Web-Based Interventions to Improve Mental Health in Home Caregivers of People With Dementia: Meta-Analysis

Abstract

Background Dementia is a major cause of disability and dependency in older adults worldwide. It is often accompanied by general psychological distress, such as depression and anxiety symptoms, among caregivers of people with dementia (PwD). The physical and mental health of the caregiver is a prerequisite and a promise to help PwD continue to live as long and as well as possible. Web-based interventions can provide convenient and efficient support and an education tool to potentially reduce the negative outcomes associated with providing care. Objective The aim of this study was to examine the effect of internet-based interventions on the mental health outcomes of family caregivers of PwD and to explore which components of the Web-based interventions play an important role. Methods A comprehensive literature search was conducted in PubMed, Excerpta Medica dataBASE, PsycINFO, Cochrane Database, and the Cumulative Index to Nursing and Allied Health Literature using relevant terms such as Web-based and caregiver as keywords, covering all studies published before June 2018. A total of 2 reviewers independently reviewed all published abstracts, according to established inclusion and exclusion criteria. We extracted information about the participants, interventions, and results and reviewed article quality in terms of the randomized trial methods, using the approach recommended by the Cochrane Handbook for Systematic Reviews of Interventions. Results A total of 815 caregivers participated in 6 studies, with 4 of the studies using depression as an outcome. The analysis found that depression scores dropped an average of 0.23 (95% CI −0.38 to −0.07; P <.01) after Web-based interventions. In 2 studies of caregivers who were experiencing anxiety symptoms, the average score for anxiety dropped by 0.32 points (95% CI −0.50 to −0.14; P <.01). However, in terms of coping, pain, and stress, the Web-based interventions showed a poor effect. On the whole, the addition of professional psychological support on the basis of education can improve caregivers’ mental health. Conclusions Internet-based interventions were generally effective at reducing anxiety and depression in dementia caregivers, although negative results were found in some studies. As for burden and stress, further research is required.

Barriers and Facilitators to Implementing Web-Based Dementia Caregiver Education from the Clinician's Perspective: A Qualitative Study

“…Despite the increase in research in this area -it has been estimated that the number of publications in this eld increases by 13% each year, including several systematic reviews -we could nd very little published with respect to the implementation of web-based caregiver interventions. (9)(10)(11)(23)(24)(25)(26) Moreover, many of the interventions described in the literature do not appear to be more broadly accessible outside of their research context. To our knowledge, no previous research has used the CFIR framework to study webbased caregiver interventions.…”

“…7Various systematic reviews suggest that web-based interventions may result in a range of improved health outcomes for caregivers, including reductions in depression, stress, distress and anxiety. (8)(9)(10)(11) Other studies have identi ed that greater public education is needed for caregivers, and improved mechanisms are needed for busy clinicians to provide caregiver education. (12) We developed iGeriCare (www.igericare.ca), a multimodal e-learning intervention to help educate family caregivers of people with dementia.…”

Caring for Dementia Caregivers in Times of the COVID-19 Crisis: A Systematic Review

“…In Zhao et al (2019) Internet-based interventions on the mental health outcomes of family dementia caregivers was examined and the components of the Web-based interventions that play significant roles were explored [36]. Among the 815 caregivers who participated in six studies, four of the studies explored depression as an outcome where results showed that scores were reduced by an average of 0.23 (95% CI -0.38 to -0.07 ; p<.01) after Web-based interventions [36]. The average scores of two caregivers who were experiencing anxiety symptoms dropped by 0.32 points (95% CI -0.50 to -0.14; p<.01) [36].…”

“…Among the 815 caregivers who participated in six studies, four of the studies explored depression as an outcome where results showed that scores were reduced by an average of 0.23 (95% CI -0.38 to -0.07 ; p<.01) after Web-based interventions [36]. The average scores of two caregivers who were experiencing anxiety symptoms dropped by 0.32 points (95% CI -0.50 to -0.14; p<.01) [36]. While this study shows that Web-based interventions were effective for anxiety in dementia caregivers, results were relatively poor when applied to coping, pain, and stress.…”

“…While this study shows that Web-based interventions were effective for anxiety in dementia caregivers, results were relatively poor when applied to coping, pain, and stress. Additionally, professional psychological support in educating caregivers can improve caregivers' mental health [36]. Although this intervention is effective at reducing anxiety and depression in caregivers, results were negative in some studies [36].…”