Psychosocial Intervention For Family Caregivers Research Articles

Rehabilitation Professionals' Perspectives on Psychosocial Needs of Family Caregivers of Persons with Spinal Cord Injury: A Qualitative Study from India.

This study explored the psychosocial needs of family caregivers of persons with spinal cord injuries from the perspective of rehabilitation professionals. An exploratory qualitative approach was used, and a total of 14 rehabilitation professionals from various backgrounds participated in face-to-face interviews. All interviews were audio recorded, and session notes were added to the existing data and later transcribed. Thematic analysis was used to identify key themes. Nine need themes emerged: informational, psychological, personal care, financial, social support, welfare, vocational, telemedicine, and referral. The findings of this study will aid the design or development of need-based customized psychosocial interventions for family caregivers of persons with spinal cord injuries in India. Multiple stakeholders involved in spinal cord injury management should understand the importance of meeting the needs of family caregivers of persons with spinal cord injuries and the timely delivery of customized psychosocial interventions.

Quality of life among family caregivers of people with schizophrenia in rural China.

To investigate quality of life (QoL) of family caregivers of people with schizophrenia and examine the influencing factors of the QoL in a Chinese rural area. This study included people with schizophrenia (n = 269) and their family caregivers (n = 269) from Xinjin district, Chengdu, China. Family caregivers' QoL was measured by the World Health Organization Quality of Life-Brief Form and its influencing factors was analyzed by the multivariate regression. Family caregivers of people with schizophrenia had very poor QoL across four domains. The regression analysis showed that physical domain of QoL was significantly associated with age, psychiatric symptoms of people with schizophrenia, and caregiving burden of family caregivers (p < 0.05). Psychological domain of QoL was significantly related to family caregivers' affiliate stigma, caregiving burden, and psychiatric symptoms of people with schizophrenia (p < 0.05). Social domain of QoL was significantly associated with age and psychiatric symptoms of people with schizophrenia, and affiliate stigma of family caregivers (p < 0.05). Environmental domain of QoL was significantly related to age and psychiatric symptoms of people with schizophrenia, and family caregivers' caregiving burden (p < 0.05). Family caregivers of people with schizophrenia had poor QoL in rural China. Family caregivers' QoL is significantly impacted by age and psychiatric symptoms of people with schizophrenia, caregivers' affiliate stigma and caregiving burden. Providing social support and psychosocial interventions for family caregivers of people with schizophrenia might be crucial to improve their QoL and caregiving.

Place4Carers: a multi-method participatory study to co-design, piloting, and transferring a novel psycho-social service for engaging family caregivers in remote rural settings

BackgroundFamily caregivers are key actors in the ageing society. They are mediators between practitioners and patients and usually provide also essential daily services for the elders. However, till now, few services have been deployed to help caregivers in their care tasks as in improving their mental health which can experience sever burden due to caregiving duties. The purpose of the study is to implement a community-based participatory research project to co-design an innovative organizational model of social services for family caregivers of elderly health consumers living in remote rural areas in Italy.MethodsThis is a community-based participatory research project in the remote area of Vallecamonica involving four main phases. These included a quantitative analysis of caregiver needs, a scoping review on existing services for caregivers, co-design workshops with local stakeholders and caregivers to create a novel service the piloting and a first implementation of the service and the assessment of project transferability to other contexts.ResultsAs the hours dedicated to elder care increases, both objective and developmental caregiver’s burden significantly increases. Conversely, higher levels of engagement were associated with lower physical and emotional burden, and caregiver engagement was positively correlated with their perceived self-efficacy in managing disruptive patient behaviours. Based on these preliminary results, four co-design workshops with caregivers were conducted and led to the definition of the SOS caregivers service, built on four pillars structured upon the previous need analysis: a citizens’ management board, training courses, peer-to-peer meetings, and project and service information. We found that co-design is an effective means of creating new services for family caregivers, whose experiential knowledge proved to be a key resource for the project team in delivering and managing services. Less positively, the transferability analysis indicated that local municipalities remain reluctant to acknowledge caregivers’ pivotal role.ConclusionsA dedicated support service for caregivers can ameliorate caregiving conditions and engagement levels. The service has resulted a successful co-productive initiative for a psycho-social intervention for family caregivers. For the future, we suggest that family caregiver should be considered an active partner in the process of designing novel psycho-social services and not just as recipients to enhance a better aging-in-place process.

