Effectiveness of a psychoeducational intervention for caregivers of People With Dementia with regard to burden, anxiety and depression: A systematic review

Abstract

Aim To assess the effectiveness of psychoeducational interventions with respect to burden, anxiety and depression in family caregivers of People With Dementia living at home. Background In dementia, the family assumes the role of main caregiver, maintaining the patient in a good state of health. Nevertheless, burden, anxiety and depression may have negative repercussions in caregivers. Therefore, professional supports through psychoeducational programmes are recommended as interventions for improving caregivers' health. Design A quantitative systematic review. Data Sources Electronic searches were performed in CINAHL/AMED/CENTRAL/Web of Science/LILACS/PUBMED from January 2005–August 2018. Review Methods The review was conducted using the JADAD scale to assess bias risk and the quality of the randomized controlled trials (RCTs) and the CONSORT instrument to assess study quality report. The extracted data were reviewed by independent reviewer pairs. The review was reported using PRISMA. Results A total of 18 RCTs met inclusion criteria. Seven were classified as Technology‐based Interventions and 11 as Group‐based Interventions. Conclusion Psychoeducational interventions for caregivers allow them to increase their knowledge of the illness, develop problem‐solving skills and facilitate social support. Technology‐based Interventions significantly affect burden while Group‐based Interventions affect anxiety, depression, insomnia and burden and quality of life and self‐efficacy. Impact Research findings can be used to classify caregivers in future interventions according to illness stage to obtain more precise results.

Informal Caregivers’ Roles in Dementia: The Impact on Their Quality of Life

“…The adjustments for daily activities generate a change in the roles in a family, so that a member becomes an informal caregiver (IC), usually the spouse or one of the offspring [ 4 ]. It is estimated that about 84% of PwD live in their own home and it is the caregiver who is responsible for keeping them in optimal health; this role can extend up to an average of 6.5 years [ 4 , 5 , 6 ].…”

“…Due to the considerable stress involved, it is essential to prevent the physical and mental effects on the IC, which include cardiovascular disease, stress-related disorders, burden, sleep problems, anxiety, and even depression, all of which affect the informal caregivers’ role [ 6 ]. In fact, there is strong evidence that the feeling of burden among IC of PwD is greater than in other types of care and that this frequently leads to them working fewer hours or losing their job, with a resulting decrease in their own quality of life (QoL) [ 4 , 5 , 6 ]. Some studies show that the emotional effects of burden can also have a negative impact on the PwD’s life, which can be even greater than the degree of severity of the disease itself [ 7 , 8 ].…”

“…They conclude that intervening to decrease or control NS and depressive symptoms in the PwD will improve or maintain informal caregivers’ QoL [ 9 ]. Nevertheless, caring generates positive aspects with respect to ICs’ satisfaction with the work carried out, the ability to overcome certain difficulties and the strengthening of the bond with the person receiving care [ 5 ]. Under these circumstances, home care needs to be oriented towards improving ICs’ roles and to improving the self-perceived caregiver’s QoL, reducing burden, and promoting home management strategies [ 5 , 7 ].…”

“…Nevertheless, caring generates positive aspects with respect to ICs’ satisfaction with the work carried out, the ability to overcome certain difficulties and the strengthening of the bond with the person receiving care [ 5 ]. Under these circumstances, home care needs to be oriented towards improving ICs’ roles and to improving the self-perceived caregiver’s QoL, reducing burden, and promoting home management strategies [ 5 , 7 ]. In this sense, professional support and counselling allow for the early detection and prevention of alterations in the IC’s physical and mental health [ 5 ].…”

Psychoeducational intervention on burden and emotional well‐being addressed to informal caregivers of people with dementia

“…In dementia, progressive loss of autonomy in activities as basic as showering, dressing or eating results in a constant search for help among friends and family. There is a change in roles in the nucleus of the family and, in general, one of the family members becomes the main or informal caregiver (IC) 2, 7–9 . There is a lack of awareness and understanding of dementia in most countries, which leads to an increase in stigmatisation and barriers to diagnosis and care that affect caregivers and the entire family.…”