Nursing interventions to reduce the overload on informal caregivers. Systematic review of clinical trials

Authors

  • Jose Manuel Tinoco Camarena Estudiante de Doctorado en Enfermeria y Ciencias de la Salud. Escuela de Enfermería, Campus de Bellvitge. Universitat de Barcelona, Calle Feixa Larga, s/n 08907 L'Hospitalet de Llobregat. Barcelona, España. https://orcid.org/0000-0001-6124-5368
  • Miguel Angel Hidalgo Blanco Profesor del Departamento de Enfermería Fundamental y Médico-Quirúrgica Facultad de Medicina y Ciencias de la Salud. Universidad de Barcelona. Calle Feixa Llarga s/n. 08870-Hospitalet de Llobregat (Barcelona), España. https://orcid.org/0000-0003-1696-5627
  • Nara Daifuku Sansano Enfermera Centro de atención de enfermería especializada en el Consorcio Sanitario Integral. Av. Josep Molins, 29. 08906- Hospitalet de Llobregat (Barcelona), España. https://orcid.org/0000-0001-9676-0976
  • Maria Teresa Lluch Canut Profesora Catedrática de Escuela Universitaria. Departamento de Enfermería de Salud Pública, Salud Mental y Materno Infantil. Facultad de Medicina y Ciencias de la Salud. Universitat de Barcelona, Calle Feixa Larga, s/n 08907 L'Hospitalet de Llobregat. Barcelona, España. https://orcid.org/0000-0002-2064-8811
  • Laia Raigal Aran Profesora asociada, Facultad de Enfermería, Universidad Rovira i Virgili. Calle de Sant Llorenç, 21 43201. Reus
  • Montserrat Puig Llobet Directora del Departamento de Enfermería de Salud Pública, Salud Mental y Materno Infantil. Facultad de Medicina y Ciencias de la Salud y Profesora Agregada en dicho Departamento. Universidad de Barcelona, Calle Feixa Larga, s/n 08907 L'Hospitalet de Llobregat. Barcelona, España. https://orcid.org/0000-0002-3893-4488
DOI: https://doi.org/10.6018/eglobal.502351
Keywords: Caregiver, Interventions, Clinical trials, Nurse

Abstract

Background: Informal caregivers are usually family members, which lead to dependence of the patient on the caregiver. This may result in disturbances to the caregivers' quality of life. Address the negative effects of informal caregiving, several types of interventions have been reported to be effective in reducing medical visits by both informal caregivers and the patients in their care
Aim: Examine the effectiveness of existing nursing interventions designed to reduce the overload of the informal caregiver of people with chronic illness.
Methodology:
Design: Systematic review
Data Sources: Databases including Pubmed (MEDLINE), Embase, The Cochrane Library and CINAHL were searched using keywords about nursing interventions in family caregivers. Articles published between 2014-2019 were retrieved and underwent data analysis and knowledge synthesis.
Review method: Two reviewers independently selected studies. Quality appraisal was based on PRISMA statements appraisal checklist. Synthesis was narrative.
Results: Ninety-five studies were examined in their entirety, with seventy-seven being discarded as not providing results or not related to reducing overload. The final count of articles included in this review was eighteen which were all randomised clinical trials. Seven were categorized as technology-based interventions; two as self-help manuals; one as a physical activity-based intervention; and eight as group or individual psychoeducational therapy.
Conclusions: Analysis of the different studies shows effectiveness in reducing symptoms such as stress, anxiety, depression or even unmet needs. The interventions that were found to be most effective in reducing caregiver overload were home care visits and psychoeducational interventions, both individual and group.

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References

Foreman KJ, Marquez N, Dolgert A, Fukutaki K, Fullman N, McGaughey M, et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016–40 for 195 countries and territories. Lancet [Internet]. 2018;392(10159):2052–90. http://dx.doi.org/10.1016/S0140- 6736(18)31694-5

Bremer P, Cabrera E, Leino-Kilpi H, Lethin C, Saks K, Sutcliffe C, et al. Informal dementia care: Consequences for caregivers’ health and health care use in 8 European countries. Health Policy [Internet]. 2015 Nov [cited 2021 Dec 1];119(11):1459–71. https://www.sciencedirect.com/science/article/abs/pii/S0168851015002511?via%3Dihub.

