Psychological interventions for depression among informal caregivers of older adult populations: protocol of a systematic review and meta-analysis of randomised controlled trials

Abstract

IntroductionIncreased life expectancy has led to an increased demand for family members to provide informal care for their older relatives in the home. Many studies suggest informal caregivers are at greater risk of experiencing symptoms of depression. However, there is a lack of research examining the effectiveness of psychological interventions targeting these symptoms alongside clinical and methodological moderators potentially associated with intervention effectiveness. This review aims to address this gap and will inform the development of a psychological intervention targeting depression among adult-child caregivers of older parents, given many studies show that among informal caregivers of older adults, adult children experience specific difficulties and needs for psychological support. Further, the lack of studies targeting adult children specifically necessitates conducting this review targeting caregivers of older adults in general.Methods and analysisRandomised controlled trials of psychological interventions targeting symptoms of depression among informal caregivers will be identified via a systematic search of electronic databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica DataBase, PsycINFO, Cochrane Library and Web of Science) and supplemented by handsearching of previous systematic reviews, reference and forward citation checking, and expert contact. If possible, a meta-analysis will be conducted to examine the: (1) effectiveness of psychological interventions for depression among informal caregivers of older adults, (2) effectiveness of psychological interventions for secondary outcomes such as anxiety, stress, caregiver burden, psychological distress, quality of life, well-being and self-efficacy and (3) moderating effects of clinical and methodological factors on effectiveness.Ethics and disseminationEthical approval will not be necessary for this study given primary data will not be collected. Results will inform the development of a psychological intervention for adult-child caregivers of older parents and will be disseminated through publication in peer-reviewed journals and conference presentations.PROSPERO registration numberCRD42020157763.

Effectiveness of cognitive behavioural therapy-based interventions for maternal perinatal depression: a systematic review and meta-analysis

“…Only RCTs were included, with non-randomized and uncontrolled designs excluded. RCTs with randomization procedures explicitly not randomly allocated and/or with sequences not explicitly concealed (high risk of bias, in line with the Cochrane Collaboration’s Risk of Bias tool 2.0 (RoB 2.0)) [ 60 ] were excluded, in accordance with previous reviews, [ 57 , 61 ] to minimize the risk of an inflated overall effect size resulting from the inclusion of low-quality studies [ 62 ].…”

“…Only RCTs were included, with non-randomized and uncontrolled designs excluded. RCTs with randomization procedures explicitly not randomly allocated and/ or with sequences not explicitly concealed (high risk of bias, in line with the Cochrane Collaboration's Risk of Bias tool 2.0 (RoB 2.0)) [60] were excluded, in accordance with previous reviews, [57,61] to minimize the risk of an inflated overall effect size resulting from the inclusion of low-quality studies [62]. OR "problem solving" OR ccbt OR icbt OR "cognitive restructuring" OR "cognitive reframing" OR "activity scheduling") AND (therapy OR therapies OR psychotherapy OR intervention OR management OR "program evaluation" OR program OR programs OR programme OR programmes OR group OR course OR online OR internet OR web OR "web-based" OR phone OR telephone OR skype OR "e-therapy" OR etherapy OR "computer assisted" OR "internet intervention" OR computer OR computerised OR computerized OR mobile OR tablet OR smartphone OR "internet administered" OR "e-mental health" OR "m-mental health" OR Ehealth OR "e-health" OR "e-intervention") AND ("randomized controlled trial" OR "randomized control trial" OR RCT OR controlled OR randomised OR randomized OR randomisation OR randomization OR "random assignment" OR "random allocation" OR random OR randomly OR control OR feasibility OR pilot OR "comparative study" OR "follow up" OR meta-analysis OR "meta analysis" OR review).…”

Effectiveness, acceptability, and completeness and quality of intervention reporting of psychological interventions for people with dementia or mild cognitive impairment: protocol for a mixed-methods systematic review

“…Sensitivity analysis regarding the overall effect size for each primary outcome (mental health and psychological well-being for people with dementia or MCI) will be conducted by temporarily removing: (1) each study individually; (2) studies with high attrition (≥30% in at least one trial arm); (3) studies with a small sample size (≤20 in at least one trial arm) 53 54 ; and (4) studies rated as high, moderate, and low risk of bias.…”

“…Non-RCTs will be excluded. Given the likelihood that including studies of low quality, [51][52][53][54] or without a proper RCT design inflates the effect size, 26 27 studies rated as high risk of bias regarding allocation and concealment randomisation processes in accordance with the RoB 2 tool 55 will be excluded.…”

Living arrangements and intergenerational support among older Chinese: Does the gender of the co-resident adult children make a difference?

“…Regarding this study's implications for gerontological interventions, there is, in the context of Eastern Asian social work and particularly in China, a lack of research focus on the impact of adult children's gender on the support given their older parents (Mårtensson et al, 2020). In that sense, more social work interventions or programmes that advocate egalitarian gender norms should be launched in urban and rural communities.…”