Table 7.
Interventions for caregivers.
| References | Focus | Methods | Interventions | Results | Conclusions |
|---|---|---|---|---|---|
| Boots et al. (2014) | Analysis of the effectiveness, feasibility and quality of Internet interventions for informal caregivers of PWD. | Systematic Review. Twelve studies, three RCTs. | Informative websites providing information and strategies; peer-support/professional support through e-mails and phone calls. | Quantitative – small significant results in 6/12 on depressive symptoms, self-efficacy, perceived competence, decision-making and burden; Qualitative – positive outcomes on awareness, competence, mastery and perceived social support. Better outcomes for interventions combining informative websites with psycho-social support. | General positive outcomes emerged. Further researches are required due to small samples, not standardized designs and examined outcomes. |
| Brando et al. (2017)* | Analysis of the advantages and disadvantages associated with the implementation of technology into works with PWD and caregivers. | Literature Review (online-caregivers section of 3/30 studies). | Psycho-education online support through videoconference among peers. | Positive qualitative outcomes regarding online social support. | Few online interventions target caregivers. Initial evidence emerged. |
| Dam et al. (2016) | Analysis of interventions targeting caregivers focused on social support. | Systematic Review (remote support section of 15 studies, 11 RCTs). | Informative/psycho-education websites; peer-support through online forums and videoconferences. | Qualitative – Positive outcomes for the perceived social isolation, social support and the relationship with the PWD. Benefits for the decision-making process using informative websites; benefits for stress, depression, self-efficacy and burden using videoconferences. | Positive qualitative outcomes emerged. Future research should use more standardized designs. |
| Egan et al. (2018) | Analysis of online interventions targeting caregivers of PWD. | Systematic Review. Eight RCTs. | Psycho-education, psychotherapy (cognitive reframing and relaxation) and cognitive training using forums, videoconferences and selected videos. | Positive evidence on depressive symptoms 2/8, anxious symptoms 2/8, acquired skills 2/8 and self-efficacy. | Positive evidence emerged from heterogeneous designs; more standardized studies are required. No benefits emerged on the QoL. |
| Godwin et al. (2013) | Analysis of the effectiveness of interventions targeting caregivers of PWD. | Systematic Review. Eight studies, four RCTs. | Informative websites; psycho-social support through forums, e-mails, chats and videos. | Positive benefits on depressive symptoms 4/8 and anxious symptoms 2/8. Mixed evidence on the social support. | Mixed results and heterogenous designs were found. Future standardized RCTs are required. |
| Hopwood et al. (2018) | Analysis of the effectiveness of online interventions targeting caregivers of PWD. | Systematic Review. Forty studies, nine RCTs. | Psycho-social support in group of peers, using chats, forums, videoconferences and avatar 3D; training on the decision-making process. | Benefits on depressive and anxious symptoms; increased self-efficacy and QoL. Peer-support is more appreciated if conducted through videoconferences; informative interventions are preferred via websites rather than using handbooks. | Mixed results, but mostly positive, emerged. Future studies should better examine the caregivers' specific needs. |
| Jackson et al. (2016) | Analysis of telephone-based and internet-based interventions targeting caregivers. | Systematic Review. Twenty-two studies, five internet-based. | Psycho-education, psychotherapy and psycho-social supportive interventions. | Qualitative positive results on depressive symptoms, general mental health and QoL. | Interventions combining different programs and devices had led to better outcomes. |
| Leng et al. (2020) | Analysis of the efficacy of internet interventions in improving health of caregivers of PWD. | Systematic Review and Meta-Analysis. Seventeen RCTs. | Online psycho-social and psycho-educative support. | Significant positive results on depressive symptoms (SMD = −0.21; 95% CI −0.31 to −0.10; P < 0.001), perceived stress (SMD = −0.40; 95% CI−0.55 to −0.24; P < 0.001), anxious symptoms (SMD = −0.33; 95% CI−0.51 to −0.16; P < 0.001) and self-efficacy (SMD = 0.19; 95% CI 0.05–0.33; P = 0.007). No significant improvements were found in caregiver burden, coping, caregiver's reactions to behavioral symptoms and quality of life. | Internet-based interventions are generally effective at improving the health of family caregivers. |
