Caregivers only Family caregivers of persons with dementia
(i) CESD (ii) Relationship Assessment Scale
Length: 5 months. Description: all participants received the same psychoeducational telephone-based intervention for the first 4 weeks, then randomized into 2 groups.Intervention: () 8 biweekly telephone-based psychoeducation with behavioral activation sessions focused on pleasant event scheduling and improving communications. Comparison: () 8 biweekly telephone-based sessions of general discussion of psychoeducation and related information.
Participants in the intervention group had decreased levels of depression versus the comparison group at endpoint. Relationship satisfaction also was significantly higher between time 2 and 3 in the intervention group; however, it did not improve significantly over time in the comparison group.
Caregivers only Older family caregivers of stroke survivors
(i) Revised Life Orientation Test (ii) Oberst Caregiving Burden Scale (difficulty subscale) (iii) Appraisal of Caregiving (threat subscale) (iv) PHQ Depression Scale (v) BCOS (vi) SF-36 (general health subscale)
Length: 8 weeks, with follow-up at 4 and 12 weeks.Intervention: () mailed a booklet on stroke caregiver tips, stress management workbook, and an American Stroke Association (ASA) brochure; received 8 weekly calls from a nurse who assessed and addressed their current needs. Attention control: () mailed ASA brochure. They received 8 weekly calls from a nurse who provided active listening and paraphrasing, referring any questions or concerns to healthcare provider or ASA.
Significant increases in caregiver self-reported optimism were noted at 4 weeks in the intervention group versus the comparison group and were maintained at the end of the intervention (8 weeks) as well as 12 weeks postintervention. Caregivers receiving the intervention also reported improved threat appraisal at 8 weeks as well as 12 weeks.
Length: 8 weeks; 12-, 24-, and 52-week follow-up. Description: all participants received 8 weekly telephone sessions, with a booster at 12 weeks.Intervention: () received a resource guide and an American Heart Association pamphlet, Caring for Stroke Survivors, in addition to 5 skill building tip sheets focusing on screening for depressive symptoms, maintaining realistic expectations, communicating with healthcare providers, problem-solving, strengthening existing relationships, and stress management. Telephone calls focused on training caregivers to identify and prioritize their needs and concerns and using innovative skill building strategies for management. Attention control: () received only the American Heart Association pamphlet. Telephone calls focused on providing support using active listening strategies.
Among caregivers with depressive symptoms scores ≥5, those in the intervention group had a greater reduction in depressive symptoms from baseline to 8, 24, and 52 weeks and greater improvement in life changes from baseline to 12 weeks versus the comparison group. However, this did not hold for the total sample. Caregivers in the intervention group also had a greater reduction in unhealthy days from baseline to 8 weeks, yet this was not sustained at 12, 24, or 52 weeks.
Caregiver-care recipient dyads Partner-caregivers of African American men surviving prostate cancer
(i) Self-Efficacy for Symptom Control Inventory (partner version-adapted, activity efficacy, coping, symptom management subscales, plus total) (ii) Profile of Mood States
Length: 7 weeks.Intervention: () weekly phone calls over 6 weeks focused on problem-solving, relaxation, communication, side effect management, cognitive restructuring, and maintenance planning. Usual care: () standard outpatient medical care.
Caregivers reported no significant differences in anger, confusion, depression, fatigue, anxiety, or vigor. There were no significant effects for caregiver strain or self-efficacy between groups.
In-person visits at home and/or in the community plus telephone and mail versus telephone and mail only
Caregiver-care recipient dyads Informal caregivers of persons with dementia
(i) ZBI (ii) RMBPC (iii) PHQ-9 (iv) Caregiver Quality of Life Instrument (spirituality and faith; benefits of caregiving subscales) (v) Health Utilities Index
Length: 12 months; follow-up data collection at 6 & 12 months. Description: all participants received a minimum of 7 contacts from care managers (i.e., social workers) covering areas such as stress management techniques, problem-solving, educational needs, and advance care planning. Intervention: ( dyads) in person home visits (primarily), but also telephone and mail. Comparison group: ( dyads) telephone or mail contacts only.
In person dyads received, on average, one in-person contact during the study duration (,) and more total telephone contacts than did the comparison group. Care quality improved substantially over time in both groups. Caregiver burden, care-recipient problem behaviors, and healthcare utilization did not differ across groups.
