Department of Clinical Psychology, University of East Anglia, Norwich, UK.
School of Health Sciences, University of East Anglia, Norwich, UK.
Gerontologist. 2019 Jul 16;59(4):e363-e379. doi: 10.1093/geront/gny024.
The application of mindfulness- and acceptance-based interventions (MABIs) for informal caregivers of people with dementia (PwD) is relatively novel, and the current state of the evidence base is unclear. This meta-analysis examined the effectiveness of MABIs on reducing symptoms of depression and burden in informal caregivers of PwD. The quality of included studies was evaluated and moderator variables explored.
A literature search of six electronic databases (PsycARTICLES, PsycINFO, MEDLINE Complete, SCOPUS, Web of Science, and ProQuest) was conducted from the first available date to 20 December 2016. Inclusion criteria involved studies that quantitatively investigated the impact of MABIs on depression and/or burden in informal caregivers of PwD.
Twelve studies, providing data on 321 caregivers, were included. Most used mindfulness-based stress reduction and were conducted in the United States. The average attrition among participants was 15.83%. The pre-post effect of MABIs was large for depression and moderate for burden. These effects were largely maintained at follow-up. Significant heterogeneity of effect sizes was observed, with no significant moderators identified. Study quality varied from very poor to moderately good.
The low attrition and moderate to large effects suggest that MABIs are acceptable and beneficial for informal caregivers of PwD. The lack of significant moderators could advocate services using more cost-effective forms of MABIs. Further higher-quality research is needed to improve the robustness of the evidence base and enable a meta-analysis to thoroughly examine and quantify moderator variables.
正念和接纳为基础的干预措施（MABI）在痴呆症患者（PwD）的非专业照护者中的应用相对较新，目前的证据基础尚不清楚。本荟萃分析研究了 MABI 对减轻痴呆症患者非专业照护者的抑郁和负担症状的有效性。评估了纳入研究的质量，并探讨了调节变量。
对六个电子数据库（PsycARTICLES、PsycINFO、MEDLINE Complete、SCOPUS、Web of Science 和 ProQuest）进行了文献检索，检索时间从最早可用日期到 2016 年 12 月 20 日。纳入标准包括定量研究 MABI 对痴呆症患者非专业照护者的抑郁和/或负担影响的研究。
纳入了 12 项研究，共 321 名照护者的数据。大多数研究使用正念减压疗法，在美国进行。参与者的平均失访率为 15.83%。MABI 的预-后效应在抑郁方面较大，在负担方面为中等。这些影响在随访中基本保持不变。观察到效应大小的显著异质性，未发现显著的调节变量。研究质量从很差到中等不等。
低失访率和中等至较大的效应表明，MABI 对痴呆症患者的非专业照护者是可接受且有益的。缺乏显著的调节变量可以主张使用更具成本效益的 MABI 形式的服务。需要进一步进行高质量的研究，以提高证据基础的稳健性，并使荟萃分析能够彻底检查和量化调节变量。
