Effectiveness of Technology-Delivered Psychosocial Interventions for Family Caregivers of Patients With Dementia: A Systematic Review, Meta-Analysis and Meta-Regression.

Jing Ying Cheng, Saatirah Bte Mohamad S Nurul, Ling Jie Cheng, Hong-Gu He
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Abstract

Family caregivers living with patients with dementia (PwD) face psychological challenges due to care burden. Technology-delivered psychosocial interventions (TPIs) have played a promising role in improving health outcomes among family caregivers living with PwD. This review aims to synthesise evidence of the effectiveness of TPIs on primary (burden and depression) and secondary outcomes (self-efficacy, stress and anxiety) for family caregivers living with PwD. Random-effects meta-analyses were performed to determine effect size. Using Cochran's Q and I2 tests, statistical heterogeneity was evaluated. Sensitivity, subgroup analyses and meta-regression were employed to explain statistical heterogeneity. Twenty-eight trials comprising 4160 family caregivers from eight countries were included. Our meta-analysis revealed that TPIs resulted in slight reduction in depression, probably resulted in a slight reduction in burden and anxiety and slight increase in self-efficacy. Subgroup differences were detected in geographical regions (Western Pacific and Southeast Asia) for burden. While there were no significant subgroup differences in other factors, TPIs with preventive function and mobile applications had a more prominent larger effect size. Meta-regression analysis showed that attrition rate was a significant moderator on depression. Results are limited by the high risk of bias of included trials, which may reduce certainty of evidence. This review suggest TPIs are recommended as an adjunct treatment for alleviating burden and depressive outcomes in healthcare institutions. PROSPERO Registration Number: PROSPERO (CRD42023387962).

技术提供的社会心理干预对痴呆症患者家庭照顾者的效果:系统综述、元分析和元回归。
与痴呆症患者(PwD)生活在一起的家庭照护者因照护负担而面临心理挑战。技术提供的社会心理干预(TPI)在改善与痴呆症患者生活在一起的家庭照护者的健康状况方面发挥了积极作用。本综述旨在综合技术性社会心理干预对与残疾人生活在一起的家庭照顾者的主要结果(负担和抑郁)和次要结果(自我效能、压力和焦虑)的有效性证据。为确定效应大小,我们进行了随机效应荟萃分析。使用 Cochran's Q 和 I2 检验对统计异质性进行了评估。采用敏感性、亚组分析和元回归来解释统计异质性。共纳入了来自 8 个国家、4160 名家庭护理人员参与的 28 项试验。我们的荟萃分析表明,TPIs 可轻微减轻抑郁,可能会轻微减轻负担和焦虑,并轻微提高自我效能。在负担方面,发现了地理区域(西太平洋和东南亚)的亚组差异。虽然在其他因素上没有明显的亚组差异,但具有预防功能和移动应用的创伤性脑卒中的效果更为突出。元回归分析表明,自然减员率是抑郁的一个重要调节因素。纳入试验的偏倚风险较高,可能会降低证据的确定性,从而限制了研究结果。本综述建议将 TPIs 作为一种辅助治疗方法,以减轻医疗机构的负担和抑郁结果。PROSPERO 注册号:PROSPERO(CRD42023387962)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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