Caregiver-care recipient dyads Family caregivers of older adults with Alzheimer’s-type dementia
(i) The Screen for Caregiver Burden (objective & subjective subscales) (ii) Geriatric Depression Rating Scale (iii) Interpersonal Support Evaluation List (iv) Life Satisfaction Index-
Length: 12 weeks with a 3-month follow-up. Intervention: () 12 weekly telephone-based appraisal and coping skills training Comparison: () 12 weekly home-based appraisal and coping skills training Attention control: () weekly “friendly” supportive telephone calls only.
Method of intervention delivery affected outcomes and timing of improvements. Caregivers receiving the intervention in-person reported significant reductions in caregiver burden and distress at posttest and follow-up. Caregivers receiving the intervention by phone did not show statistically significant reductions at posttest but did show reductions at follow-up. Caregivers in the attention control reported significant reductions in burden and distress at posttest but this was not sustained at follow-up. There were no effects for caregiver depression, perceived social support, or life satisfaction.
Caregivers only Older family caregivers of patients receiving in-home hospice care
(i) Caregiver Quality of Life Index-Revised (ii) The State-Trait Anxiety Inventory (iii) Problem-Solving Inventory
Length: 2 weeks. Description: received the intervention either in-person () or by videophone (). The first session was conducted in-person for both groups, including consent, randomization, identification of 3 problems on checklist, and installation of videophone if applicable. For both groups, a total of three contacts were made between days 5 and 18 of hospice admission. Each contact lasted about 45 minutes. The sessions focused on problem-solving training.
Method of intervention delivery did not affect outcomes. Videophone-delivered intervention was not inferior to in-person intervention. Caregiver quality of life improved and state anxiety decreased under both conditions, and the observed changes in scores were similar for each group.
Caregivers only Family caregivers of persons with advanced cancer receiving palliative care
(i) CESD (ii) PG-13
Length: 3 weekly contacts after advanced cancer diagnosis, then monthly phone calls, including 1 after the death of the care recipient. Follow-up data collection at 6, 12, 18, and 24 weeks, then every 12 weeks until the care recipient expired. Intervention: () participants received telephone intervention at the time of care recipient’s diagnosis of advanced cancer and completed after-death questionnaires. Delayed/comparison: () participants received delayed telephone intervention, beginning 12 weeks later, and completed after-death questionnaires.
Groups did not differ by early versus delayed intervention, on follow-up measures of depression and grief.
Caregivers only Rural family caregivers of older adults
(i) Outcomes Questionnaire-45 (symptom distress, interpersonal relationship, and social role functioning subscales) (ii) Social Provisions Scale (guidance, reliable alliance, reassurance of worth, attachment, social integration, and opportunity for nurturance)
Length: 8 weeks, with 6-month follow-up. Intervention: () received a manualized, but flexible intervention addressing knowledge, problem-solving skills, social support, and affect. Comparison: () received access to a caregiver-initiated call-in helpline staffed by masters level counselors, with content drawn from the same manual, based on the presenting concern. Control: () no intervention.
Over time, caregivers in the control group reported increased symptoms of distress, and increased difficulties in social roles and interpersonal relations. Caregivers in the comparison group also reported increased symptoms of distress and increased difficulties in interpersonal relations. Caregivers who completed the intervention reported significantly less stress, and improved social role functioning that was still evident at 6 months. Scores on the opportunity for nurturance subscale also decreased significantly over time in the intervention group.
In-person (initial session for all groups), videoconferencing
Caregiver-care recipient dyads Family caregivers of persons with spinal cord injury
(i) SPSIR (ii) Inventory to Diagnose Depression (iii) SWLS
Length: 12 months; follow-up at 6 months and postintervention at 12 months. Description: both groups were asked to identify and prioritize problems unique to their situation. Intervention: () individualized problem-solving training delivered via videoconferencing sessions that focused on (a) problem definition, (b) optimism and orientation toward problem-solving, (c) creativity and generating alternatives, (d) understanding and decision-making, and (e) solving the problem with implementation and evaluation of a solution. Attention control: () weekly telephone contacts to discuss educational materials received by mail and monthly face-to-face interactions with the videoconferencing device.
There was a significant decrease in depression among caregivers in the intervention group at 6 months. Caregivers in the intervention group also were projected to improve social functioning over 12 months, while the comparison group was projected to decline. There were no statistically significant findings for caregiver satisfaction with life, quality of life, or problem-solving styles.
