Evaluating the effectiveness of a 6-week hybrid mindfulness-based intervention in reducing the stress among caregivers of patients with dementia during COVID-19 pandemic: protocol of a randomized controlled trial

Abstract

Background Mindfulness-based intervention (MBI), an emotion-focused approach, has been shown promising and sustainable effects on enhancing the well-being of caregivers of patients with dementia (PWD). However, the conventional MBI was quite demanding, had high rates of attrition and inconsistent long-term effect. The social distancing measures introduced during the COVID-19 pandemic also restricted face-to-face psychosocial intervention. The study aims to evaluate the effectiveness of a 6-week hybrid MBI in caregivers of PWD over a 6-month follow up. Methods This is a single-blinded, parallel-group randomized controlled trial (RCT). Eligible participants from three local nongovernmental organizations (NGOs) will be randomly divided into intervention groups and control groups in a ratio of 1:1. The participants in the intervention group will receive 6 weekly 90-min group-based sessions delivered through a face-to-face and online approach. The participants in the control group will receive brief education on dementia care with the same group size, duration, and frequency as the sessions in the intervention group. Immediately after the intervention and at the 6-month follow-up, caring stress and other outcomes will be assessed. Besides, a focus group interview will be conducted to identify the strengths, limitations, and therapeutic components of the intervention from their perspectives. For quantitative data, intention-to-treat analysis and Generalized Estimating Equations (GEE) will be used. For qualitative data, content analysis will be used. Discussion This proposed hybrid model of MBI has several advantages, such as lower duration, longer follow-up period and easier access by family caregivers. Also, physiological indicators (e.g., heart rate viability and neuropsychiatric symptoms) will be measured in this study to show the body change after MBI. The quantitative and qualitative data of this research can also benefit the development of online or hybrid MBI for caregivers of PWD during the COVID-19 pandemic. Despite these strengths, it does have practical challenges and limitations. However, this proposed intervention has the potential to benefit not only the participants, but also the researcher as well as public health providers. Trial registration: NCT05242614. Registered on 2022-02-16, https://clinicaltrials.gov/ct2/show/NCT05242614

A meta‐analysis of mindfulness‐based interventions for improving mental health and burden among caregivers of persons living with dementia

“…Long‐term practice of mindfulness leads to reduced emotional reactivity by promoting tolerance of emotions and enhancing present‐moment awareness (Marchand, 2014). In this meta‐analysis, seven studies had an intervention duration of ≥8 weeks, and three of the studies showed a significant reduction in depression (Danucalov et al., 2013; Kor et al., 2022; Whitebird et al., 2013). Caregivers of persons living with dementia frequently suffer depression as a result of the complex and difficult duty of caring for persons living with dementia without knowing when this caregiving will end (Cheng et al., 2021; Huang, 2022).…”

Health maintenance through home-based interventions for community-dwelling older people with sarcopenia during and after the COVID-19 pandemic: A systematic review and meta-analysis

“…As there is a dose–response relationship between exercise intensity and health outcomes, low-intensity exercise may not be able to relieve the symptoms of sarcopenia. Regarding intervention fidelity, although digital technologies that enable mutual communication (i.e., video conference platform and social media) have been widely used in health interventions during and after the COVID-19 pandemic ( Kor et al, 2022 ), the majority of the included RCTs only used self-learning materials (i.e., booklets and CDs) to deliver the exercise interventions without conducting fidelity checks, such as checking whether the participants achieved the target intensity or performed the exercise program strictly following the intervention protocol ( Chang et al, 2021 ; Maruya et al, 2016 ). This one-way delivery modality has a high risk of leading to inadequate progress among the exercise program participants, which further undermines the beneficial effect of home-based exercise on sarcopenia.…”

Feasibility and preliminary effects of a mindfulness-based physical exercise (MBPE) program for community-dwelling older people with sarcopenia: A protocol for a parallel, two-armed pilot randomised controlled trial

“…The MBPE intervention will be conducted twice a week for 12 weeks [ 19 ]. The content of week 8 will be repeated in weeks 9–12 to enhance the benefits of MBPE and help the participants incorporate MBPE into their daily lives, given that they are expected to be able to learn the MBI within 8 weeks [ 54 ]. To better combine the MBI and PE components, tips on remaining mindful during PE will be given to the participants.…”

“…The comments and suggestions from the older adults with sarcopenia were collected to refine the MBPE protocol in this proposed study. The study will be conducted in a hybrid mode, combination of at CHCC and at home [53,54]. Table 1.…”