Effectiveness of interventions that assist caregivers to support people with dementia living in the community: a systematic review

Abstract

Objectives The objective of this review was to assess the effectiveness of interventions that assist caregivers to provide support for people living with dementia in the community. Inclusion criteria Types of participants Adult caregivers who provide support for people with dementia living in the community (non-institutional care). Types of interventions Interventions designed to support caregivers in their role such as skills training, education to assist in caring for a person living with dementia and support groups/programs. Interventions of formal approaches to care designed to support caregivers in their role, care planning, case management and specially designated members of the healthcare team - for example dementia nurse specialist or volunteers trained in caring for someone with dementia. Types of studies This review considered any meta-analyses, systematic reviews, randomised control trials, quasi-experimental studies, cohort studies, case control studies and observational studies without control groups that addressed the effectiveness of interventions that assist caregivers to provide support for people living with dementia in the community. Search strategy The search sought to identify published studies from 2000 to 2005 through the use of electronic databases. Only studies in English were considered for inclusion. The initial search was conducted of the databases, CINAHL, MEDLINE and PsychINFO using search strategies adapted from the Cochrane Dementia and Cognitive Improvement Group. A second more extensive search was then conducted using the appropriate Medical Subject Headings (MeSH) and keywords for other available databases. Finally, hand searching of reference lists of articles retrieved and of core dementia, geriatric and psycho geriatric journals was undertaken. Assessment of quality Methodological quality of each of the articles was assessed by two independent reviewers using appraisal checklist developed by the Joanna Briggs Institute and based on the work of the Cochrane Collaboration and Centre for Reviews and Dissemination. Data collection and analysis Standardised mean differences or weighted mean differences and their 95% confidence intervals were calculated for each included study reported in the meta-analysis. Results from comparable groups of studies were pooled in statistical meta-analysis using Review Manager Software from the Cochrane Collaboration. Heterogeneity between combined studies was tested using standard chi-square test. Where statistical pooling was not appropriate or possible, the findings are summarised in narrative form. Results A comprehensive search of relevant databases, hand searching and cross referencing found 685 articles that were assessed for relevance to the review. Eighty-five papers appeared to meet the inclusion criteria based on title and abstract, and the full paper was retrieved. Of the 85 full papers reviewed, 40 were accepted for inclusion, three were systematic reviews, three were meta-analysis, and the remaining 34 were randomised controll...

Caregiver support groups in patients with dementia: a meta‐analysis

“…For effectiveness indicators, we examined various factors affecting a caregiver and analyzed existing studies on support groups for caregivers of demented patients. Using classifications developed by previous studies, including Brodaty et al (2003), Cooke et al (2001), Nelis et al (2007), Parker et al (2008), Pusey and Richards (2001), and Schulz et al (2002), the assessment indicators for support groups focused on the main caregiver's psychological well-being, depression, burden, and social outcome variables.…”

Family Caregiving in Dementia: The Asian Perspective of a Global Problem

“…The focus of care for persons with dementia has shifted from the sick person to family-oriented care, with family members being partners in care. There is a growing amount of empirical evidence supporting that some intervention strategies have a beneficial impact on the burden of family caregivers [62]. For example, a training program for caregiving skills has been found to be relatively more effective in reducing family distress and strengthening care management [63,64].…”

“…Multicomponent interventions resulted in statistically significant effects in improving self-efficacy, depression, subjective well-being and perceptions of burden. Noneffective interventions that should be avoided included only referring caregivers to support groups, only providing self-help materials and only offering peer support [62]. …”

Self-Efficacy Partially Mediates between Social Support and Health-Related Quality of Life in Family Caregivers for Dementia Patients in Shanghai

“…A positive relationship between self-efficacy and caregiver HRQoL has also been identified [11,25]. The results of intervention studies have found that enhancing caregiver self-efficacy significantly improved these caregivers' mental and physical health outcomes [26,27,28,29]. According to Bandura [24], people's self-efficacy for a specific behavior is influenced by external factors.…”

“…Self-efficacy is defined as ‘the belief in one's capabilities to organize and execute the course of action required to produce given attainments' [24]. An increasing number of studies have reported on the significant association between caregiver self-efficacy and health-related outcomes [11,18,25,26,27,28,29]. Studies on caregiver self-efficacy have found significantly lower levels of self-efficacy in caregivers who are dealing with relatives with dementia than in caregivers dealing with relatives with other diseases [18].…”