Web-Based Interventions to Improve Mental Health, General Caregiving Outcomes, and General Health for Informal Caregivers of Adults With Chronic Conditions Living in the Community: Rapid Evidence Review

Abstract

BackgroundMost adults with chronic conditions live at home and rely on informal caregivers to provide support. Caregiving can result in negative impacts such as poor mental and physical health. eHealth interventions may offer effective and accessible ways to provide education and support to informal caregivers. However, we know little about the impact of Web-based interventions for informal caregivers of community-dwelling adults with chronic conditions.ObjectiveThe purpose of this rapid evidence review was to assess the impact of Web-based interventions on mental health, general caregiving outcomes, and general health for informal caregivers of persons with chronic conditions living in the community.MethodsA rapid evidence review of the current literature was employed to address the study purpose. EMBASE, MEDLINE, PsychInfo, CINAHL, Cochrane, and Ageline were searched covering all studies published from January 1995 to July 2016. Papers were included if they (1) included a Web-based modality to deliver an intervention; (2) included informal, unpaid adult caregivers of community-living adults with a chronic condition; (3) were either a randomized controlled trial (RCT) or controlled clinical trial (CCT); and (4) reported on any caregiver outcome as a result of use or exposure to the intervention.ResultsA total of 20 papers (17 studies) were included in this review. Study findings were mixed with both statistically significant and nonsignificant findings on various caregiver outcomes. Of the 17 included studies, 10 had at least one significant outcome. The most commonly assessed outcome was mental health, which included depressive symptoms, stress or distress, and anxiety. Twelve papers examined the impact of interventions on the outcome of depressive symptoms; 4 found a significant decrease in depressive symptoms. Eight studies examined the outcome of stress or distress; 4 of these found a significant reduction in stress or distress as a result of the intervention. Three studies examined the outcome of anxiety; 2 of these found significant reductions in anxiety. Other significant results of the interventions were seen in the outcomes of caregiver gain (ie, positive aspects of caregiving), knowledge, bonding, reduction of anger-hostility, and negative mood. Based on this review, it is not possible to determine which interventions were most effective since studies differed in their design, sample, and intervention. Study results suggest that Web-based interventions may result in reduced depressive symptoms, anxiety, and stress or distress among informal caregivers of adults with chronic conditions in the community.ConclusionsThis is the first review assessing the impact of Web-based technologies on mental health, general caregiving outcomes, and general health for caregivers of adults with chronic conditions living in the community. Further rigorous research is needed that includes adequately powered studies examining the critical components of the intervention and the dosage needed to have an effect.

Using a six‐step co‐design model to develop and test a peer‐led web‐based resource (PLWR) to support informal carers of cancer patients

“…Google analytics demonstrated that demand for the resource was good with 2800 visits within 6 months and 750 repeat visits, of these repeat visitors 70% visited the site multiple times. Set in the context of 9000 new cancer cases per year in Northern Ireland, a high usage trend supports the evidence that carers regularly access web‐based information . The majority of visitors were directed to the site via Facebook and Google and accessed via a mobile device.…”

“…9 Interventions targeted at the cancer carer can improve outcomes such as quality of life and caregiver burden, [14][15][16][17][18][19] in particular those utilizing technology and a self-directed format. 20 A review of web-based interventions for carers across various chronic illnesses found positive changes in psychological health, knowledge, and relationships; however, much of the quality of these studies were deemed as methodologically weak, and therefore more work on the subject is needed. 20 It is argued that the best way to ensure that interventions meet the needs of the target population is to involve stakeholders in design and development.…”

“…20 A review of web-based interventions for carers across various chronic illnesses found positive changes in psychological health, knowledge, and relationships; however, much of the quality of these studies were deemed as methodologically weak, and therefore more work on the subject is needed. 20 It is argued that the best way to ensure that interventions meet the needs of the target population is to involve stakeholders in design and development. 21,22 This process known as co-design has the potential to increase intervention effectiveness.…”

What is known from the existing literature about peer support interventions for carers of individuals living with dementia: A scoping review

“…Online mode of delivery was utilised in 43% ( n = 12/28) of the studies, although representing just under half of the identified research it demonstrates that its usage is being considered as a credible method. This mode of delivery for interventions for carers of individuals living with chronic diseases other than dementia, has been shown to effectively improve self‐esteem, self‐efficacy and depression (Ploeg et al, ). Web‐based interventions in particular are beneficial for informal carers due to the 24/7 nature of caring and consequent difficulties in accessing services (Duggleby et al, ).…”

Psychological Symptomatology in Informal Caregivers of Persons with Dementia: Influences on Health-Related Quality of Life

“…The provision of extraordinary care for a person with Alzheimer's disease or other dementias to develop activities of daily living (ADLs) and instrumental activities of daily living (IADLs) resides in a person who is considered as a caregiver [1]. Sometimes the role of caregiver may be perceived as a satisfying and rewarding task [4,5]; nevertheless, providing continued support to people with dementia entails an enormous short and long term effort because of the irrepressible decline caused by the disease [6]. In addition, the task may prove difficult, requiring caregivers to face stressful and uncontrolled situations as a result of having to deal with a wide range of care conditions, some of which are very complex [7].…”