Interventions Effective in Decreasing Burden in Caregivers of Persons with Dementia: A Meta-Analysis

Abstract

Introduction: Chronic non-communicable diseases, including diseases of mental origin such as Alzheimer's, affect all age groups and countries. These diseases have a major impact on the patient and their family environment. It is interesting that different questionnaires are measured in the same direction, given that different health questionnaires are used to measure caregiver burden. Objectives: To identify which type of intervention is the most appropriate to improve the health of the primary caregiver in patients with dementia. To understand the role played by the nurse within multidisciplinary teams and to know whether the different questionnaires used in the studies measure caregiver health in the same direction. Methods: A systematic search of the published and gray literature was carried out without restriction of the language used in the studies. Caregiver burden of patients with dementia, receiving an intervention to improve caregiver burden, was assessed. Standardized mean difference was used as the effect size measure, and there were possible causes of heterogeneity in the effect size. Results: In total, 1512 records were found, and 39 articles with 4715 participants were included. We found individual information with an effect of 0.48 (CI95%: 0.18; 0.79; I2 = 0%); group therapy with an effect of 0.20 (CI95%: 0.08; 0.31; I2 = 6%); workshops with an effect of 0.21 (CI95%: 0.01; I2 = 48%) and 0.32 (CI95%: 0.01; 0.54; I2 = 0%) when a nurse intervenes; respite care with an effect of 0.22 (CI95%: 0.05; 0.40; I2 = 66%); individual therapy with an effect of 0.28 (CI95%: 0.15; 0.4; I2 = 68%); and support groups with an effect of 0.07 (CI95%: 0; 0.15; I2 = 78%). Conclusions: The magnitude of the effects of the interventions has been low-moderate. Different instruments are not associated with the magnitude of the effect. The presence of nurses improves the effect of the intervention on caregivers when it is carried out in the form of workshops.

Keywords: caregiver burden; dementia; health questionaries; mental health; meta-analysis; nursing.

Figure 1

PRISMA flow chart [16].

Figure 2

Forest plot of the different intervention groups. (a) Support group; (b) group therapy [32,45,46,47,48,49,50,51,52,53,54,55,58,59,60,61,62].

Figure 3

Forest plot of the different intervention groups. (a) Individual therapy; (b) respite care [31,32,33,34,35,36,37,38,39,40,41,43,44,56,57].

Figure 4

Forest plot of the different intervention groups. (a) Individual information; (b) workshop [20,28,29,30,63,64].

Figure 5

Forest plot of the different intervention groups after analyzing the origin of the existing heterogeneity.