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Abstract
BackgroundDespite the existence of formal professional support services, informal support (mainly family members) continues to be the main source of eldercare, especially for those who are dependent or disabled. Professionals on the primary health care are the ideal choice to educate, provide psychological support, and help to mobilize social resources available to the informal caregiver.Controversy remains concerning the efficiency of multiple interventions, taking a holistic approach to both the patient and caregiver, and optimum utilization of the available community resources. .For this reason our goal is to assess whether an intervention designed to improve the social support for caregivers effectively decreases caregivers burden and improves their quality of life.Methods/designDesign: Controlled, multicentre, community intervention trial, with patients and their caregivers randomized to the intervention or control group according to their assigned Primary Health Care Team (PHCT).Study area: Primary Health Care network (9 PHCTs).Study participants: Primary informal caregivers of patients receiving home health care from participating PHCTs.Sample: Required sample size is 282 caregivers (141 from PHCTs randomized to the intervention group and 141 from PHCTs randomized to the control group.Intervention: a) PHCT professionals: standardized training to implement caregivers intervention. b) Caregivers: 1 individualized counselling session, 1 family session, and 4 educational group sessions conducted by participating PHCT professionals; in addition to usual home health care visits, periodic telephone follow-up contact and unlimited telephone support.Control: Caregivers and dependent patients: usual home health care, consisting of bimonthly scheduled visits, follow-up as needed, and additional attention upon request.Data analysisDependent variables: Caregiver burden (short-form Zarit test), caregivers’ social support (Medical Outcomes Study), and caregivers’ reported quality of life (SF-12)Independent variables: a) Caregiver: sociodemographic data, Goldberg Scale, Apgar family questionnaire, Holmes and Rahe Psychosocial Stress Scale, number of chronic diseases. b) Dependent patient: sociodemographic data, level of dependency (Barthel Index), cognitive impairment (Pfeiffer test).DiscussionIf the intervention intended to improve social and family support is effective in reducing the burden on primary informal caregivers of dependent patients, this model can be readily applied throughout usual PHCT clinical practice.Trial registrationClinical trials registrar: NCT02065427
Highlights
Despite the existence of formal professional support services, informal support continues to be the main source of eldercare, especially for those who are dependent or disabled
If the intervention intended to improve social and family support is effective in reducing the burden on primary informal caregivers of dependent patients, this model can be readily applied throughout usual primary health care team (PHCT) clinical practice
Support decreases as years go by, and a negative first experience with caregiving can mean that the same person will not want to do it again and may prematurely choose the alternative of institutionalizing a dependent family member
Summary
Despite the existence of formal professional support services, informal support (mainly family members) continues to be the main source of eldercare, especially for those who are dependent or disabled. Professionals on the primary health care are the ideal choice to educate, provide psychological support, and help to mobilize social resources available to the informal caregiver. Despite the existence of formal professional support services, informal support continues to be the main source of eldercare, especially for those who are dependent or disabled [2,3]. Members are the main source of informal support for the dependent person, and their support is a clear predictor of the patient’s ability to remain in the home community and delay –or avoid– institutionalization. The person who takes the major responsibility for this care is defined as the primary caregiver for the dependent patient [5,6]
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