Interventions for Caregivers of People Who Have Had a Stroke: A Systematic Review

Abstract

Importance: It is vital that occupational therapy practitioners address caregivers' needs to enable them to maintain participation in caregiving for people poststroke.

Objective: To explore the evidence for the effectiveness of interventions within the scope of occupational therapy practice for caregivers of people poststroke that facilitate maintaining participation in the caregiver role.

Data sources: We conducted a narrative synthesis systematic review of the literature published in the MEDLINE, PsycINFO, CINAHL, OTseeker, and Cochrane databases between January 1, 1999, and December 31, 2019. Article reference lists were also hand searched.

Study selection and data collection: The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines were used, and articles were included if they were within the date range and scope of occupational therapy practice and included caregivers of someone poststroke. Two independent reviewers used Cochrane methodology to perform the systematic review.

Findings: Twenty-nine studies met the inclusion criteria and were divided into five intervention themes: cognitive-behavioral therapy (CBT) techniques, caregiver education only, caregiver support only, caregiver education and support, and multimodal interventions. Both the CBT technique of problem-solving combined with stroke education and one-on-one caregiver education and support interventions had strong strength of evidence. Multimodal interventions had moderate strength of evidence, and caregiver education only and caregiver support only had low strength of evidence.

Conclusions and relevance: Addressing caregiver needs with problem-solving and caregiver support in addition to typical education and training is essential. More research is needed that uses consistent doses, interventions, treatment settings, and outcomes. What This Article Adds: Although more research is needed, occupational therapy practitioners should provide combinations of interventions such as problem-solving techniques, customized support for each caregiver, and individualized education in the care of the stroke survivor.