Effect of multicomponent interventions on competence of family caregivers of people with dementia: A systematic review

Jin, Ying; Wang, Yonghong; Zhang, Meiling; Wang, Shouqi; Shi, Ying; Li, Huanhuan; Li, Yuan; Xing, Zhuangjie; Sun, Jiao

doi:10.1111/jocn.14326

Cited by 23 publications

(23 citation statements)

References 37 publications

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“…At the same time, 20 articles provided negative or mixed reviews. These included reviews on psychoeducation [12,23,58,62,70], CBT-based psychotherapeutic interventions [37], mindfulness [43], support interventions [12,24,62], respite [65,66], home care [56], physical activity interventions [70], multicomponent interventions [12,70,72], dyadic interventions [40,60], technology-based interventions [25,26,42,64,68], and miscellaneous (e.g., physical activity, dyadic) interventions [40,67,70]. Note that the same article might have provided both positive and negative reviews, depending on the intervention category concerned.…”

Section: Burdenmentioning

confidence: 99%

“…By mastery, we refer to several interrelated constructs including ability, sense of competence and self-efficacy, which altogether were covered by 13 reviews. Eight reviews concluded that certain interventions could enhance mastery, including psychoeducation [51,53,66], OT interventions [16,66], multicomponent interventions [72], technology-based interventions [17,51], and miscellaneous/general interventions [35,53,61]. Five other reviews, however, found no effect of psychoeducation [62], technology-based interventions [26,42,46], or miscellaneous interventions [67].…”

Section: Masterymentioning

confidence: 99%

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A comprehensive meta-review of systematic reviews and meta-analyses on nonpharmacological interventions for informal dementia caregivers

Cheng

Zhang

2020

BMC Geriatr

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Background: Many reviews with conflicting findings on dementia caregiver interventions have been published. A meta-review was conducted to synthesize the findings of systematic reviews and meta-analyses. Methods: MEDLINE, PsycINFO, CINAHL and Cochrane Library were searched to identify reviews published during 2006-2018. Results: Sixty reviews covering > 500 intervention studies were selected and appraised with Assessment of Multiple Systematic Reviews (AMSTAR) II. The great majority of studies were of low quality according to AMSTAR II, but quality factors appeared unrelated to the conclusions obtained. Depression was most modifiable, with effects found across a spectrum of interventions (psychoeducation, counseling/psychotherapy, occupational therapy, mindfulnessbased interventions, multicomponent interventions, etc.). Evidence of intervention effect was also found for quality of life (psychoeducation), mastery (psychoeducation, occupational therapy and multicomponent interventions) and communication skills (communication training). Null or weak results were found for anxiety, social support and burden. Support groups and respite were generally ineffective. There was no evidence that dyadic programs were better than caregiver-only programs, or that programs delivered individually or in groups would differ in their impacts. The evidence also does not support multicomponent interventions to have broader impacts than single-component programs. Methodological issues in the existing reviews (e.g., selective use of studies to serve different research purposes and inconsistent classification of interventions) were noted and taken into account when interpreting findings. (Continued on next page)Conclusions: This meta-review clarified variations in review methodology and identified a few potent groups of intervention (most notably psychoeducation, psychotherapy, occupational therapy, and multicomponent interventions), although no intervention type had broad effects on caregiver outcomes. We note that improvements are needed in the reporting of intervention studies and in making the classification of interventions more transparent and consistent. We further recommend fewer and larger-scale reviews and more attention to positive outcomes in order to better inform the field. Developing interventions with broader impacts and packaging them to meet caregivers' changing needs in the course of dementia should be a priority for researchers and practitioners.

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Section: Burdenmentioning

confidence: 99%

Section: Masterymentioning

confidence: 99%

A comprehensive meta-review of systematic reviews and meta-analyses on nonpharmacological interventions for informal dementia caregivers

Cheng

Zhang

2020

BMC Geriatr

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“…2,7 Evidence has shown that appropriate multicomponent interventions which include psycho-education, training and support can significantly reduce caregiver burden and improve well-being and competence of caregivers. [8][9][10][11] However, most of these studies have been conducted in high-income countries and the interventions are typically time-intensive and require trained health personnel such as psychologists, therapists or medical doctors. [12][13][14] In India, a home based support intervention was found to be effective in reducing caregiver burden and promoting caregiver mental health, but required the involvement of psychiatrists, counselors and community volunteers.…”

