高齢者における家族間コミュニケーションの改善：パイロット無作為化比較試験 (ReFrame-P)

実験的：リフレームRトレーニング

ReFrame-Rは、4回の週次90分グループセッション（合計6時間）で構成され、障壁のトラブルシューティングと家庭での実践の強化を目的とした短い週次個別相談が補完されます。 既存の素人向けMIプロトコル（Kline et al., 2022）を適応したこのプログラムは、家族システム理論に基づき、高齢の親と成人した子供の関係における過剰／過少機能のダイナミクスに対処すると同時に、共感的傾聴と自律性を支援するコミュニケーションを重視しています。 MIスキルブックレットが配布され、家庭での実践をサポートし記録します。

行動：リフレーム-R

ReFrame-Rプログラムは、素人向けの確立された動機付け面接（MI）プロトコル（Kline et al., 2022）に基づいて適応されています。 家族システム理論に基づき、このカリキュラムは特に、高齢の親と成人した子どもとの関係でよく見られる過剰機能と機能不全のダイナミクス、および香港の文化的特異的文脈に焦点を当てています。 一般的なコミュニケーションワークショップとは異なり、このプログラムは親と成人した子どもの関係内での役割の境界を強調しています。

介入なし：対照群

対照群の参加者は、研究期間中に能動的なトレーニングを受けません。
同じMIスキルブックレットが参照および自主的な練習のために提供されます。

Perceived communication competence

Participants' self-perceived communication competence is assessed using an 11-item scale adapted from the Family Communication Scale (FCS). The scale consists of 10 items adapted from the original FCS to measure perceived ability to engage in positive communication with adult children, plus an additional item regarding overall communicagtion competence. Each item is rated on a 5-point scale (1-5), with a total score ranging from 11 to 55. Higher scores indicate a higher level of perceived communication competence.

Meaning in life

The 10-item Meaning in Life Questionnaire (MLQ; Steger et al., 2006) is used. It consists of two subscales: presence of meaning (5 items) and search of meaning (5 items). Each subscale is rated on a 7-point scale, with summed scores are calculated (ranged 5-35 for each). Higher scores indicate stronger sense of purpose and motivation to find meaning, respectively.

Self-efficacy

Participants' self-efficacy will be assessed using the 6-item General Self-Efficacy Scale (GSE-6; Romppel et al., 2013). It is typically rated on a 4-point scale from 1 to 4. Total scores range from 6 to 24, with higher scores reflecting greater perceived self-efficacy.

Well-being

The 5-item WHO Well-Being Index will be adopted for measuring participants' subjective well-being (Bech, 1998; Kong et al., 2016), rated on a 7-point scale. The WHO-5 score ranges from 0 to 25, zero representing worst possible mental well-being and 25 representing best possible mental well-being.

Role boundaries

We used a 5-item scale adapted from the Control subscale of the Parent-Adult Child Relationship Questionnaire's Relationship with Father component (PACQF; Peisah et al., 1999). While the original scale assess children's perceptions of parental conrtol, this adapted version is a self-report measure for parent to assess their attempt to maintain power, influence, or dominance over their adult children. Each item is rated on a 5-point scale, with a total score ranging 5-25. Higher scores indicater higher levels of parent control, reflecting weaker awareness of role boundaries in parent-adult children relationship.

Family functioning

The 5-item Family Adaption, Partnership, Growth, Affection, Resolve questionnaire (Family APGAR; Chan et al., 1988; Smilkstein, 1978) is used. This scale assesses participants' satisfaction with five aspects of family function. Each item is rated on a 3-point scale (0-2), with a total score ranged from 0 to 10. Higher scores indicate better family functioning.

Training appropriateness

We used the 4-item Intervention Appropriateness Measure (IAM) from Weiner et al (2017) to access training appropriateness. All items are rated on a 5-point scale (1-5), with an average score being calculated. Higher scores indicate greater perceived appropriateness of training.

Training acceptability

The 4-item Acceptability of Intervention Measure (AIM) from Weiner et al (2017) is adopted to access training appropriateness. All items are rated on a 5-point scale (1-5), with an average score being calculated. Higher scores indicate greater perceived acceptability of training.

Training feasibility

This study used the 4-item Intervention Appropriateness Measure (IAM) from Weiner et al (2017) to access training feasibility. All items are rated on a 5-point scale (1-5), with an average score being calculated. Higher scores indicate greater perceived feasibility of training.