The effectiveness of psychosocial interventions for stroke family caregivers and stroke survivors: A systematic review and meta-analysis

Cheng, Ho Yu; Chau, Janita Pak Chun

doi:10.1016/j.pec.2014.01.005

Cited by 118 publications

(164 citation statements)

References 61 publications

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“…Of the reviews, 14 [19][20][21][22][23][24][25][26][27][28][29][30][31][32] focused on interventions for carers of people with dementia, four [33][34][35][36] focused on carers of people with cancer, four [37][38][39][40][41] focused on carers of people with stroke, three [42][43][44] focused on carers of people with various conditions at the end of life and two 45,46 focused on carers of people with mental health problems. Not all reviews reported the geographic location of the included primary studies.…”

Section: Overview Of the High-quality Reviewsmentioning

confidence: 99%

“…Multicomponent interventions were the focus in many reviews; those with psychosocial or psychoeducational content featured prominently, 28,[34][35][36][37][38]46 as did those containing education and/or communication skills training. 21,24,26,40,44,45 Other (more specific) interventions included stroke liaison workers, 39 volunteer mentoring, 32 meditation-based activity, 23 art-making classes 33 and home-based exercise.…”

Section: Overview Of the High-quality Reviewsmentioning

confidence: 99%

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Updated meta-review of evidence on support for carers

Thomas

Dalton

Harden

et al. 2017

Health Serv Deliv Res

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BackgroundPolicy and research interest in carers continues to grow. A previous meta-review, published in 2010, by Parkeret al.(Parker G, Arksey H, Harden M.Meta-review of International Evidence on Interventions to Support Carers. York: Social Policy Research Unit, University of York; 2010) found little compelling evidence of effectiveness about specific interventions and costs.ObjectiveTo update what is known about effective interventions to support carers of ill, disabled or older adults.DesignRapid meta-review.SettingAny relevant to the UK health and social care system.ParticipantsCarers (who provide support on an unpaid basis) of adults who are ill, disabled or older.InterventionsAny intervention primarily aimed at carers.Main outcome measuresAny direct outcome for carers.Data sourcesDatabase searches (including Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, MEDLINE, Applied Social Sciences Index and Abstracts and Social Care Online) for systematic reviews published from January 2009 to 2016.Review methodsWe used EndNote X7.4 (Thomson Reuters, CA, USA) to screen titles and abstracts. Final decisions on the inclusion of papers were made by two reviewers independently, using a Microsoft Excel®2013 spreadsheet (Microsoft Corporation, Redmond, WA, USA). We carried out a narrative synthesis structured by patient condition and by seven outcomes of interest. We assessed the quality of the included systematic reviews using established criteria. We invited a user group of carers to give their views on the overall findings of our review.ResultsSixty-one systematic reviews were included (27 of high quality, 25 of medium quality and nine of low quality). Patterns in the literature were similar to those in earlier work. The quality of reviews had improved, but primary studies remained limited in quality and quantity. Of the high-quality reviews, 14 focused on carers of people with dementia, four focused on carers of those with cancer, four focused on carers of people with stroke, three focused on carers of those at the end of life with various conditions and two focused on carers of people with mental health problems. Multicomponent interventions featured prominently, emphasising psychosocial or psychoeducational content, education and training. Multiple outcomes were explored, primarily in mental health, burden and stress, and well-being or quality of life. Negative effects following respite care were unsupported by our user group. As with earlier work, we found little evidence on intervention cost-effectiveness. No differences in review topics were found across high-, medium- and low-quality reviews.LimitationsThe nature of meta-reviews precludes definitive conclusions about intervention effectiveness, for whom and why. Many of the included reviews were small in size and authors generally relied on small numbers of studies to underpin their conclusions. The meta-review was restricted to English-language publications. Short timescales prevented any investigation of the overlap of primary studies, and growth in the evidence base since the original meta-review meant that post-protocol decisions were necessary.ConclusionsThere is no ‘one size fits all’ intervention to support carers. Potential exists for effective support in specific groups of carers. This includes shared learning, cognitive reframing, meditation and computer-delivered psychosocial support for carers of people with dementia, and psychosocial interventions, art therapy and counselling for carers of people with cancer. Counselling may also help carers of people with stroke. The effectiveness of respite care remains a paradox, given the apparent conflict between the empirical evidence and the views of carers.Future workMore good-quality, theory-based, primary research is warranted. Evidence is needed on the differential impact of interventions for various types of carers (including young carers and carers from minority groups), and on the effectiveness of constituent parts in multicomponent programmes. Further research triangulating qualitative and quantitative evidence on respite care is urgently required. The overlap of primary studies was not formally investigated in our review, and this warrants future evaluation.Study registrationThis study is registered as PROSPERO CRD42016033367.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Overview Of the High-quality Reviewsmentioning

