by high sustainability and widespread acceptance, this innovation serves as a model for policy development in family and community-based elderly care. It effectively reduces the burden on the public health system while fostering a sustainable healthcare network.

References

World Health Organization. Global status report on the public health response to dementia. [Internet]. 2021. [cited 2025 Nov. 12]. Available from: https://www.who.int/ publications/i/item/9789240033245

Livingston G, Huntley J, Liu KY, Costafreda SG, Selbæk G, Alladi S, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet Standing Commission. Lancet 2024;404(10452):572-628. DOI:10.1016/S0140-6736(24)01296-0

อาทิตยา สุวรรณ์, สุทธิศรี ตระกูลสิทธิโชค. ผลของโปรแกรมการส่งเสริมการรู้คิดโดยใช้ดนตรีบำบัดร่วมกับการกระตุ้นประสาทการรับรู้หลายด้านต่อความสามารถด้านการรู้คิด ปัญหาพฤติกรรม อารมณ์และจิตใจของผู้สูงอายุที่มีภาวะสมองเสื่อม. วารสารพยาบาลสภากาชาดไทย 2564;14(2):221-34. https://he02.tci-thaijo.org/index.php/trcnj/article/view/256641

Sakamoto R. Aging in Southeast Asia and Japan: Challenges and opportunities. Geriatr Gerontol Int 2025;25(7):837–54. DOI:10.1111/ggi.70062

ธรณินทร์ คุณแขวน, ปัญญ์กรินทร์ หอยรัตน์, สุวารี ทวนวิเศษกุล. ปัจจัยที่มีอิทธิพลต่อพฤติกรรมป้องกันภาวะสมองเสื่อมของผู้สูงอายุในจังหวัดชัยภูมิ. วารสารพยาบาล 2566;72(3):47-54. https://he02.tci-thaijo.org/index.php/TJN/article/view/260817

หยาดพิรุณ ดวงเนตร, ณัฐดนัย แก้วโพนงาม. ปัจจัยที่มีผลต่อการมีส่วนร่วมของภาคีเครือข่ายในการดูแลผู้สูงอายุในชุมชนบ้านกรุงสามัคคี ตำบลบลโคกกุง อำเภอแก้งคร้อ จังหวัดชัยภูมิ. วารสารเสฏฐวิทย์ปริทัศน์ 2568;5(3):1501–9. https://so12.tci-thaijo.org/index.php/stw/article/view/2245

โรงพยาบาลส่งเสริมสุขภาพตำบลนาฝาย. รายงานผลการปฏิบัติงานประจำปี 2564. ชัยภูมิ : โรงพยาบาลส่งเสริมสุขภาพตำบลนาฝาย, 2565.

Sherifali D, Ali MU, Ploeg J, Markle-Reid M, Valaitis R, Bartholomew A, et al. Impact of Internet-Based Interventions on Caregiver Mental Health: Systematic Review and Meta-Analysis. J Med Internet Res 2018;20(7):e10668. DOI:10.2196/10668

Sani TP, Cheung G, Peri K, Yates S, Kerse N, Whaanga H, et al. Cultural adaptations of the WHO iSupport for dementia: A scoping review. Dementia (London) 2025;24(4):767–93. DOI:10.1177/14713012241283860

World Health Organization. Integrated care for older people: guidelines on community-level interventions to manage declines in intrinsic capacity. Geneva : World Health Organization, 2017. https://www.who.int/publications/i/item/9789241550109

Krejcie RV, Morgan DW. Determining sample size for research activities. Educational and Psychological Measurement 1970;30(3):607-10. https://doi.org/10.1177/001316447003000308

Polit DF, Beck CT. Nursing Research: Generating and Assessing Evidence for Nursing Practice. (10thed.). Philadelphia : Wolters Kluwer Health, 2017.

Bandura A. Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, N.J. : Prentice-Hall, 1986.

Knowles MS, Holton EF, Swanson RA. The adult learner: The definitive classic in adult education and human resource development. (8th ed.). London : Routledge, 2015.

Thoits PA. Mechanisms linking social ties and support to physical and mental health. J Health Soc Behav 2011;52(2):145-61. DOI:10.1177/0022146510395592

Liu Z, Chen QL, Sun YY. Mindfulness-based interventions for family caregivers of people with dementia: A systematic review and meta-analysis of randomized controlled trials. Clin Interv Aging 2017;12:1521-9. DOI:https://doi.org/10.2147/CIA.S146213

He J, Wang J, Zhong H, Guan C. The Effectiveness of Multi-Component Interventions on the Positive and Negative Aspects of Well-Being among Informal Caregivers of People with Dementia: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2022;19(12):6973. DOI:10.3390/ijerph19126973

Vandepitte S, Van Den Noortgate N, Putman K, Verhaeghe S, Verdonck C, Annemans L. Effectiveness of respite care in supporting informal caregivers of persons with dementia: A systematic review. Int J Geriatr Psychiatry 2016;31(12):1277-88. DOI:10.1002/gps.4504

de-Moraes-Ribeiro FE, Moreno-Cámara S, da-Silva-Domingues H, Palomino-Moral PA, Del-Pino-Casado R. Effectiveness of Internet-Based or Mobile App Interventions for Family Caregivers of Older Adults with Dementia: A Systematic Review. Healthcare (Basel) 2024;12(15):1494. DOI:10.3390/healthcare12151494

Walter E, Pinquart M. How Effective Are Dementia Caregiver Interventions? An Updated Comprehensive Meta-Analysis. Gerontologist 2020;60(8):609-19. DOI:10.1093/geront/gnz118

Noel MA, Lackey E, Labi V, Bouldin ED. Efficacy of a Virtual Education Program for Family Caregivers of Persons Living with Dementia. J Alzheimers Dis 2022;86(4):1667–78. DOI:10.3233/JAD-215359

Messina A, Lattanzi M, Albanese E, Fiordelli M. Caregivers of people with dementia and mental health during COVID-19: findings from a cross-sectional study. BMC Geriatr 2022;22(1):56. DOI:10.1186/s12877-022-02752-x

Cheng ST, Au A, Losada A, Thompson LW, Gallagher-Thompson D. Psychological Interventions for Dementia Caregivers: What We Have Achieved, What We Have Learned. Curr Psychiatry Rep 2019;21(7):59. DOI:10.1007/s11920-019-1045-9

Zheng Y, Tang PK, Zhao Y, Song M, Hu H, Ung COL. Qualitative study of stakeholder perspectives on dementia policy implementation in Macao: progress, challenges and future directions. BMJ Open 2025;15(10):e102523. DOI:10.1136/bmjopen-2025-102523

Schulz KF, Altman DG, Moher D ; CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ 2010;340:c332. DOI:10.1136/bmj.c332

Haley WE, Bergman EJ, Roth DL, McVie T, Gaugler JE, Mittelman MS. Long-Term Effects of Bereavement and Caregiver Intervention on Dementia Caregiver Depressive Symptoms. Gerontologist 2008;48(6):732-40. DOI:10.1093/geront/48.6.732