The Effectiveness of Nonpharmacological Interventions for Informal Dementia Caregivers: An Updated Systematic Review and Meta-Analysis

被引:136
|
作者
Cheng, Sheung-Tak [1 ]
Li, Kin-Kit [2 ]
Losada, Andres [3 ]
Zhang, Fan [1 ]
Au, Alma [4 ]
Thompson, Larry W. [5 ]
Gallagher-Thompson, Dolores [5 ,6 ]
机构
[1] Educ Univ Hong Kong, Dept Hlth & Phys Educ, Hong Kong, Peoples R China
[2] City Univ Hong Kong, Dept Social & Behav Sci, Hong Kong, Peoples R China
[3] King Juan Carlos Univ, Dept Psychol, Madrid, Spain
[4] Hong Kong Polytech Univ, Dept Appl Social Sci, Hong Kong, Peoples R China
[5] Stanford Univ, Dept Psychiat & Behav Sci, Sch Med, Stanford, CA 94305 USA
[6] Univ Calif Davis, Betty Irene Moore Sch Nursing, Davis, CA 95616 USA
关键词
dementia; family caregiving; caregiver interventions; meta-analysis; systematic review; RANDOMIZED CONTROLLED-TRIAL; QUALITY-OF-LIFE; COGNITIVE-BEHAVIORAL THERAPY; MENTAL-HEALTH OUTCOMES; FAMILY CAREGIVERS; ALZHEIMERS-DISEASE; TRAINING-PROGRAM; PUBLICATION BIAS; CARE MANAGEMENT; PSYCHOSOCIAL INTERVENTION;
D O I
10.1037/pag0000401
中图分类号
R4 [临床医学]; R592 [老年病学];
学科分类号
1002 ; 100203 ; 100602 ;
摘要
This systematic review and meta-analysis compared the effects of 131 randomized controlled trials, published between 2006 and mid-2018, for dementia caregivers with community-dwelling care-recipients. A new classification of interventions was proposed to enable a more detailed examination of the effectiveness of psychological interventions; 350 postintervention effect sizes in 128 studies and 155 follow-up effect sizes in 55 studies were computed. Postintervention effects were significant for all outcomes when all interventions are pooled together. Follow-up effects were found for all outcomes, except physical health and positive aspects of caregiving. Educational programs with psychotherapeutic components, counseling/psychotherapy, and mindfulness-based interventions had the strongest effects on reducing depressive symptoms. Multicomponent and miscellaneous interventions had the largest effects on reduction of burden/stress. Multicomponent and mindfulness-based interventions had the largest effects on enhancing subjective well-being. It should be noted that mindfulness and counseling/psychotherapy studies generally had small samples, and studies with smaller sample sizes tended to report larger effects. Metaregression analyses revealed that, overall, younger caregivers benefited more from the interventions. Although the majority of studies were from North America and Europe, there were a growing number from Asia and other parts of the world. Recommendations were made, including developing new theoretical models that address caregivers' changing needs over time; development of interventions that can be flexibly administered and individually "tailored," and assessing positive as well as negative aspects of caregiving to encourage development of greater resilience. We conclude with observations on the global health significance of improving the impact of psychosocial interventions on caregivers' lives.
引用
收藏
页码:55 / 77
页数:23
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