Long-Term Outcomes of the Benefit-Finding Group Intervention for Alzheimer Family Caregivers: A Cluster-Randomized Double-Blind Controlled Trial

Cheng, Sheung‐Tak; Chan, Wai Chi; Lam, Ling Ning

doi:10.1016/j.jagp.2019.03.013

Cited by 31 publications

(37 citation statements)

References 34 publications

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“…In a series of analyses, we demonstrated that BFT increased caregivers' PAC and SE-CUT, that only SE-CUT uniquely predicted the outcomes longitudinally, and that only SE-CUT mediated BFT effects on depressive symptoms. There was no mediation effect on global burden, although it was predicted by SE-CUT and both burden (Cheng, Chan, & Lam, 2019) and SE-CUT (this study) were impacted by BFT. Taken together, the analyses provided a thorough support for SE-CUT being a therapeutic mechanism of BFT.…”

Section: Discussioncontrasting

confidence: 58%

“…The group form of the BFT, delivered by paraprofessionals, consisted of eight biweekly sessions and was evaluated against two variants of psychoeducation matched on exposure. The outcome analysis has been reported earlier (Cheng, Chan, & Lam, 2019; Cheng, Fung, et al, 2016). At 4- and 10-month follow-up, BFT led to improvements in depressive symptoms ( d = −0.70 to −0.89) and global burden ( d = −0.47 to −0.56), although the improvements leveled off after the first follow-up.…”

Section: Testing Therapeutic Mechanisms In An Intent-to-treat Contextmentioning

confidence: 99%

“…Other information obtained included the caregiver's education, employment, household income, relationship and whether living together with the care recipient, caregiving duration, use of psychotropic medications, and community services used. These variables were not used because they were found to be uncorrelated with the outcome variables in preliminary analysis (Cheng, Chan, & Lam, 2019). This document is copyrighted by the American Psychological Association or one of its allied publishers.…”

Section: Covariatesmentioning

confidence: 99%

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Self-efficacy in controlling upsetting thoughts, but not positive gains, mediates the effects of benefit-finding group intervention for Alzheimer family caregivers.

Cheng¹,

Chan²,

Fung³

et al. 2022

Psychology and Aging

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This study aimed to examine the therapeutic mechanism of the benefit-finding therapeutic (BFT) intervention that used cognitive reappraisal and alternative thinking to construct positive aspects of caregiving (PAC), in a cluster-randomized controlled trial for Alzheimer caregivers. Forty two caregivers received BFT, whereas 87 received psychoeducation as control. Depressive symptoms and global burden were outcomes measured at baseline, postintervention, and 4-and 10-month follow-up. Mediators considered included PAC (measured by benefit word count to a qualitative measure) and three self-efficacies-controlling upsetting thoughts (SE-CUT), responding to disruptive behaviors, and obtaining respite. Using mixed-effects regression, we demonstrated that benefit-finding increased caregivers' PAC and SE-CUT, but that only SE-CUT uniquely predicted depressive symptoms and global burden longitudinally. Path analyses with bootstrapped confidence intervals, using full information maximum likelihood estimation to retain the whole sample with partial missing data, showed that SE-CUT change from baseline to postintervention mediated intervention effects on depressive symptoms, but not global burden, at both follow-ups. No mediation effects were found for PAC and the other self-efficacies. The BFT effect on depressive symptoms was partly accounted for by improvement in SE-CUT. The therapeutic mechanism for the effect on burden remained unknown. The study sheds light on the importance of actively promoting positive caregiver functioning.

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Section: Discussioncontrasting

confidence: 58%

Section: Testing Therapeutic Mechanisms In An Intent-to-treat Contextmentioning

confidence: 99%

Section: Covariatesmentioning

confidence: 99%

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Self-efficacy in controlling upsetting thoughts, but not positive gains, mediates the effects of benefit-finding group intervention for Alzheimer family caregivers.

