Hopwood Jenny, Walker Nina, McDonagh Lorraine, Rait Greta, Walters Kate, Iliffe Stephen, Ross Jamie, Davies Nathan
Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, London, United Kingdom.
Research Department of Primary Care and Population Health, University College London, London, United Kingdom.
J Med Internet Res. 2018 Jun 12;20(6):e216. doi: 10.2196/jmir.9548.
Caring for someone with dementia is one of the most challenging caring roles. The need for support for family caregivers has been recognized for some time but is often still lacking. With an aging population, demand on health and social care services is growing, and the population is increasingly looking to the internet for information and support.
In this review, we aimed to (1) identify the key components of existing internet-based interventions designed to support family caregivers of people with dementia, (2) develop an understanding of which components are most valued by caregivers, and (3) consider the evidence of effectiveness of internet-based interventions designed to support family caregivers of people with dementia.
We conducted a systematic search of online databases in April 2018. We searched reference lists and tracked citations. All study designs were included. We adopted a narrative synthesis approach with thematic analysis and tabulation as tools.
We identified 2325 studies, of which we included 40. The interventions varied in the number and types of components, duration and dose, and outcomes used to measure effectiveness. The interventions focused on (1) contact with health or social care providers, (2) peer interaction, (3) provision of information, (4) decision support, and (5) psychological support. The overall quality of the studies was low, making interpretation and generalizability of the effectiveness findings difficult. However, most studies suggested that interventions may be beneficial to family caregiver well-being, including positive impacts on depression, anxiety, and burden. Particular benefit came from psychological support provided online, where several small randomized controlled trials suggested improvements in caregiver mental health. Provision of information online was most beneficial when tailored specifically for the individual and used as part of a multicomponent intervention. Peer support provided in online groups was appreciated by most participants and showed positive effects on stress. Finally, online contact with a professional was appreciated by caregivers, who valued easy access to personalized practical advice and emotional support, leading to a reduction in burden and strain.
Although mixed, the results indicate a positive response for the use of internet-based interventions by caregivers. More high-quality studies are required to identify the effectiveness of internet interventions aimed at supporting family caregivers, with particular focus on meeting the needs of caregivers during the different stages of dementia.
照顾患有痴呆症的人是最具挑战性的护理角色之一。家庭护理人员对支持的需求已被认识到一段时间，但往往仍然缺乏。随着人口老龄化，对健康和社会护理服务的需求不断增长，人们越来越多地在互联网上寻求信息和支持。
在本综述中，我们旨在（1）确定现有基于互联网的干预措施的关键组成部分，这些措施旨在支持痴呆症患者的家庭护理人员；（2）了解护理人员最看重哪些组成部分；（3）考虑基于互联网的干预措施对痴呆症患者家庭护理人员有效性的证据。
我们于2018年4月对在线数据库进行了系统检索。我们搜索了参考文献列表并追踪了引用情况。纳入了所有研究设计。我们采用了以主题分析和列表为工具的叙述性综合方法。
我们识别出2325项研究，其中纳入了40项。这些干预措施在组成部分的数量和类型、持续时间和剂量以及用于衡量有效性的结果方面各不相同。这些干预措施侧重于（1）与健康或社会护理提供者的联系；（2）同伴互动；（3）信息提供；（4）决策支持；（5）心理支持。研究的整体质量较低，使得对有效性结果的解释和推广变得困难。然而，大多数研究表明，干预措施可能有利于家庭护理人员的福祉，包括对抑郁、焦虑和负担产生积极影响。特别有益的是在线提供的心理支持，几项小型随机对照试验表明护理人员的心理健康有所改善。当专门为个人量身定制并作为多成分干预的一部分使用时，在线提供信息最为有益。在线小组中提供的同伴支持受到大多数参与者的赞赏，并对压力产生了积极影响。最后，护理人员对与专业人员的在线联系表示赞赏，他们重视能够轻松获得个性化的实用建议和情感支持，从而减轻了负担和压力。
尽管结果不一，但表明护理人员对使用基于互联网的干预措施有积极反应。需要更多高质量的研究来确定旨在支持家庭护理人员的互联网干预措施的有效性，特别关注满足痴呆症不同阶段护理人员的需求。