Not Just Sitting By: Family Caregivers’ Perspectives on Triadic Communication

Most studies of communication in gerontology and palliative care focus on dyadic communication. In reality, encounters in palliative oncology very often involve three or more people: a healthcare professional, a patient, and a family caregiver. This triadic communication differs in important ways from communication involving only two parties. In this secondary analysis of qualitative data collected during a randomized controlled trial of a psychosocial intervention for family caregivers receiving palliative oncology services, researchers explored family caregivers’ (n = 63) perspectives on triadic communication encounters involving themselves, the patient and one or more clinicians. Family caregivers tended to appreciate clinicians’ efforts to involve them in communication, rather than regarding them as “just sitting by” the patient. Many perceived that their own wishes regarding information provision were often ignored and reported that their own coping and wellbeing were not often assessed outside of encounters with the specialist palliative care team.

Multimodal psychosocial intervention for family caregivers of patients undergoing hematopoietic stem cell transplantation: A randomized clinical trial.

Caregivers of patients undergoing hematopoietic stem cell transplantation (HCT) experience an immense caregiving burden before, during, and after HCT. We conducted an unblinded, randomized trial of a psychosocial intervention (BMT-CARE) for caregivers of patients undergoing autologous and allogeneic HCT at Massachusetts General Hospital. Caregivers were randomly assigned to BMT-CARE or usual care. BMT-CARE was tailored to the HCT trajectory and integrated treatment-related education and self-care with cognitive-behavioral skills to promote coping. Caregivers assigned to BMT-CARE met with a trained interventionist (a psychologist or a social worker) in person, via telephone, or via videoconferencing for 6 sessions starting before HCT and continuing up to day +60 after HCT. The primary endpoint was feasibility, which was defined as at least 60% of eligible caregivers enrolling and completing 50% or more of the intervention sessions. We assesed caregiver quality of life (QOL; Caregiver Oncology Quality of Life Questionnaire), caregiving burden (Caregiver Reaction Assessment), psychological distress (Hospital Anxiety and Depression Scale), self-efficacy (Cancer Self-Efficacy Scale-Transplant), and coping (Measures of Current Status) at baseline and 30 and 60days after HCT. We used mixed linear effect models to assess the effect of BMT-CARE on outcomes longitudinally. We enrolled 72.5% of eligible caregivers (100 of 138), and 80% attended 50% or more of the intervention sessions. Caregivers randomized to BMT-CARE reported improved QOL (B=6.11; 95% CI, 3.50-8.71; P<.001), reduced caregiving burden (B=-6.02; 95% CI, -8.49 to -3.55; P<.001), lower anxiety (B=-2.18; 95% CI, -3.07 to -1.28; P<.001) and depression symptoms (B=-1.23; 95% CI, -1.92 to -0.54; P<.001), and improved self-efficacy (B=7.22; 95% CI, 2.40-12.03; P=.003) and coping skills (B=4.83; 95% CI, 3.04-6.94; P<.001) in comparison with the usual-care group. A brief multimodal psychosocial intervention tailored for caregivers of HCT recipients is feasible and may improve QOL, mood, coping, and self-efficacy while reducing the caregiving burden during the acute HCT period.

A Web-Based Psychosocial Intervention for Family Caregivers of Older People: Results from a Mixed-Methods Study in Three European Countries

A Web-Based Psychosocial Intervention for Family Caregivers of Older People: Results from a Mixed-Methods Study in Three European Countries

A Web-Based Psychosocial Intervention for Family Caregivers of Older People: Results from a Mixed-Methods Study in Three European Countries.