Section: Introductionmentioning

confidence: 99%

“…Evidence has shown that appropriate multicomponent interventions which include psycho‐education, training and support can significantly reduce caregiver burden and improve well‐being and competence of caregivers 8–11 . However, most of these studies have been conducted in high‐income countries and the interventions are typically time‐intensive and require trained health personnel such as psychologists, therapists or medical doctors 12–14 .…”

Section: Introductionmentioning

confidence: 99%

Feasibility and preliminary effectiveness of an online training and support program for caregivers of people with dementia in India: a randomized controlled trial

Baruah

Varghese

Loganathan

et al. 2021

Int J Geriat Psychiatry

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Objectives Internet‐based interventions involving elements of cognitive behavior therapy, psychoeducation, relaxation and skills training for caregivers of people with dementia have been found to be promising in Western countries. Given these outcomes, the adapted version of a multi‐component online caregiver skills training and support program of the World Health Organization, called iSupport, was tested for feasibility and preliminary effectiveness in India. Methods One hundred fifty‐one caregivers of family members with a diagnosis of Alzheimer's disease or dementia were randomized to either the intervention arm (iSupport; n = 74) or to the control group (an education‐only e‐book program; n = 77). Participants were assessed using self‐rated measures of depression and perceived burden, which were the primary outcome measures, at baseline and 3‐month follow‐up. Person‐centered attitude, self‐efficacy, mastery and self‐rated health were also assessed. Results Fifty‐five caregivers (29 in the iSupport group and 26 in the control condition) completed the study. The recruitment and retention rate of the study were 44.67% and 36.42% respectively. No significant differences were found between the two groups at 3‐month follow‐up on the primary outcomes. Among the secondary outcomes, significant improvement was only seen in caregivers' person‐centered attitude towards persons with dementia in the iSupport group (t = 2.228; p < 0.05). Conclusions Despite efforts to recruit and retain participants to the online program, this study had a low recruitment and retention rate, which require closer attention and indicates a need for further adaptations of the Indian version of the iSupport program to improve its acceptability and accessibility. The lessons learned from this study will guide the further development of caregiver training and support interventions in India. The trial was registered with the Clinical Trials Registry‐India (Trial Registration No. CTRI/2017/02/007876).

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“…And above all, it is preferred by most patients with dementia [31][32][33]. The competence of caregivers is essential for the life quality of patient with dementia, and multicomponent interventions may be appropriate for nurses to practice [34].…”

Section: Needs and Demands Socio-health Of The Patientsmentioning

confidence: 99%

Healthcare Models in Alzheimer’s Disease

Garzón-Maldonado¹,

Torres²

2019

Redirecting Alzheimer Strategy - Tracing Memory Loss to Self Pathology

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Alzheimer's disease is currently a health care problem and in the future, when we have effective treatments, it will become a public health priority. Health systems should adapt to this situation. New technologies are tools that can improve healthcare and lower costs. The mobile phone with call o video call conference is going to suppose a radical change in the control of these patients. The telephone assistance to patient or relatives is very satisfactory for both due to the rapidity in the response to their problem and the comfort with which they are attended to. Also the health system reduces the costs of face-to-face consultation. In addition, this telemedicine could be applied for cognitive stimulation, with specific programs for each patient and for the follow-up of patients in their homes, delaying their entry into residences. The objective is to turn the patients and their caregiver into cotherapists together with the nurse and the physician, in the follow-up of Alzheimer's disease.

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Effect of multicomponent interventions on competence of family caregivers of people with dementia: A systematic review

Abstract: The competence of family caregivers is essential for the life quality of PwD. To promote the health of the family caregiver and PwD, multicomponent interventions may be appropriate for nurses to practice.

Cited by 23 publications

References 37 publications

A comprehensive meta-review of systematic reviews and meta-analyses on nonpharmacological interventions for informal dementia caregivers

A comprehensive meta-review of systematic reviews and meta-analyses on nonpharmacological interventions for informal dementia caregivers

Feasibility and preliminary effectiveness of an online training and support program for caregivers of people with dementia in India: a randomized controlled trial

Healthcare Models in Alzheimer’s Disease

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