| Lorenz et al. (2019)* | Mapping technologies for PWD and caregivers, classified by function, target user and disease progression. | Rapid Review, interviews and blog analysis. | Online psycho-social support, cognitive training, psycho-education and remote monitoring of the PWD. | Most technologies targeting carers are focused on memory sustainment and care delivery. | Little evidence back up the practical application of the identified technologies. Further researches should examine the impact of a wide range of technologies on daily living. |
| Lucero et al. (2019) | Analysis of the effectiveness on health of ICT-based interventions targeting caregivers. | Systematic Review. Twelve RCTs, 6 internet-based. | Online psychotherapy; informative and educative interventions using websites; cognitive and physical training. | Internet interventions -> increased positive affect (P = 0.01), decreased concerns for PWD's behaviors (P = 0.02). Internet + telephone -> increased satisfaction (P = 0.015), physical activity (P < 0.01), self-efficacy (P < 0.01); decreased depressive symptoms (P = 0.02), anxious symptoms (P = 0.01) and stress (P < 0.05). | Positive benefits on health emerged from heterogeneous studies. A standardized methodology is required. |
| McKechnie et al. (2014) | Analysis of computer-based interventions targeting caregivers of PWD. | Systematic Review. Twelve studies, six RCTs. | Psycho-education, psycho-social support among peers, psycho-social support with health care professionals. | Positive significant results (P < 0.05) on: depressive symptoms (four studies), general mental health (three studies), burden and stress (five studies), social support (one study), positive aspect of caregiving (one study) and self-efficacy (two studies). | Depression and burden were the most examined outcomes. Future studies should use a standardized methodology and examine the same outcomes. |
| Parra-Vidales et al. (2017) | Analysis of online psycho-educational interventions targeting caregivers of PWD. | Systematic Review. Seven studies. | Online informative support, psycho-social support among peers and with health care professionals through chat and videoconference; cognitive training. | Positive results on self-efficacy (two studies), acquired knowledge (two studies), functional autonomy (one study), anxious/depressive symptoms (one study). | Outcomes examination is often not reported or not standardized. Online interventions have benefits on the social aspect and are usually perceived as positive. |
| Rathnayake et al. (2019) | Analysis of interventions based on mHealth-App targeting caregivers. | Integrative Review. Seven studies. | Information, psycho-education, cognitive training and PWD's monitoring. | The main focus areas of mHealth App studies are categorized as: carer education, monitoring and cognitive training. | A theoretical model is required to guide the designing of mHealth App interventions. Further researches should focus more on psycho-education and psycho-social support. |
| Ruggiano et al. (2018) | Analysis of technology-based interventions targeting caregivers of PWD living in rural areas. | Systematic Review. Thirty studies, 18 RCTs. | Online interventions focused on psycho-social support groups, psycho-education, psychotherapy, monitoring of mental and physical health. | Significant positive benefits (P < 0.05) on: depressive symptoms (five studies), anxious symptoms (two studies), other psycho-social aspect (six studies), as stress and perceived support. No benefits on self-efficacy and caregiver's skills emerged. | Few studies identified their sample population as living in rural areas. Future interventions should analyze the needs of the specific population. |
| Scott et al. (2016) | Analysis of the effectiveness of TB-CBT interventions targeting caregivers of PWD. | Systematic Review. Four studies. | Cognitive-behavioral therapy using the internet and selected multimedia. | Small significant effects post-intervention of the TB-CBT on depression (P = 0.04); equivalent to the traditional CBT. | Future studies should analyze long-term effects of the TB-CBT. TB-CBT is an economical alternative to the traditional CBT. |
| Waller et al. (2017) | Analysis of the acceptability, utilization and effectiveness of ICT-based interventions targeting caregivers. | Systematic Review. Online section of 19 studies. | Online psycho-education, cognitive training, psycho-social support among peers and with health care professionals. | Heterogeneous positive evidence emerged on general mental health, depressive symptoms, burden, positive aspect of caregiving and perceived social support. A positive acceptability emerged. | Potential benefits of ICT-based interventions emerged. High-quality studies are required to detect the most recommended types of intervention. |