In-person (4 additional contacts in intervention group only), telephone
Caregiver-care recipient dyads Family caregivers of women with disabilities
(i) CES-D (ii) SWLS (iii) PILL (iv) SPSIR
Length: 48 weeks. Intervention: () in-home problem-solving training sessions at months 1, 4, 8, and 12. Monthly telephone calls were conducted on the 8 alternate months. Attention control: () monthly education-only telephone calls reviewing previously mailed health-education materials on topics such as emotions, relaxation, dental health, osteoporosis, exercise, respite, and long-term care.
Depression scores decreased over time in the intervention group, while depression scores for the comparison group increased. Constructive coping increased over time in the intervention group, while constructive coping decreased over time in the comparison group. No effects were observed for caregiver health or life satisfaction.
Caregivers only Family caregivers of older adults with Alzheimer’s or other dementia
(i) CES-D (ii) Behavior Management Scale-Revised (iii) Revised Memory and Problem Behavior Checklist
Length: 12 weekly sessions (5 weekly group and 7 weekly individual phone sessions), followed by group booster sessions at 6 and 12 months, and as-needed contacts throughout the 12-month intervention period. Intervention: () caregiver skill building related to behavioral symptoms of dementia, as well as self-efficacy in managing those symptoms. The telephone calls were used to address individual needs. Comparison: () standardized implementation of psychoeducation methods, as well as general information and support. These were not tailored to individual needs in phone calls.
The intervention and comparison groups did not differ in efficacy; there were significant improvements over time in caregiver mood, caregiver confidence in behavior management skills, and number of reported disruptive behaviors of the care recipient. The groups did not differ in time to institutionalization.
Caregivers only Family caregivers of persons with dementia
(i) Subjective Caregiving Burden Scale (ii) CESD (iii) Positive and Negative Affect Scales (iv) CHAMPS
Length: 12 months, including a home visit at baseline, 6 and 12 months, and tapered telephone follow-up. Data were collected in-person at baseline, 6, and 12 months and via telephone at 3 and 9 months. Intervention: () caregivers received the Enhanced Physical Activity Intervention (EPAI) via in-person and telephone to increase total and total moderate physical activity, plus caregiver skill building information. Intervention/comparison: () caregivers received the Caregiver Skill Building Intervention (CSBI) in-person and via telephone only.
No significant mean differences between the EPAI and CSBI for any of the mental health variables at either baseline or 12 months were noted, but there were significant interactions between the EPAI and increased positive affect at both 6 and 12 months. The EPAI group participants increased physical activity over the course of the study, while he CSBI group tparticipants decreased physical activity over that period.
Telephone (CTIS system), in-person (initial and last session for intervention only)
Caregivers only Older family caregivers of older adults with Alzheimer’s or other dementia
(i) CES-D (ii) RMBC-24 (iii) Caregiver Health & Health Behaviors Scale (iv) Inventory of Socially Supportive Behaviors (received social support subscale)
Length: 24 months. Intervention: () received a screen phone intervention providing information about the disease, community resources, and strategies to enhance safety, communication, self-care, social support, and management of problem behaviors. Teleconference calls included 8 individual educational and 6 group support sessions. Initial and last sessions were in-person. Comparison: () received basic educational materials, two brief telephone check-in calls at three and five months postrandomization and were invited to participate in a workshop following the 6-month assessment.
No significant main effects for treatment were noted. Two significant interactions were found: caregivers with higher baseline depression scores who received the intervention had significantly greater reductions in posttest depression scores. Similarly, among caregivers at baseline who reported a higher level of support, those provided the intervention were more likely to report receiving similar levels of support by posttest, compared to reduced support received by the comparison group participants.
Telephone, video modules (intervention group only; mailed to client, format not listed in article)
Caregivers only Male caregivers of a family member with dementia
(i) Researcher-Developed Likert Scale Items of How “Bothered or Upset” or “Irritated or Annoyed” the Caregiver Became When Behavioral Problems Occurred (ii) The Revised Scale of Caregiving Self-Efficacy (iii) Positive and Negative Affect Scale (iv) Interviews
Length: 12 weeks. Intervention: () a 10-session video series, caregiving workbook, and 12 weekly phone calls. The intervention was behaviorally focused, utilizing videos (VHS) along with homework and discussions focused on each participant’s unique problems. Comparison: () 7 biweekly phone calls to review materials, discuss use of strategies, and answer any questions using a standardized script.