Hiel L, Beenackers MA, Renders CM, Robroek SJW, Burdorf A, Croezen S. Providing personal informal care to older European adults: Should we care about the caregivers’ health? Preventive Medicine [Internet]. 2015 Jan [cited 2020 Dec 1];70:64–8. https://www.sciencedirect.com/science/article/abs/pii/S009174351400396X?via%3Dihub

Pinquart M, Sorensen S. Correlates of Physical Health of Informal Caregivers: A Meta- Analysis. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences [Internet]. 2007 Mar 1 [cited 2020 Dec 1];62(2):P126–37. https://academic.oup.com/psychsocgerontology/article/62/2/P126/548950

Vitaliano, P. P., Zhang, J., & Scanlan, J. M. (2003). Is Caregiving Hazardous to One's Physical Health? A Meta-Analysis. Psychological Bulletin, 129(6), 946–972. https://doi.org/10.1037/0033-2909.129.6.946

Corry M, While A, Neenan K, Smith V. A systematic review of systematic reviews on interventions for caregivers of people with chronic conditions. Journal of Advanced Nursing [Internet]. 2014 Sep 16 [cited 2020 Dec 1];71(4):718–34. https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.12523

Mosquera I, Vergara I, Larrañaga I, Machón M, del Río M, Calderón C. Measuring the impact of informal elderly caregiving: a systematic review of tools. Quality of Life Research [Internet]. 2015 Oct 16 [cited 2020 Dec 1];25(5):1059–92. https://link.springer.com/article/10.1007/s11136-015-1159-4

Strömberg A, Luttik ML. Burden of caring: risks and consequences imposed on caregivers of those living and dying with advanced heart failure. Curr Opin Support Palliat Care. 2015 Mar;9(1):26-30. doi: 10.1097/SPC.0000000000000111. PMID: 25588208.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Medicine [Internet]. 2009 Jul 21 [cited 2020 Dec 1];6(7):e1000097. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000097

Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Controlled Clinical Trials [Internet]. 1996 Feb [cited 2020 Dec 1];17(1):1–12. https://pubmed.ncbi.nlm.nih.gov/8721797/

Espí-López GV, Arnal-Gómez A, Balasch-Bernat M, Inglés M. Effectiveness of Manual Therapy Combined With Physical Therapy in Treatment of Patellofemoral Pain Syndrome: Systematic Review. Journal of Chiropractic Medicine [Internet]. 2017 Jun [cited 2020 Dec 1];16(2):139–46. https://pubmed.ncbi.nlm.nih.gov/28559754/

Seminario-Amez M, Lopez-Lopez J, Estrugo-Devesa A, Ayuso-Montero R, Jane-Salas E. Probiotics and oral health: A systematic review. Medicina Oral Patología Oral y Cirugia Bucal [Internet]. 2017 [cited 2020 Dec 1];0–0. https://pubmed.ncbi.nlm.nih.gov/28390121/

Kales HC, Gitlin LN, Stanislawski B, Myra Kim H, Marx K, Turnwald M, et al. Effect of the WeCareAdvisorTM on family caregiver outcomes in dementia: A pilot randomized controlled trial. BMC Geriatr. 2018 May 10;18(1).

Núñez-Naveira L, Alonso-Búa B, De Labra C, Gregersen R, Maibom K, Mojs E, et al. UnderstAID, an ICT Platform to Help Informal Caregivers of People with Dementia: A Pilot Randomized Controlled Study. Biomed Res Int. 2016;2016.

Bakas T, Austin JK, Habermann B, Jessup NM, McLennon SM, Mitchell PH, et al. Telephone assessment and skill-building kit for stroke caregivers: A randomized controlled clinical trial. Stroke. 2015 Dec 1;46(12):3478–87.

Moskowitz JT, Cheung EO, Snowberg KE, Verstaen A, Merrilees J, Salsman JM, et al. Randomized controlled trial of a facilitated online positive emotion regulation intervention for dementia caregivers. Heal Psychol. 2019 May 1;38(5):391–402.

Pfeiffer K, Beische D, Hautzinger M, Berry JW, Wengert J, Hoffrichter R, et al. Telephone- based problem-solving intervention for family caregivers of stroke survivors: A randomized controlled trial. J Consult Clin Psychol. 2014;82(4):628–43.

