Methods

RCT

Participants

‐ N=38, 86% female

‐ Age M=58.1 (SD=13.8)

‐ Drop out N=3 (7.9%)

‐ Duration of caregiving (years) M=3.6 (SD=2.09)

‐ Hours caregiving per week M=111 (SD= 59.4)

‐ Referral through print media, brochures, online articles, community presentations, and paid radio announcement

Interventions

1. CBT (cognitive‐behavioural therapy). Didactic skills training using a multidimensional model to address physical, cognitive and behavioural components associated with caregiver anxiety. Two‐hour weekly meetings for 9 weeks

2. Control: wait list

Outcomes

Anxiety (BAI)

Hamilton Anxiety Scale (HAMA)

Notes

Treatment sessions in small groups: 4‐8 caregivers. Follow‐up: 10 weeks (post‐intervention), 16w, 20w, 26w.

Methods

RCT

Participants

‐ N=299, 73% female, 80% caucasian, 4% african american, 8% hispanic and 8% other

‐ Age M=46.9 (SD=12.2; range 19.2‐84.3);

‐ Drop out N=8

‐ 90% completed college or trade school.

‐ 33% primary caregiver, 27% shared caregiving, 40% not primary caregivers

‐ 67% son or daughter, 7% spouse, 23% relative, 3% non‐relative

Interventions

1. Caregiver’s Friend: Dealing With Dementia is a web‐based multimedia intervention that provides text material and videos that model positive caregiving strategies

2. Control: usual care

Outcomes

Stress
Self‐efficacy
Ways of coping
Caregiver strain
Depressive symptoms
State anxiety

Notes

The stress and coping model by Lazarus and Folkman (1984) is used as theoratical basis. No process analysis.

Methods

RCT

Participants

‐ N=65; 100% female, 79.1% Caucasian Americans of European background, 16.3% African‐American

‐ Age M= 66.52 (SD= 11.96)

‐ Drop out 25%

‐ Duration caregiving (years) M=3.36 (SD=2.77)

‐ Spouses: 88.6%

‐ Referral through Alzheimer associations, Alzheimer clinics and local support groups

Interventions

1. Treatment group (N = 34) ‐ CBI ‐ cognitive‐behavioral intervention tailored to the specific deficits of persons with dementia (PWDs): a. videotapes demonstrating assisted modeling behavior; b. nurse line support programme to reinforce video information and to explore coping strategies

2. Control group (N= 31): attention only by telephone calls

Outcomes

Coping strategies scale (Moos 1992)

Somatic and emotional manifestations of depression, anxiety, and hostility ‐ Brief Symptom Inventory (BSI)

Notes

Process analysis by registration of phone calls.

The study is conceptualised using the stress and coping framework of Lazarus and Folkman (Lazarus 1984).

Methods

RCT

Participants

‐ N=169; 100% female

‐ Age M=6.7 (SD 8.4)

‐ 57% spouse

‐ Drop out 23% (including institutionalisation)

‐ Duration of caregiving (months) M=40.7

‐ Referral through variety of means, clinical and non‐clinical, including newspapers

Interventions

Anger management class, N = 41

Depression management class, N = 45

Wait‐list control, N = 44

Outcomes

State anger (STAXI)
MAACL Hostility subscale
MAACL Depression subscale
Negative and Positive Coping: Self‐efficacy, Managing behaviors, Controlling thoughts (WCCL‐R)

Notes

The cognitive behavioral model is used. There was a 4‐month follow‐up period and control variables were used.

No process analysis.

Methods

RCT

Participants

‐ N=143, 82.5% female, 81.1% white, 18.9% black

‐ 51.8% non‐spouse and 49.2% spouse

‐ Participants were recruited from a variety of settings

Interventions

1. Caregiver skill building treatment intervention

2. Information and support oriented therapies

Outcomes

Distress with behavioral symptoms

Behavioral management skill

Notes

Group and individual telephone sessions were tape recorded and written summaries of all sessions were reviewed to maintain treatment integrity.

Methods

RCT

Participants

‐ N = 45

‐ Age M=59.33 (SD = 12.23)

‐ Drop out N = 10

‐ Years of education M=13.42 (SD = 20.93)

‐ Years in the United States M=31.13 (SD = 20.93)

‐ 14 spouses and 31 non‐spouses

‐ Duration of caregiving (months): 1. TSC(N=23), M=41.26 (SD=29.77), 2. IHBMP (N=22), M=48.32 (SD=42.86)

Interventions

1. IHBMP ‐ In‐home behavioral management program for 4 months is comprised of six modules that focus on learning new skills to help the CG cope with caregiving stress: Introduction, Behavior management, Unhelpful thoughts, Communication issues, End‐of‐life (EOL), Pleasant events.

