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The effects of a multi-component dyadic intervention on the psychological distress of family caregivers providing care to people with dementia: a randomized controlled trial.

Abstract

BACKGROUND

Earlier research showed that multi-component dyadic interventions - including a combination of intervention strategies and addressing both the person with dementia and caregiver - have a beneficial impact on the mental and physical health of people with dementia and their family caregivers. A randomized controlled trial (RCT) of a multi-component dyadic intervention, which is a translated and adapted version of an intervention that has been shown to be effective in the US by Teri et al. (2003), was performed. The effects on caregivers' mood (primary outcome), burden, general health, and salivary cortisol levels (secondary outcomes) were studied.

METHODS

Community-dwelling people with dementia and their family caregivers (N = 111 dyads) were randomly assigned. The experimental group received eight home visits during three months, combining physical exercise and support (psycho-education, communication skills training, and planning of pleasant activities). Both the physical exercise and support component were directed at both the person with dementia and the caregiver. The comparison group received monthly information bulletins and phone calls. There were three measurements at baseline (prior to the intervention), at three months, and at six months into the intervention. Data were analyzed with Generalized Estimating Equations (GEE) based on an intention-to-treat analysis of all available data.

RESULTS

All analyses showed no benefits of the intervention over time on any of the outcomes.

CONCLUSION

The negative results might be explained by the translation and adaptation of the intervention that has been shown to be effective in the US: the intervention was shortened and did not include cognitive reframing. However, only the health effects on people with dementia and not on caregivers were studied in the US. Several other factors might also have played a role, which are important for future studies to take into account. These are: the usual health care in the country or region of implementation; the wishes and needs of participants for specific intervention components; the room for improvement regarding these components; the inclusion of positive outcome measures, such as pleasure, and the quality of the relationship.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Clinical Psychology and the EMGO institute for Health and Care Research,Faculty of Psychology and Education,VU University,Van der Boechorststraat 1,1081 BT Amsterdam,the Netherlands.

    ,

    Research Centre Innovations in Care,Rotterdam University of Applied Sciences,Rochussenstraat 198,3015 EK Rotterdam,the Netherlands.

    ,

    Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research,VU University Medical Centre,De Boelelaan 1118,1081 HV Amsterdam,the Netherlands.

    Department of Clinical Psychology and the EMGO institute for Health and Care Research,Faculty of Psychology and Education,VU University,Van der Boechorststraat 1,1081 BT Amsterdam,the Netherlands.

    Source

    International psychogeriatrics 27:12 2015 Dec pg 2031-44

    MeSH

    Activities of Daily Living
    Adult
    Affect
    Aged
    Aged, 80 and over
    Caregivers
    Cost-Benefit Analysis
    Delivery of Health Care
    Dementia
    Depression
    Exercise
    Female
    House Calls
    Humans
    Hydrocortisone
    Male
    Middle Aged
    Outcome Assessment (Health Care)
    Psychiatric Status Rating Scales
    Quality of Life
    Social Support
    Stress, Psychological
    Surveys and Questionnaires

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    26004290

    Citation

    Prick, Anna-Eva, et al. "The Effects of a Multi-component Dyadic Intervention On the Psychological Distress of Family Caregivers Providing Care to People With Dementia: a Randomized Controlled Trial." International Psychogeriatrics, vol. 27, no. 12, 2015, pp. 2031-44.
    Prick AE, de Lange J, Twisk J, et al. The effects of a multi-component dyadic intervention on the psychological distress of family caregivers providing care to people with dementia: a randomized controlled trial. Int Psychogeriatr. 2015;27(12):2031-44.
    Prick, A. E., de Lange, J., Twisk, J., & Pot, A. M. (2015). The effects of a multi-component dyadic intervention on the psychological distress of family caregivers providing care to people with dementia: a randomized controlled trial. International Psychogeriatrics, 27(12), pp. 2031-44. doi:10.1017/S104161021500071X.
    Prick AE, et al. The Effects of a Multi-component Dyadic Intervention On the Psychological Distress of Family Caregivers Providing Care to People With Dementia: a Randomized Controlled Trial. Int Psychogeriatr. 2015;27(12):2031-44. PubMed PMID: 26004290.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The effects of a multi-component dyadic intervention on the psychological distress of family caregivers providing care to people with dementia: a randomized controlled trial. AU - Prick,Anna-Eva, AU - de Lange,Jacomine, AU - Twisk,Jos, AU - Pot,Anne Margriet, Y1 - 2015/05/25/ PY - 2015/5/26/entrez PY - 2015/5/26/pubmed PY - 2016/8/19/medline KW - Alzheimer’s disease KW - mental health KW - prevention KW - treatment SP - 2031 EP - 44 JF - International psychogeriatrics JO - Int Psychogeriatr VL - 27 IS - 12 N2 - BACKGROUND: Earlier research showed that multi-component dyadic interventions - including a combination of intervention strategies and addressing both the person with dementia and caregiver - have a beneficial impact on the mental and physical health of people with dementia and their family caregivers. A randomized controlled trial (RCT) of a multi-component dyadic intervention, which is a translated and adapted version of an intervention that has been shown to be effective in the US by Teri et al. (2003), was performed. The effects on caregivers' mood (primary outcome), burden, general health, and salivary cortisol levels (secondary outcomes) were studied. METHODS: Community-dwelling people with dementia and their family caregivers (N = 111 dyads) were randomly assigned. The experimental group received eight home visits during three months, combining physical exercise and support (psycho-education, communication skills training, and planning of pleasant activities). Both the physical exercise and support component were directed at both the person with dementia and the caregiver. The comparison group received monthly information bulletins and phone calls. There were three measurements at baseline (prior to the intervention), at three months, and at six months into the intervention. Data were analyzed with Generalized Estimating Equations (GEE) based on an intention-to-treat analysis of all available data. RESULTS: All analyses showed no benefits of the intervention over time on any of the outcomes. CONCLUSION: The negative results might be explained by the translation and adaptation of the intervention that has been shown to be effective in the US: the intervention was shortened and did not include cognitive reframing. However, only the health effects on people with dementia and not on caregivers were studied in the US. Several other factors might also have played a role, which are important for future studies to take into account. These are: the usual health care in the country or region of implementation; the wishes and needs of participants for specific intervention components; the room for improvement regarding these components; the inclusion of positive outcome measures, such as pleasure, and the quality of the relationship. SN - 1741-203X UR - https://www.unboundmedicine.com/medline/citation/26004290/The_effects_of_a_multi_component_dyadic_intervention_on_the_psychological_distress_of_family_caregivers_providing_care_to_people_with_dementia:_a_randomized_controlled_trial_ L2 - https://www.cambridge.org/core/product/identifier/S104161021500071X/type/journal_article DB - PRIME DP - Unbound Medicine ER -