Aoun, S. M., Grande, G., Howting, D., Deas, K., Toye, C., Troeung, L., Stajduhar, K., & Ewing, G. (2015). The impact of the carer support needs assessment tool (CSNAT) in community palliative care using a stepped wedge cluster trial. PLoS ONE, 10(4). https://doi.org/10.1371/journal.pone.0123012" https://doi.org/10.1371/journal.pone.0123012

Heckel L, Fennell KM, Reynolds J, Boltong A, Botti M, Osborne RH, et al. Efficacy of a telephone outcall program to reduce caregiver burden among caregivers of cancer patients [PROTECT]: A randomised controlled trial. BMC Cancer. 2018 Jan 8;18(1).

Tanner JA, Black BS, Johnston D, Hess E, Leoutsakos JM, Gitlin LN, et al. A randomized controlled trial of a community-based dementia care coordination intervention: Effects of MIND at home on caregiver outcomes. Am J Geriatr Psychiatry. 2015 Apr 1;23(4):391–402.

Gabriel IO, Mayers PM. Effects of a psychosocial intervention on the quality of life of primary caregivers of women with breast cancer. Eur J Oncol Nurs. 2019 Feb 1;38:85–91.

Hendrix CC, Bailey DE, Steinhauser KE, Olsen MK, Stechuchak KM, Lowman SG, et al. Effects of enhanced caregiver training program on cancer caregiver’s self-efficacy, preparedness, and psychological well-being. Support Care Cancer. 2016 Jan 1;24(1):327–36.

Kochaki Nejad Z, Aghdam AM, Hassankhani H, Sanaat Z. The effects of a patient- caregiver education and follow-up program on the breast cancer caregiver strain index. Iran Red Crescent Med J. 2016 Feb 1;18(2).

Schulz R, Rosen J, Klinger J, Musa D, Castle NG, Kane AL, et al. Effects of a Psychosocial Intervention on Caregivers of Recently Placed Nursing Home Residents: A Randomized Controlled Trial. Clin Gerontol. 2014;37(4):347–67.

Rodríguez-Gonzalo A, García-Martí C, Ocaña-Colorado A, Baquera-De Micheo MJ, Morel- Fernández S. Efficiency of an intensive educational program for informal caregivers of hospitalized, dependent patients: Cluster randomized trial. BMC Nurs. 2015 Jan 31;14(1).

Yu DSF. Effects of a Health and Social Collaborative Case Management Model on Health Outcomes of Family Caregivers of Frail Older Adults: Preliminary Data from a Pilot Randomized Controlled Trial. J Am Geriatr Soc. 2016 Oct 1;64(10):2144–8.

Mccann T V, Songprakun W, Stephenson J. Effectiveness of guided self-help in decreasing expressed emotion in family caregivers of people diagnosed with depression in Thailand: a randomised controlled trial. BMC Psychiatry [Internet]. 2015 [cited 2020 Feb 10]; https://www.anzctr.org.au/Trial/Registration/

Gallagher-Thompson D, Tzuang M, Hinton L, Alvarez P, Rengifo J, Valverde I, et al. Effectiveness of a Fotonovela for Reducing Depression and Stress in Latino Dementia Family Caregivers HHS Public Access. Alzheimer Dis Assoc Disord. 2015;29(2):146–53.

Chiang VCL, Lee RLP, Ho FM, Leung CK, Tang YP, Wong WS, et al. Fulfilling the psychological and information need of the family members of critically ill patients using interactive mobile technology: A randomised controlled trial. Intensive Crit Care Nurs. 2017 Aug 1;41:77–83.

Cuthbert CA, King-Shier KM, Ruether JD, Tapp DM, Wytsma-Fisher K, Fung TS, et al. The Effects of Exercise on Physical and Psychological Outcomes in Cancer Caregivers: Results from the RECHARGE Randomized Controlled Trial. Ann Behav Med. 2018 Jul 13;52(8):645–61.

Published
01-10-2022
How to Cite
[1]
Tinoco Camarena, J.M. et al. 2022. Nursing interventions to reduce the overload on informal caregivers. Systematic review of clinical trials. Global Nursing. 21, 4 (Oct. 2022), 562–586. DOI:https://doi.org/10.6018/eglobal.502351.