Interventions to foster resilience in family caregivers of people with Alzheimer disease: a scoping review

Abstract

Background: The family caregiver of a person with Alzheimer disease still has, in most cases, negative consequences in their bio-psycho-social sphere, which are related to the acquisition of this role. However, it has been objectified that this fact is not universal in this type of population, as benefits have been obtained in the act of caring through the development of resilience. Given this possibility, and since nurses are the healthcare professionals that support the dyad in both health and disease processes, there is an urgent need of identifying which non-pharmacological interventions could improve or foster resilience in family caregivers of people with Alzheimer disease. Objectives: General objective: To determine which interventions have been useful in order to foster resilience of family caregivers of people with Alzheimer disease. Specific objectives: 1) To determine the concept of resilience applied to family caregivers of people with Alzheimer disease; 2) To identify variables that have been studied together with resilience; 3) To determine the profile of family caregivers of people with Alzheimer disease; 4) To find out the implication of nursing professionals in the development of the intervention; 5) To describe the intervention’s main features. Design: A scoping review of research published in English and Spanish between 2009 and 2022 was undertaken. Medline (PubMed), CinahlPlus, PsycInfo and Cochrane Library were searched to obtain eligible articles. Methods: Data was analysed using an adapted version of Arksey and O’Malley’s methodological framework, having done a previous critical reading of the articles with the CasP and MMAT tools. Contents and intervention techniques were narratively synthesised. Results: Nine articles (5 analytical-experimental, 2 quantitatives and 2 mixed) whose methodology and implementation of interventions were highly heterogeneous were included. Three types of interventions related to the furtherance of resilience in family caregivers of people with Alzheimer disease were identified: meditation, multicomponent psychoeducation and creative art; nurses participated as co-therapists in the last two. Although the concept of resilience presented variations in its definition and assessment, it seems that scientific literature has related it more to a decrease of negative variables (stress, depression) than to the furtherance of other more positive ones (mental health). Conclusions: This scoping review objectifies with low certainty that the interventions that can be useful for the improvement of resilience in family caregivers of people with Alzheimer disease are multicomponent psychoeducation, creative art and meditation. The need of carrying out more high methodological quality research is emphasised, deepening on the definition of the concept of resilience, on the nurses’ role in the activity’s execution process, on the support of the caregiver and on the assessment and maintenance of the outcomes.