Cheng Jing Ying, Nurul Saatirah Bte Mohamad S, Cheng Ling Jie, He Hong-Gu
Khoo Teck Puat Hospital, Yishun Health, National Healthcare Group, Singapore.
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Int J Ment Health Nurs. 2024 Dec;33(6):1796-1816. doi: 10.1111/inm.13390. Epub 2024 Jul 21.
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 I 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).
与痴呆症患者(PwD)共同生活的家庭照顾者由于护理负担而面临心理挑战。技术提供的心理社会干预(TPI)在改善与PwD共同生活的家庭照顾者的健康结果方面发挥了有前景的作用。本综述旨在综合TPI对与PwD共同生活的家庭照顾者的主要结果(负担和抑郁)和次要结果(自我效能感、压力和焦虑)有效性的证据。进行随机效应荟萃分析以确定效应大小。使用 Cochr an的 Q 和 I² 检验评估统计异质性。采用敏感性分析、亚组分析和元回归来解释统计异质性。纳入了来自八个国家的28项试验,共4160名家庭照顾者。我们的荟萃分析表明,TPI导致抑郁略有减轻,可能导致负担和焦虑略有减轻,自我效能感略有增加。在负担方面,在地理区域(西太平洋和东南亚)检测到亚组差异。虽然在其他因素上没有显著的亚组差异,但具有预防功能的TPI和移动应用程序的效应大小更为显著。元回归分析表明,失访率是抑郁的一个显著调节因素。结果受到纳入试验的高偏倚风险的限制,这可能会降低证据的确定性。本综述建议,在医疗机构中,TPI被推荐作为减轻负担和抑郁结果的辅助治疗方法。PROSPERO注册号:PROSPERO(CRD42023387962)。