BackgroundInformal caregiving is the main source of care for older people in Europe. An enormous amount of responsibility and care activity is on the shoulders of family caregivers, who might experience problems in their psychological well-being and in reconciling caregiving and their personal sphere. In order to alleviate such burden, there is increasing interest and growing research in Europe on Web-based support addressing family caregivers and their needs. However, the level of development and penetration of innovative Web-based services for caregivers is still quite low and the access to traditional face-to-face services can be problematic for logistic, availability, and quality reasons.ObjectiveAs part of the European project INNOVAGE, a pilot study was conducted for developing and testing a Web-based psychosocial intervention aimed at empowering family caregivers of older people in Italy, Sweden, and Germany. The program offered information resources and interactive services to enable both professional and peer support.MethodsA mixed-methods, sequential explanatory design was adopted. Caregivers’ psychological well-being, perceived negative and positive aspects of caregiving, and social support received were assessed before and after the 3-month intervention. Poststudy, a subsample of users participated in focus groups to assist in the interpretation of the quantitative results.ResultsA total of 94 out of 118 family caregivers (79.7%) from the three countries used the Web platform at least once. The information resources were used to different extents in each country, with Italian users having the lowest median number of visits (5, interquartile range [IQR] 2-8), whereas German users had the highest number (17, IQR 7-66) (P<.001). The interactive services most frequently accessed (more than 12 times) in all countries were the social network (29/73, 40%) and private messages (27/73, 37%). The pretest-posttest analysis revealed some changes, particularly the slight worsening of perceived positive values of caregiving (Carers of Older People in Europe [COPE] positive value subscale: P=.02) and social support received (COPE quality-of-support subscale: P=.02; Multidimensional Scale of Perceived Social Support subscale: P=.04), in all cases with small effect size (r range -.15 to -.18). Focus groups were conducted with 20 family caregivers and the content analysis of discussions identified five main themes: online social support, role awareness, caregiving activities, psychological well-being, and technical concerns. The analysis suggested the intervention was useful and appropriate, also stimulating a better self-efficacy and reappraisal of the caregivers’ role.ConclusionsThe intervention seemed to contribute to the improvement of family caregivers’ awareness, efficacy, and empowerment, which in turn may lead to a better self-recognition of their own needs and improved efforts for developing and accessing coping resources. A major implication of the study was the finalization and implementation of the InformCare Web platform in 27 European countries, now publicly accessible (www.eurocarers.org/informcare).

Effectiveness of Web-Based Psychosocial Interventions for Family Caregivers of Older People: What Do We Know?

The contribution of family caregivers to long-term care of older people is a relevant issue. Family caregivers may face different psychological and social needs arising from the challenging caregiving situation. In this respect, webbased psychosocial programs are progressively being refined and demonstrating they can be effective in supporting caregivers. This commentary describes the main types of web-based interventions for family caregivers of older people and available evidence on their effectiveness. Psychoeducational, peer and multicomponent programs have been the main object of research so far and can improve, under certain conditions, psychological wellbeing and social inclusion of caregivers. General integration, user and transferability issues are also discussed and call for future research in the field.

Health Economic Analysis on a Psychosocial Intervention for Family Caregivers of Persons with Dementia

Background/Aims: Psychosocial intervention has shown positive effects on the caregivers' burden and satisfaction. The aims of this study were to describe the cost and cost-effectiveness of such an intervention. Methods: We analyzed resource use and costs of formal care for 308 persons with dementia and their caregivers' health-related quality of life (HRQoL). Results: The costs of home help services were lower in the subgroup of spouse caregivers in the intervention group and the cost of nursing home placement was lower in the intervention group. While the person with dementia lived at home, caregivers in the intervention group reported a higher HRQoL (p < 0.01). After the person with dementia had moved to a nursing home, spouses in the control group had a lower HRQoL (p < 0.001). Conclusion: The result can be interpreted as a positive effect of the intervention focusing on the identified specific needs of the family caregivers.

