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Effectiveness and Cost-effectiveness of Technology-enriched Cognitive Stimulation Therapy(teleCST) and Carer Support

Hong Kong is among the first places in the world preparing for a ‘post-COVID-19 era’ – with lessons learned to protect vulnerable groups and mitigate mental health consequences. People living with dementia are vulnerable, with higher risks of infection and death, disrupted services,and deteriorating symptoms during the pandemic. Carers therefore also suffer. Infection control measures would remain necessary in this vulnerable population, which may affect person-centred engagement – a key element in existing evidence-based interventions. Initial experience suggests information and communication technology (ICT)-enriched interventions can be alternative protection measures, while potentially advancing practice and knowledge. Through three inter-connected studies (1) gerontechnology participatory research (2) randomized control trial, and (3) big data analytics, we would refine, evaluate, and further enhance an ICT- delivered intervention package based on existing evidence-based person-centred care traditionally delivered in-person: group Cognitive Stimulation Therapy (CST) for people living with dementia and a multicomponent support programme for family carers. The study is funded by Research Grants Council (Project number: C7055-21GF) and collaborates with different universities and NGOs.

The Feasibility and Efficacy of Family-oriented Support Program for Carers of Persons with Dementia: A Mixed-Method Study

Conventional carer support programme often focused on a primary carer and overlooked the family as a whole unit consisting of multiple potential carers. Previous research work of the team had explored family preparedness for dementia care and observed families sharing care duties as a collaborative work team. We collaborated with Hong Kong Family Welfare Society (HKFWS) since April 2020 and co-developed a family-centred carer support programme that focuses on facilitating the resources within the family system and empowering the family functioning for sustainable care. The programme consists of six weekly sessions and one booster session on 6 themes: (1) new perceptions as caregivers; (2) positive emotions at my home; (3) verbal and non-verbal communication; (4) meaningful activities in daily care; (5) caregiving team in family; and (6) sustainable growth as a family. The programme aims at enhancing the capacity of carer at a family level to reduce care burden and improve family functioning. This study is supported by a donation from Mr Tin Hing-Sin Sam for the promotion of non-pharmacological interventions for people with dementia and their caregivers in community.

A Culturally Appropriate Multimodal Non-pharmacological Intervention for Chinese People with Mild-to-Moderate Dementia

This is a randomized single-blind controlled trial that consists of three groups: 1) Six Arts intervention; 2) Cognitive Stimulation Therapy (CST); and 3) usual care.  This study examines the effectiveness of the Six Arts intervention, a multimodal intervention stems from ancient Confusion philosophy, as compared with CST, a multimodal intervention designed and tested in western population and usual care in improving quality of life and maintaining cognition in Chinese people with mild-to-moderate dementia.  The acceptance and understanding of the Six Arts intervention and CST are explored through conducting focus groups with family caregivers that have observed the session.  This study is funded by Research Grants Council (Project number: 17612418) and collaborated with different NGOs.

Effectiveness of Targeting Residual Delusional Ideations in Cognitive Behavioural Approach to Reduce Social Anxiety in People with Early Psychosis

Social anxiety disorder is one of the most common comorbid conditions in psychotic disorders, found in up to one fifth of outpatients, and has significant negative impact on the quality of life and functioning of people living with psychosis in the community. This single-blinded randomized controlled trial tests a theoretically based design of cognitive behavioural therapy (CBT) for social anxiety in early psychosis.  Study participants are randomly allocated to receive the residual delusional ideation(RDI)-targeted CBT or unstructured recreational activities for 18 sessions.  The effect of the RDI-targeted CBT in achieving treatment response and remission of social anxiety and whether it improves function, quality of life and reduce RDIs would be explored. The study is funded by the Research Grants Council (Project number: 27610117).

The Implementation of Cognitive Stimulation Therapy Hong Kong Version (CST-HK) for Promoting Cognitive Functioning and Psychosocial Well-being of People with Dementia

This is a cluster randomized wait-list control study conducted in collaboration with the Hong Kong Young Women’s Christian Association (HKYWCA). It aims 1) to investigate the effectiveness of CST-HK among people with mild-to-moderate cognitive impairment across service settings in Hong Kong, including two residential care units and seven community care units, and 2) to explore the effectiveness of CST-HK delivered by non-professional staff, as a possible solution to address the shortage of specialized healthcare manpower and increasing demands of non-pharmacological interventions for people living with dementia. A total of 40 young-old volunteers (aged 50+) without a professional healthcare background will be trained as CST-HK facilitator to deliver CST-HK under the supervision of certified CST-HK interventionists. The project was commenced in 2018 and funded by the Health Care and Promotion Scheme of the Health and Medical Research Fund (Project No.: 01171138).

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