2. TSC ‐ the telephone support condition (comparison)

Outcomes

1. Depressive symptoms, CES‐D
2. Perceived Stress Scale
3. Conditional Bother Subscale (CBS) derived from the Revised Memory and Behavior Problems Checklist (RMBPC) ‐ 24 items describing possible troublesome behaviors that the CR might engage in (e.g. wandering)
4. Self‐efficacy. The revised self‐efficacy scale (SE) is used, 15 items (5 on each subscale) measuring CGs’ beliefs about their ability to handle situations in three domains: 1) obtaining respite from caregiving burdens; 2) responding effectively to disruptive behaviors; and 3) controlling upsetting thoughts while in the caregiving role

Notes

No process analysis.

Methods

RCT

Participants

‐ N=118; intervention group N=60 (80.0% women), control group N=58 (81.0% women)

‐ Mean age 60 years

‐ Drop out N = 40

‐ Years of education: 1. intervention group ‐ M=11.77 (SD=3.80) , 2. control group M=12.19 (SD=4.39)

‐ Duration of caregiving: 1. intervention group M= 2.90 (SD=2.23) , 2. control group M=2.74 (SD=2.00)

‐ Spouses: 1. intervention group 61.7% , control group 60.3%

Interventions

1. Experimental program aimed to improve the caregiver's ability to cope with the numerous daily sources of stress associated with caring for a person with dementia. Developed according to the Lazarus and Folkman (1984) transactional theory of stress and coping. It comprised two components: cognitive appraisal and coping strategies

2. Control group: referral to traditional support group Alzheimer Society

Outcomes

1. Reactions to behavioral problems (RMBPC) frequency and upset

2. Burden

3. Psychological distress (Bradburn Revised Affect Scale)

4. Anxiety (STAI)

5. Personal efficacy (Bandura)

Notes

No control variables were used. Theory used: transactional model of stress and coping (Folkman 1991).

No process analysis.

Methods

RCT

Participants

1. Day‐to‐day group (N=79): 77.2% female; age M=65.2 years; 68.4% of spouses are the primary caregiver

2. Decision making group (N=72): 77.8% female; age M=64.6 years; 61.2% of spouses are the primary caregiver

3. Control group (N=64) 71.9% female; age M=69.7 years; 67.2% of spouses are the primary caregiver

‐ Drop out 20.9%

Interventions

1. Day‐to‐day session focuses on developing strategies for everyday caregiving

2. Decision making session focuses on identifying and using values and preferences as a way to evaluate the options available in everyday caregiving

3. Control group

Outcomes

Caregiver Distress Measure

Notes

The programme and distress measure are tied to a stress mediation framework (Lazarus 1984).

No process analysis.

Methods

RCT

Participants

‐ N=74

1. Intervention group N=34, 82.4 % female

‐ Age M=58.1 (SD=13.9)

‐ Years of education M=10.6 (SD=6.3)

‐ Duration of caregiving (months) M=52.8 (SD=45.6)

‐ 55.3% spouse; 40% son, 6.7% other relative

2. Wait list control group (N=40), 77.5 % female

‐ Age M=55.4 (SD=15.9);

‐ Years of education M=9.2 (SD= 4.8)

‐ Duration of caregiving (months) M=49.0 (SD=29.5)

‐ 43.6% spouse, 51.3% son, 5.1% other relative

Interventions

1. MDTC ‐ Modification of Disfunctional Thoughts associated with Caregiving (CBT‐based)

2. Waiting list control group (WL)

Outcomes

Depression

Frequency of behavioural problems

Apppraisal of behavioural problems (transformed)

Dysfunctional thoughts about caregiving

Notes

No process analysis.

Based on the CBT (cognitive behavioral therapy) adapted to the experience of caregiving model (Losada 2006).

Methods

Prospective single blind RCT

Participants

‐ N = 42, 69% female

‐ Age: 1. no interview control group (N=14), M=58.1 (SD=16.7), 2. interview control group (N=14), M=63.0 (SD=14.0), intervention group(N=14), M=69.6 (SD=15.2)

‐ 53% spouse, 40% child

‐ Drop out 45%

‐ Referral through old age psychiatry service

Interventions

1. Family intervention: in depth interview (CFI) and cognitive behavioral family intervention

2. Control 1 in depth interview

3. Control 2 no intervention

Outcomes

2. Depression (BDI)

Notes

Treatment: 14 sessions, two weeks interval, follow‐up period 9 months and 12 months; no control variables used. Use of theoretical model (Tarrier et al 1988). Single blinded study. No process analysis.

Methods

RCT

Participants

‐ N = 184

‐ Age M=62.2 (SD=12.8)

‐ Years of education M=14.38 (SD=2.69)

‐ 28% wife, 24% husband, 35% daughters, 6% sons, 7% others

‐ 80% co‐resident

‐ Drop out 36%

‐ Referral through local agencies and newspapers

Interventions

1. Family counselling (N = 36)

2. Support groups (N = 44)

3. Wait list (N = 39)

Both treatment groups use stress management model: information, problem solving, identifying potential support

Outcomes

1. Burden Interview (ZBI)

2. Distress (MBPC)

3. BSI‐total

4. Management of patient's behaviours (MBPC) upset

Notes

8 Sessions. Process analysis by audiotapes and supervision sessions.