Brief telephone counselling is effective for caregivers who do not experience any major life events – caregiver-related outcomes of the German day-care study

Abstract

BackgroundTo date, there has been a dearth of scientifically tested, established intervention concepts focussed on supporting informal caregivers and embedded in routine health care structures. The aim of this study was to assess effects of a brief telephone intervention for caregivers of persons with cognitive impairment (PCIs) on caregivers’ depressiveness and subjective burden.MethodsA two-arm cluster-randomised controlled intervention study was carried out at 32 German day-care centres. During the six-month intervention period, informal caregivers in the intervention group (n = 205) received counselling in three phone calls focussed on stress reduction, development of self-management strategies, and how to deal with challenging behaviours. Both the control group (n = 154) and the intervention group were free to take part in any support programmes offered by the German Health Care System (TAU). Caregivers’ subjective burden and depressiveness were measured with the Burden Scale for Family Caregivers – short version (BSFC-s) and the WHO-5 Well-Being Index (WHO-5). Outcomes were assessed by means of computer-assisted telephone interviews (CATIs) at baseline and at the end of the six-month intervention phase. Multiple regression analyses were used to show the influence of group allocation.ResultsAfter the intervention phase, group allocation was not found to significantly predict caregivers’ subjective burden or depressiveness. The baseline scores (p < 0.001) were the only significant predictors of change in both outcomes. However, sensitivity analyses for caregivers who did not experience any events that they felt were major (in a negative or positive sense) during the six months (n = 271) showed that group allocation (p < 0.05) was a significant predictor of positive change in both outcomes (BSFC-s: Δ-1.3, [− 2.4, − 0.3], Cohen’s d = 0.27; WHO-5: Δ1.5, [0.4, 2.7], Cohen’s d = 0.26). Effect sizes were highest in the subgroup of caregivers of people with mild dementia (BSFC-s: Cohen’s d = 0.43; WHO-5: Cohen’s d = 0.42).ConclusionsA “low-dose” psychoeducative telephone intervention designed to empower caregivers is effective, especially in an early stage, if the overlap between the effect of the intervention and the effect of events that are experienced as major events in the caregiver’s life is considered.Trial registrationIdentifier: ISRCTN16412551 (Registration date: 30 July 2014, registered retrospectively).Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3853-8) contains supplementary material, which is available to authorized users.

Can brief telephone interventions reduce caregiver burden and depression in caregivers of people with cognitive impairment? - long-term results of the German day-care study (RCT)

“…For detailed reasons for the dropout and the distributions of the dropouts in the control and intervention groups between baseline and the 6-month follow-up, see Behrndt el al. [18]. Three hundred four dyads could be included in the analysis of the follow-up data after 12 months (t2).…”

“…In addition, an outreach telephone counseling intervention for their caregivers was carried out, and both were analyzed for their efficacy. The DeTaMAKS short-term effects were published [15, 16]. However, it is not yet clear whether the German day-care study interventions have long-term effects, and if so, for which aspects.…”

“…The first aim of this study was to analyze whether the interventions aimed at the caregivers in the German Day-Care study (brief telephone counseling) that have been shown to be effective for a subsample in the short-term [18] could improve caregiver burden and/or depressiveness 1 year after the study began and 6 months after the end of the controlled study period.…”

Long-Term Effects of a Cognitive Behavioral Conference Call Intervention on Depression in Non-Professional Caregivers

“…While some studies found the interventions to be effective (e.g., [ 23 , 24 , 25 , 26 ]), others found no significant difference between the intervention and control groups (e.g., [ 27 , 28 , 29 , 30 ]). Still, others found partial support for the telephone interventions that were limited to certain subgroups of caregivers (e.g., [ 31 , 32 ]) or at certain follow-up points (e.g., [ 33 , 34 , 35 , 36 ]) regarding depressive symptoms. However, some studies had significant results in other outcomes, such as a high percentage of complete or partial attainment [ 33 ], an improvement in well-being [ 34 , 35 , 36 ], coping with the care situation [ 34 , 36 ], perceived health [ 34 ], physical health [ 35 , 36 ], quality of life [ 35 ], the behavior of the care recipient [ 36 ], and a reduction in physical complaints [ 34 , 35 ].…”

“…The results for reported depressive symptoms of these long-term evaluations were not very encouraging. Donath et al [ 39 ] analyzed the long term data of the cluster-randomized controlled trial by Berhndt et al [ 32 ] in which 453 caregivers received a telephone advice intervention ( n = 263) or usual care ( n = 190). There were no significant differences between the two groups at the 12-month follow-up, although secondary analyses found a moderate effect size (Cohen’s d = 0.52) for caregivers of people with mild dementia.…”