Abstract
BackgroundNonprofessional carers who provide support to an individual with a psychiatric or neurological disorder will often themselves experience symptoms of stress, anxiety, or low mood, and they perceive that they receive little support. Internet-based interventions have previously been found to be effective in the prevention and treatment of a range of mental health difficulties in carers.ObjectiveThis review seeks to establish the status of internet-based interventions for informal (nonprofessional) carers of people with psychiatric or neurological disorders by investigating (1) the number and quality of studies evaluating the efficacy or effectiveness of internet-based carer interventions and (2) the impact that such interventions have on carer mental health, as well as (3) how internet-based interventions compare with other intervention types (eg, face-to-face treatment).MethodsA systematic literature search was conducted in January 2019 using the EMBASE (1974-present), Ovid MEDLINE (1946-present), PsychARTICLES, PsychINFO (1806-present), and Global Health (1973-present) databases, via the Ovid Technologies database. Search terms included carer, caregiver, online, technology, internet-based, internet, interactive, intervention, and evaluation. Studies selected for inclusion in this review met the following predetermined criteria: (1) delivering an intervention aimed primarily at informal carers, (2) carers supporting individuals with psychiatric disorders, stroke, dementia, or brain injury, (3) the intervention delivered to the carers was primarily internet based, (4) the study reported a pre- and postquantitative measure of carer depression, anxiety, stress, burden, or quality of life, (5) appeared in a peer-reviewed journal, and (6) was accessible in English.ResultsA total of 46 studies were identified for inclusion through the detailed search strategy. The search was conducted, and data were extracted independently by 2 researchers. The majority of studies reported that 1 or more measures relating to carer mental health improved following receipt of a relevant intervention, with interventions for carers of people with traumatic brain injury showing a consistent link with improved outcomes.ConclusionsStudies investigating internet-based interventions for carers of individuals with diverse psychiatric or neurological difficulties show some evidence in support of the effectiveness of these interventions. In addition, such interventions are acceptable to carers. Available evidence is of varying quality, and more high-quality trials are needed. Further research should also establish how specific intervention components, such as structure or interactivity, contribute to their overall efficacy with regard to carer mental health.
Highlights
BackgroundNonprofessional carers are individuals who provide free-of-charge care for another person, who would find it difficult to cope without the carer’s support
This review seeks to establish the status of internet-based interventions for informal carers of people with psychiatric or neurological disorders by investigating (1) the number and quality of studies evaluating the efficacy or effectiveness of internet-based carer interventions and (2) the impact that such interventions have on carer mental health, (3) as well as how internet-based interventions compare with other intervention types
Of the 46 studies identified for inclusion in the review, 16 Randomized controlled trials (RCTs) and 0 non-RCTs were rated as high quality, 11 RCTs and 6 non-RCTs were rated as moderate quality, and 2 RCTs and 11 non-RCTs were rated as low quality
Summary
BackgroundNonprofessional (or informal) carers are individuals who provide free-of-charge care for another person (usually a family member or friend), who would find it difficult to cope without the carer’s support. Informal carers play a crucial role in providing both practical and emotional care for individuals with a wide range of difficulties, including physical and mental health difficulties, disabilities, or addictions. It has been widely documented that caring for a loved one with a long-term illness can have a multitude of effects on the informal carer, including increased levels of perceived burden [3], feelings of entrapment, shame, guilt [4], and higher rates of physical symptoms, such as fatigue, headaches, and weight loss [5]. It is important to recognize that disorder- or patient-related factors can profoundly impact carers’ experience of caregiving Such factors may include the nature and severity of different symptoms, societal reactions, and certain pathologies, which may vary widely both within and between disorders. Internet-based interventions have previously been found to be effective in the prevention and treatment of a range of mental health difficulties in carers
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