Participants in both conditions improved significantly, with no evidence of greater efficacy in the intervention group for reducing psychosocial distress, increasing positive affect, or caregiving self-efficacy, compared to the more intense and more structured intervention.
Telephone, in-person (initial session for intervention group only)
Caregivers only Older family caregivers of stroke patients recently discharged from inpatient rehabilitation
(i) SF-36 (ii) SRSIR (iii) The Client Satisfaction Questionnaire (iv) CES-D (v) Preparedness for Caregiving Scale (vi) Caregiving Burden Scale (difficulty subscale)
Length: 12 weeks. Description: 74 caregivers were randomized to 1 of 3 groups. Intervention: an initial in-home session within a week of discharge from the hospital, followed by weekly phone calls at week 2, 3, 4, and biweekly calls at weeks 6, 8, 10, and 12 postdischarge. The problem-solving intervention followed the same general structure for each of the top 3 caregiver concerns at the point of contact: identifying problems, listing solutions, choosing and testing a solution, and evaluating outcomes. Attention control: telephone calls (same timing), but caregivers were asked to report specific data on a healthcare utilization since the last contact. Control: usual care.
The intervention group showed relatively greater improved scores in vitality, role limitations, mental health, negative problem orientation, rational problem-solving, impulsivity-carelessness, caregiver preparedness, and caregiver depression.
Telephone, in-person (only some intervention group members)
Caregivers only Spouse caregivers of stroke survivors after rehabilitation
(i) CES-D (ii) UCLA Loneliness Scale (iii) Caregiver Competence Scale (iv) The Burden Interview (v) The Pressing Problem Index
Length: 8 weeks, with a 6-month follow-up. Intervention: () structured, psychoeducational training based on stress and coping theory was delivered via 8 one-hour small-group telephone-based sessions. A group stress management manual was mailed, as well as a list of contact information for group members. Comparison: () received the stress management manual and a brief written description of caregiver stress and stroke.
The comparison group showed a significant increase in burden during the study; intervention group showed a significant increase in self-rated competence.
Length: 3 months; plus a 3-month postintervention follow-up. Intervention: () multidisciplinary education and support group meetings in person, plus weekly nurse telephone calls for 3 months and as needed telephone contacts. Cultural sensitivity was included for the Chinese culture, including effects of role changes and available resources. Usual care: () standard care only.
There were no significant differences at baseline in outcome variables. At posttest and 3-month follow-up, the experimental group reported significantly less burden, greater QoL related to mental health, and less depression. No differences were found in QoL related to physical health.
Telephone, videoconferencing, patient vital signs monitoring system equipment
Caregiver-care recipient dyads Caregivers of patients undergoing elective, first-time coronary artery bypass graft surgery
(i) State-Trait Anxiety Inventory (anxiety subscale) (ii) CES-D
Length: 1 week; 3-week follow-up. Intervention: (; dyads) standard care, plus follow-up audio-visual telehealth sessions for heart monitoring, symptom reports and discussion of symptoms, and review of postoperative care instructions. Usual care: ( dyads) standard care only, which included education prior to the surgery, daily education and physical therapy during hospitalization, and a scheduled follow-up with the surgeon in six weeks.
Caregivers’ levels of depressive symptoms decreased significantly more for those in the intervention group, compared to control. Caregivers of male patients in the intervention group experienced a greater decrease in anxiety from presurgery to 3 weeks after discharge than did caregivers of male patients who were in the control group. There was no evidence that the intervention had a greater impact than control on patient anxiety from presurgery to 3 weeks after discharge. Patients who received the intervention were less likely than the control to have contacted a physician during the first 3 weeks after hospital discharge postsurgery.
Caregivers only Older female family caregivers of persons with dementia
(i) Short Form General Health Survey Screen for Caregiver Burden (ii) CHAMPS (iii) Cardiovascular Reactivity to Emotional Challenge (iv) Pittsburgh Sleep Quality Index (v) PSS (vi) BDI (vii) Block95 Food Frequency Questionnaire
Length: 12 months. Intervention: () one at-home session to set up an exercise program, then follow-up telephone contacts were conducted biweekly for the first 2 months, then once monthly through the last 10 months for a total of 14 contacts. Contacts lasted 15-20 minutes to monitor exercise progress, answer questions, and provide feedback. Participants completed and mailed daily logs to the study team monthly. Comparison: () one at-home session to describe the nutritional program then telephone contacts to follow up. Telephone contacts followed the same schedule as the intervention. Phone contacts focused on different topics each month. Participants completed and mailed daily logs to the study team monthly.