Cheng¹,

Chan²,

Fung³

et al. 2022

Psychology and Aging

Self Cite

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“…Effects were discussed or analyzed without differentiating types of intervention, or without categorizing interventions psychoeducational in nature (i.e., with structured content and delivery using a heavily educational, rather than psychotherapeutic, approach) and included CBT techniques in one or more of their modules. These interventions were recently recognized as psychoeducation with psychotherapeutic components [78,79], a subtype of psychoeducation distinguished from others that do not borrow from psychotherapeutic approaches. Other reviews would have classified these interventions under the category of psychoeducation or psychotherapy.…”

Section: Study Characteristicsmentioning

confidence: 99%

A comprehensive meta-review of systematic reviews and meta-analyses on nonpharmacological interventions for informal dementia caregivers

Cheng

Zhang

2020

BMC Geriatr

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Background: Many reviews with conflicting findings on dementia caregiver interventions have been published. A meta-review was conducted to synthesize the findings of systematic reviews and meta-analyses. Methods: MEDLINE, PsycINFO, CINAHL and Cochrane Library were searched to identify reviews published during 2006-2018. Results: Sixty reviews covering > 500 intervention studies were selected and appraised with Assessment of Multiple Systematic Reviews (AMSTAR) II. The great majority of studies were of low quality according to AMSTAR II, but quality factors appeared unrelated to the conclusions obtained. Depression was most modifiable, with effects found across a spectrum of interventions (psychoeducation, counseling/psychotherapy, occupational therapy, mindfulnessbased interventions, multicomponent interventions, etc.). Evidence of intervention effect was also found for quality of life (psychoeducation), mastery (psychoeducation, occupational therapy and multicomponent interventions) and communication skills (communication training). Null or weak results were found for anxiety, social support and burden. Support groups and respite were generally ineffective. There was no evidence that dyadic programs were better than caregiver-only programs, or that programs delivered individually or in groups would differ in their impacts. The evidence also does not support multicomponent interventions to have broader impacts than single-component programs. Methodological issues in the existing reviews (e.g., selective use of studies to serve different research purposes and inconsistent classification of interventions) were noted and taken into account when interpreting findings. (Continued on next page)Conclusions: This meta-review clarified variations in review methodology and identified a few potent groups of intervention (most notably psychoeducation, psychotherapy, occupational therapy, and multicomponent interventions), although no intervention type had broad effects on caregiver outcomes. We note that improvements are needed in the reporting of intervention studies and in making the classification of interventions more transparent and consistent. We further recommend fewer and larger-scale reviews and more attention to positive outcomes in order to better inform the field. Developing interventions with broader impacts and packaging them to meet caregivers' changing needs in the course of dementia should be a priority for researchers and practitioners.

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“…The adult caregiver's quality of life questionnaire used was a Chinese version of the questionnaire revised by Mei et al [14]. It includes 5 dimensions with 31 items in total, which are care benefit-finding (13 items), care pressure (6 items), care options (5 items), care support (4 items) and money issue (3 items).…”

Section: Evaluation Methodsmentioning

confidence: 99%

Effects of care transitions intervention mode on the beneﬁt-ﬁnding in caregivers for patients with acute cerebral infarction

2021

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To explore the effect of care transitions intervention (CTI) on the sense of benefit-finding of caregivers for patients with acute cerebral infarction (ACI). Ninety caregivers for patients with ACI were divided into two groups according to the random number table method (n = 45 in each group). The control group was given regular health guidance, and the intervention group was given care transitions intervention on the basis of the guidance used in the control group. The changes in the sense of benefit-finding and quality of life between the two groups were compared before and after the intervention. There was no statistically significant difference in caregivers between the two groups in gender, age, educational level, occupational status, gender and age of the patients, activities of daily living (ADL) scores before discharge, and the relationships between the caregiver and the patient. Before CTI, there was no statistically significant difference in the caregivers’ sense of benefit-finding (including sense of benefit, family relationship, personal growth, social relationship and healthy behavior) and quality of life (including benefit-finding of care, stress of care, choice of care, support to care and money issue) between the two groups. While after CTI, the scores of each dimension of the caregivers’ sense of benefit-finding and quality of life in the intervention group were significantly higher than those in the control group (p < 0.05). The CTI can help improve the sense of benefit-finding and quality of life of caregivers for patients with ACI.

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Long-Term Outcomes of the Benefit-Finding Group Intervention for Alzheimer Family Caregivers: A Cluster-Randomized Double-Blind Controlled Trial

Abstract: Kong to Sheung-Tak Cheng. The funding source had no involvement in any part of the project. We have no disclosures to report.

Cited by 31 publications

References 34 publications

Self-efficacy in controlling upsetting thoughts, but not positive gains, mediates the effects of benefit-finding group intervention for Alzheimer family caregivers.

Self-efficacy in controlling upsetting thoughts, but not positive gains, mediates the effects of benefit-finding group intervention for Alzheimer family caregivers.

A comprehensive meta-review of systematic reviews and meta-analyses on nonpharmacological interventions for informal dementia caregivers

Effects of care transitions intervention mode on the beneﬁt-ﬁnding in caregivers for patients with acute cerebral infarction

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