confidence: 99%

Section: Overview Of the High-quality Reviewsmentioning

confidence: 99%

Updated meta-review of evidence on support for carers

Thomas

Dalton

Harden

et al. 2017

Health Serv Deliv Res

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“…En fazla örneklem sayısına, meta-analiz çalışmasında ulaşılmıştır (1723 aile bakım verici ve 1836 inmeli hasta). 22 En az örneklem 21'i müdahale, 19'u kontrol grubu olmak üzere (40 aile bakım vericisi) oluşturmaktadır.…”

Section: Bulgularunclassified

“…On sekiz randomize kontrollü çalışmanın, dördünde SVH'lı hastaların sağlık bakım hizmetleri kullanımı azalmıştır. 22 Bakım 28 Uygulanan başka bir grup eğitiminde, bakım vericilere iletişim stratejileri, stres ve duygu yönetimi, gevşeme, iletişim hizmetlerine erişim ve koruyucu önlemlerin öğretimi yapılmıştır. Girişim sonrasında, iletişim becerileri açısından müdahale ve kontrol grubu arasında önemli bir fark belirlenmemiştir.…”

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“…Bakım vericileri geliştirme, güçlendirmeye yönelik bu girişimler maliyet etkili olduğu için uygulanabilir. 22,24,27,28,30,31,36 İnme öz yönetimini artırmak için yapılan bir çalışma, 10 hafta iki saatlik grup eğitimlerinden oluşmaktadır. Uygulanan öz yönetim programının en önemli sonuçlarından biri, bakım verenlerin topluma katılım oranındaki artıştır.…”

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İnmeli Hastaların Ailelerinin, Bakım Verme Yeterliliğini Geliştirmek İçin Yapılan Girişimler: Sistematik Derleme

Avcı¹,

Gözüm²,

Özer³

2016

TJFMPC

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Objective: It is to determine interventions performed to develop competence of family caregivers of patients with stroke in coping with caregiving and what are they of these interventions. Method: 20 randomized controlled studies, one of them meta-analysis, were evaluated in accordance with inclusion criteria. All studies were systematized and examined. Results: Types of interventions made to the caregivers were consultancy via phone, e-mail, web aided training, home visits, and group education. The intervention provided to caregivers was found to be effective in 15 of 20 studies included in the study. In other five studies, there was no statistical difference in terms of a measured parameter; whereas, it was found useful for caregivers in at least one of the other measured parameters. Conclusion: The fact that interventions for strengthening caregivers were highly effective points out the requirement of determining cost effective methods in future studies.Key words: Stroke, family caregivers, caregivers competence, care burden, cope with stress, systematic review ÖZET Amaç: İnmeli hastaların, aile bakım vericilerinin, bakım vermede baş etme yeterliliklerini geliştirmek amacıyla yapılan girişimler ve bu girişimlerin neler olduğunun belirlenmesidir. Yöntem: Dâhil edilme kriterlerine uygun olarak, biri meta analiz olmak üzere, 20 randomize kontrollü çalışma değerlendirilmiştir. Tüm çalışmalar sistematize edilerek incelenmiştir. Bulgular: Bakım vericilere yapılan girişim türlerinin; telefonla danışmanlık, e-posta, web destekli eğitim, ev ziyaretleri ve grup eğitimi olduğu belirlenmiştir. Araştırma kapsamına alınan 20 araştırmanın, 15'inde bakım vericilere yapılan girişimin etkin olduğu belirlenmiştir. Diğer beş araştırmada ise, ölçülen bir parametrede istatistik açısından farklılık yok iken, ölçülen diğer parametrelerin en az birinde girişimin bakım verenler için faydalı olduğu belirlenmiştir. Sonuç: Bakım vericileri güçlendirmeye yönelik girişimlerin büyük oranda etkin olması, gelecek çalışmalarda maliyet etkili yöntemlerin belirlenmesi gerektiğine işaret etmektedir.Anahtar kelimeler: İnme, aile bakım verici, bakım verme yeterliliği, bakım yükü, stresle başa çıkma, sistematik derleme

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