The intervention group had significantly greater increase in self-reported activity level and sleep quality, as well as reduced systolic and diastolic blood pressure reactivity, compared to the comparison group. Conversely, the comparison group reported significantly greater reduction in consumption of high-fat and high-sugar foods, and in fat as a percentage of total calories. Both groups reported reduction in psychological distress and depression, with no significant difference between the groups.
Caregivers only Family caregivers of persons with dementia of any stage
Chinese Versions (i) ZBI (ii) Caregiving Self-Efficacy-Revised
Length: 12 weeks. Intervention: () an educational DVD, plus a psychoeducation program delivered over the telephone in 12 weekly sessions. Topics included information about dementia, skills of communicating with the patient, management of behavioral and psychological symptoms of dementia, caregivers’ own emotional issues, resources available in the community, and long-term care plan. Comparison: () DVD of educational information about dementia caregiving only.
Caregivers receiving the intervention obtained significantly larger change scores on burden and on caregiving self-efficacy-obtaining respite.
Caregiver-care recipient dyads Informal family caregivers who had difficulty managing medications for persons with memory loss
(i) MedMaIDE (ii) Medication Deficiency Checklist (Researcher-Developed)
Length: 16 weeks (8 weeks active intervention, 8 weeks maintenance/check-in). Intervention: () participants received a booklet covering 7 key areas of medication management. A nurse or social worker reviewed these areas with the caregiver and provided problem-solving support in 2-3 home visits over 4-6 weeks followed by 2-3 telephone sessions over 2-4 weeks. Skills were reinforced through 4 biweekly telephone calls over 8 weeks. Control: () participants received a resource manual and medication reconciliation in-person at baseline, plus the intervention manual at the completion of the study.
Both groups showed significant decreases in medication management problems at follow-up.
Caregivers only Family caregivers of persons with moderate depression receiving outpatient treatment
(i) ECI
Length: 3 months (8 weeks intervention; 1-month follow-up). Intervention: () participants received a cognitive behavioral-based, guided self-help manual geared towards individuals with depression xand/or their caregivers and were asked to complete one module per week for 8 weeks. Weekly follow-up brief telephone calls were conducted for 8 weeks to answer questions and provide support. Also received occasional unplanned in-person visits at outpatient medical appointments. Attention control: () participants received brief telephone calls on a similar schedule to respond to questions and provide brief support. Occasional unplanned in-person visits at outpatient medical appointments were also provided.
Caregivers showed a significant decrease in negative experience and a significant increase in positive experience postintervention, which was maintained at the one-month follow-up.
Caregiver-care recipient dyads Family caregivers of persons with lung cancer (stage I-III) at any point in treatment
(i) Profile of Mood States-B (ii) CSI (iii) Self-Efficacy Scale (modified)
Length: 8 months, with 4-month follow-up. Description: dyads received equal number and length of sessions. Dyads participated together via speakerphone in all sessions. Intervention: ( dyads) received coping skills training which included symptom management and stress management strategies, with caregivers being encouraged to adopt a “coach” role, and to utilize coping for self-care. Comparison: ( dyads) received cancer education and support tailored to the stage and treatment of each patient, such as lung cancer symptoms and treatments, as well as information about palliative versus curative care.
No significant differences in outcomes between the intervention and the comparison group were noted. There was a significant effect of time: caregivers in both groups reported increased self-efficacy and reduction in anxiety over time. Caregivers of patients with less advanced cancer in the comparison group had significant reduction in strain and increased self-efficacy, whereas those caring for patients with more advanced cancer responded better to the intervention.
Length: 12 months. Intervention: () problem-solving training including 4 in-home sessions teaching problem-solving skills and 8 telephone calls, spread across 1 year. The intervention was tailored to individuals’ identified problems and priorities. Attention control: () received educational materials in the mail, plus monthly follow-up calls to discuss the information; these telephone calls were 10-15 minutes in length, on average.