The effectiveness of caregiver psychosocial interventions on the psychosocial wellbeing, physical health and quality of life of stroke family caregivers and their stroke survivors: A systematic review.

Family caregivers play a significant role in the rehabilitation of stroke survivors. Various types of psychosocial interventions have been developed to improve the well-being of both stroke survivors and their caregivers. However, studies showed the results to be mixed and provided insufficient evidence about the optimal dose, approach and format of interventions. To identify the best available evidence related to the effectiveness of psychosocial interventions for family caregivers on the psychosocial and physical wellbeing of family caregivers and stroke survivors. Adult patients were community-dwelling stroke survivors with a clinical diagnosis of stroke. Family caregivers were adult family members of stroke survivors who were the primary caregivers.Trials of psychosocial interventions for family caregivers that aimed at improving the wellbeing of caregivers and stroke survivors.Randomised controlled trials, quasi-randomised, historical cohort and pre- and post-test studies.Primary outcomes were psychosocial wellbeing, physical health, and quality of life of both family caregivers and their stroke survivors. Secondary outcomes were family functioning, intervention satisfaction and use of social resources. Thirty-nine electronic bibliographic databases in English and Chinese were searched from their inception to March 2011 and yielded 5,327 citations.Methodological quality The JBI Critical Appraisal Checklists were used to critically appraise study quality.Data Collection Two reviewers extracted and summarised the details of included studies using the JBI-MAStARI data extraction form independently.Data synthesis Standardised mean difference and 95% confidence interval were calculated for the summary effect of continuous data measured by different scales, and mean difference and 95% confidence interval were calculated for each included study using the same scale. Narrative summary was used when statistical pooling was not possible. A total 18 studies involving 1,723 family caregivers and 1,836 stroke survivors, were included. Three types of psychosocial interventions, including counselling, psychoeducation and social support group were identified. On the basis of two studies examining the outcomes of counselling intervention, there was a significant improvement in family functioning (SMD: -0.12; 95% CI: -0.23 to -0.01; p = 0.03) immediately post-intervention. Caregivers receiving psychosocial interventions also reported a higher level of satisfaction when compared to those receiving usual care. No statistically significant effects on physical health, psychosocial wellbeing and quality of life of caregivers, or on their stroke survivors were found. The review demonstrated evidence of positive effect of psychosocial interventions on family functioning of caregivers. More well designed randomised controlled trials are needed to further examine the optimal dose and format of psychosocial interventions owing to the diversity of interventions.

Family caregivers&amp;rsquo; assessment of symptoms in persons with dementia using the GBS-scale: differences in rating after psychosocial intervention &amp;ndash; an 18-month follow-up study

The purpose of this study was to examine if psychosocial intervention for family caregivers made any differences in describing symptoms of dementia in the persons they cared for. The study population comprised family caregivers of persons aged 70 years and older receiving social services and diagnosed with dementia disorders. A group of 129 family caregivers underwent psychosocial intervention including education, information, and provision of a support group, while 133 family caregivers did not and these formed the control group. Family caregivers were followed-up every 6 months for a total of 18 months. They rated intellectual, emotional, and activity of daily living (ADL) functions in persons with dementia using the Gottfries-Bråne-Steen scale (GBS-scale). Family caregivers who underwent psychosocial intervention rated the intellectual and emotional symptoms of dementia significantly higher 6 months later compared to controls and the effect was sustained during the 18-month follow-up irrespective of relationship and education. Most notably, decrease in function of recent memory, ability to increase tempo, long-windedness, distractibility, and blunting were better identified. Our findings suggest that the family caregivers who underwent psychosocial intervention achieved better understanding of different symptoms and the behaviors of dementia. These findings may explain earlier findings of positive effects after psychosocial intervention on family caregivers’ sense of burden, satisfaction, and ability to delay nursing home placement.

