Alternative Carer Respite: A Study on Its Effectiveness and Potential Mechanism

The Carer Needs Screening Tool (CNST-11) is a self-developed tool that measures different aspects of caregiving needs over the past 1 week period. It is a 11-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

The Patient History Questionnaire (PHQ-9) is a widely used tool that consists of nine questions designed to screen and monitor the presence and severity of depression. The total score on the PHQ-9 ranges from 0 to 27, with higher scores indicating more severe depressive symptoms. The score ranges for the PHQ-9 are as follows: 0-4: Minimal depression symptoms; 5-9: Mild depression; 10-14: Moderate depression; 15-19: Moderately severe depression; 20-27: Severe depression Change in score = Immediate after intervention - baseline

The Generalized Anxiety Disorder 7 (GAD-7) involves 7- items assessing the severity of anxiety symptoms. The total score on the GAD-7 ranges from 0 to 21, with higher scores indicating more severe anxiety symptoms. The score ranges for the GAD-7 are as follows: 0-4: Minimal anxiety symptoms; 5-9: Mild anxiety; 10-14: Moderate anxiety; 15-21: Severe anxiety.

Change in score = Immediate after intervention - baseline

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

The Positive Aspect of Caregiving scale is a 11-item scale that measures how the caregiver perceive caregiving experience, specifically in a positive aspect (e.g., caregiving makes me feel useful). It is rated in a 5-point Likert scale from "very disagree" to "very agree", with potential score from 0 to 44. A higher score indicates caregiving perceiving it in a more positive way.

Caregivers will complete the primary outcome measurements (1 to 5) 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 5 will be measured. Participants with improved/sustained score indicates better retention.