The effectiveness of psychosocial interventions for family caregivers on the psychosocial wellbeing, physical health and quality of life of stroke family caregivers and their stroke survivors: a systematic review

The effectiveness of psychosocial interventions for family caregivers on the psychosocial wellbeing, physical health and quality of life of stroke family caregivers and their stroke survivors: a systematic review

The effectiveness of psychosocial interventions for family caregivers on the psychosocial wellbeing, physical health and quality of life of stroke family caregivers and their stroke survivors: a systematic review

Objectives The objective of this systematic review is to identify the best available evidence related to the effectiveness of psychosocial interventions for caregivers on the psychosocial wellbeing, physical health and quality of life of family caregivers and their stroke survivors. The specific review questions to be addressed are: Family caregivers • What are the effectiveness of varying formats and types of psychosocial intervention on the family caregiver’s psychosocial wellbeing including anxiety, depression, burden and strain of caregiving, mental health, social relationship and support? • What are the effectiveness of varying formats and types of psychosocial intervention on the family caregiver’s physical health including somatic complaints and incidence of accidents or injuries? • What are the effectiveness of varying formats and types of psychosocial intervention on the family caregiver’s quality of life including the psychological, physical, social, and environmental domains? Stroke survivors • What are the effectiveness of varying formats and types of psychosocial intervention on the stroke survivor’s psychosocial wellbeing including anxiety, depression and social recovery? • What are the effectiveness of varying formats and types of psychosocial intervention on the stroke survivor’s physical health including physical functioning? • What are the effectiveness of varying formats and types of psychosocial intervention on the stroke survivor’s quality of life including the psychological, physical, social, and environmental domains from the stroke survivors’ perspective and also their family caregivers’ perspective? Criteria for considering studies for this review Population Adult patients aged 18 or above, with a clinical diagnosis of ischemic or hemorrhagic stroke, which was confirmed by computed tomography (CT) or magnetic resonance imaging (MRI), and were the community-dwelling survivors of the first or recurrent of stroke, received in-patient stroke treatment and were discharged home after hospitalization. Family caregivers will be the adult family member of stroke survivors, aged 18 or above, who were the primary caregivers that was the one who spent the most time of caring their stroke survivors, or the one who was identified by the stroke survivors as their primary caregivers. In addition, investigator’s definition of family caregivers, for example, family members spent on average TRUNCATED AT 350 WORDS

Behavioral and Psychosocial Interventions for Family Caregivers

Behavioral and Psychosocial Interventions for Family Caregivers

Behavioral and Psychosocial Interventions for Family Caregivers

Characteristics of effective approaches and flaws in study design.

Effective psychosocial intervention for family caregivers lengthens time elapsed before nursing home placement of individuals with dementia: a five-year follow-up study

This study was designed to determine the effectiveness of a psychosocial intervention for family caregivers in delaying nursing home placement of individuals with dementia. The participants comprised 153 family caregivers of persons with dementia who underwent intervention and 155 family caregivers who did not. The intervention consisted of five weekly counselling sessions and a three-month conversation group. All patients with dementia underwent a standardized assessment of cognitive and functional ability. The degree of burden and the subjective health of family caregivers were assessed. Participation continued until the patient moved to a nursing home or died, or until five years of living at home had passed. There were significant delays (6 months) in nursing home placement, and a longer time at home for persons with dementia with adult children as caregivers in the intervention group compared to the control group at follow-up (p = 0.004). A greater delay of institutionalization was found where intervention-group caregivers were daughters (p = 0.028). The proportional hazards regression showed factors associated with nursing home placement to be the family caregiver's influence on intervention (OR = 1.55, p = 0.019), caregiver gender (OR = 0.66, p = 0.033) and the patient's severity of dementia (OR = 1.45, p = 0.002). Family caregiver intervention for adult children was significantly associated with prolonged time to nursing home placement.

Chapter 12; Familial Caregivers of Older Adults

SUMMARY Caregivers of older adults face many obstacles as they balance family, career, and caregiving demands. Caregivers are at an increased risk for burden, stress, depression, and a variety of other mental and physical health complications. It is not uncommon for caregivers to receive some form of pharmacological therapy to treat the physical and mental health changes that may occur throughout their caregiving career. However, while pharmacological forms of treatment are invaluable, medications only may not be sufficient to treat the needs of caregivers. As such, geriatric professionals also have a responsibility to intervene with caregivers through psychosocial interventions. This paper provides an overview of caring, a summary of evidence-based psychosocial interventions for family caregivers of older adults, and recommendations for future interventions.

Psychosocial intervention for family caregivers of people with dementia reduces caregiver's burden: development and effect after 6 and 12 months

A number of different intervention programmes have been described in the literature for caregivers of people with dementia, but the nature of intervention has varied widely. The aim of the present study was to evaluate the efficacy of psychosocial intervention on family caregiver's level of burden and satisfaction, and possible influence of the caregiver's relationship and health and the patient's severity of the disease on the effects of intervention. All persons, 70 years and older, from two districts of a municipality (2721 individuals) who were in receipt of any form of social services were invited to participate in a screening of cognitive decline, and 1656 home visits were made. Those with symptoms of cognitive decline, and having a family caregiver, were invited for a further medical examination. Data were analysed from 308 family caregivers: 153 caregivers who underwent intervention and 155 control caregivers who did not. Repeated measures were carried out 6 and 12 months later. Outcomes were measured using instruments that had been tested for reliability and validity, and all patients were diagnosed according to DSM-IV dementia criteria. Caregivers who underwent the psychosocial intervention (5-week programme and 3-month conversation group) reported significantly lower strain and disappointment after 6 months, and this trend remained after 12 months. Satisfaction, measured in terms of purpose, increased in the intervention group and decreased in the control group. The best effect on caregivers in the intervention group was found early in the progression of dementia and in caregivers with impaired health. These findings emphasize the importance of identifying family caregivers early in the caring process to optimize well-being. This study demonstrates that psychosocial intervention with a clearly defined aim that includes giving information and having a conversation group have significant, positive effects on burden and satisfaction for caregivers of people with dementia.

Caring for Others: Internet Video-Conferencing Group Intervention for Family Caregivers of Older Adults With Neurodegenerative Disease

The aim of this pilot feasibility study was to evaluate the effects of an innovative, Internet-based psychosocial intervention for family caregivers of older adults with neurodegenerative disease. After receiving signed informed consent from each participant, we randomly assigned 66 caregivers to an Internet-based intervention or to a no-intervention control group. The intervention group received computers and training in order to access a password-protected Web site with links to information, e-mail, and threaded discussion. Unique to the Web site was a video-conferencing link that supported caregivers' participation in a 10-session, manual-guided psychosocial support group, followed by 12 additional online sessions facilitated by a group member. Participants completed health-status and stress-response measures at baseline and 6-month follow-up. Content analysis of archived video sessions showed (a) reliable adherence to the manual-guided support-group intervention and (b) online group discussion themes similar to those in face-to-face caregiver support groups. Analyses of stress-response outcome data showed significant between-group differences, with the intervention group experiencing a decline in stress compared with an escalation in stress for the control group. Despite the limitations of this pilot study in terms of limited sample size and 54% dropout of control participants at 6-month follow-up, the results provide preliminary supportive evidence for a technology-based psychosocial intervention for family caregivers of individuals with neurodegenerative disease.

Measuring the outcome of psychosocial intervention for family caregivers of dementia sufferers: A factor analytic study

There is an increasing demand for measures which permit the assessment of the effectiveness of psychosocial interventions in community care. Existing measures of objective and subjective burden have limited utility because they have not been adequately psychometrically evaluated. A full psychometric evaluation of two commonly used measures of objective and subjective burden was conducted amongst 114 dementia caregivers. The patterns of association obtained between the two measures suggest that the use of this technique in caregiver assessment may assist in the targeting of appropriate interventions.