The intervention group reported significantly greater reduction in depression, health complaints, and “dysfunctional problem-solving”, compared to the comparison group. Results on other outcome measures were not significant.
Caregivers only Caregivers and friends of persons diagnosed with poor prognosis upper gastrointestinal or Duke D colorectal cancer
(i) SF-12 (ii) Caregiver Reaction Assessment Scale (iii) Distress Thermometer (1-item) (iv) Supportive Care Needs Survey-Caregiver (v) Health Services Utilization Index
Length: 10 weeks posthospital discharge, with follow-up at 3 and 6 months. Intervention: () participants received a standardized manual providing education related to domains of patient care, family relationships, and emotional and physical care. Individualized education and support were provided in 4 standardized telephone calls over 10 weeks posthospital discharge by clinical psychologists. Usual care: () standard care only.
At the 3-month and 6-month posthospital discharge intervals, no significant differences were noted between the intervention and usual care participants across all caregiver measures. However, intervention participants reported significantly fewer patient emergency department visits and unplanned hospital readmissions at the 3-month postdischarge, but this difference was not maintained at the 6-month postdischarge interval.
Caregivers only Spouse and adult child caregivers of frail older adults with significant need for assistance with activities of daily living
(i) MOS Social Support Survey (ii) ZBI (iii) CES-D (iv) State-Trait Anxiety Inventory (v) Pressing Problems Index (vi) Community Services Inventory
Length: 12 weeks. Intervention: () telephone-based therapy delivered to small groups of spouse or adult children caregivers, led by a social worker who guided them through strategies for emotion-focused coping (stress inoculation training), problem-focused coping, and use of group/peer support. Usual care: () standard care, offered by a senior services center to which all were referred, with opportunity to participate in a telephone support group after 12 weeks and completion of the follow-up assessments.
No significant differences between groups were noted in spouses on any of the outcome measures. Positive social interaction and emotional/informational support increased for adult children in the intervention group but decreased for those in the control group. Adult children in the intervention group had significant decreases in total strain over time, while adult children in the control group had increases in total strain. Depressive symptoms decreased significantly more in adult children in the intervention group versus the control. There were no significant findings for anxiety. Decreases in the level of stress of pressing problems over time were significantly greater in adult children in the intervention group than those in the control group. Adult children in the intervention group also reported significantly greater feelings of effectiveness to manage pressing problems over time, compared to those in the control group. Adult children in the intervention group had increased knowledge of services, greater knowledge of how to access services, and used more services over time, whereas adult children in the control group showed decreases in all three of these measures.
Caregiver-care recipient dyads Informal caregivers of elders with a memory disorder living at home
(i) JHDCNA (ii) ZBI (iii) Geriatric Depression Scale (iv) Researcher-Developed Items on Caregiver Burden & Perceived Daily Difficulty Providing Care (V) Self-Rated Overall Health (Vi) Self-Rated Overall Stress
Length: 18 months; data collected at baseline, 9 months, & 18 months. Intervention: ( dyads) 18 months of care coordination by an interdisciplinary intervention team that included nonclinical community workers (coordinators) as the frontline staff, a registered nurse, and a geriatric psychiatrist. The manualized care coordination protocol consisted of four key components: (1) identification of needs and individualized care planning based on the JHDCNA to address unmet needs and to match the priorities and preferences of the dyad and family; (2) provision of dementia education and skill building strategies; (3) coordination, referral, and linkage to health and community services; and (4) care monitoring. There were a minimum of 2 in-home visits and monthly telephone contacts provided, with opportunity for more home-visits, visits at medical appointments, and additional telephone contacts (additional contacts not tracked). Comparison: ( dyads) received the written needs assessment results and intervention recommendations, as well as a brief resource guide developed for the study that provided program and contact information for local and national aging service organizations.
There were no statistically significant group differences in reduction of total percent of unmet needs from baseline to 18 months or in any of the four need domains; however, the total percent of unmet needs decreased in both the comparison and intervention groups when modeled independently using mixed effects linear regression models. There was a decrease in hours per week caregivers spent with care recipients in the intervention group relative to the comparison group from baseline to 18 months and an increase in the control group, but this was not statistically significant after multiple comparison correction. Similarly, though not statistically significant, ZBI score estimates increased in the comparison group and decreased in the intervention group.
Caregivers only Caregivers of person with dementia
(i) ZBI (ii) Geriatric Depression Scale (iii) RMBPC (iv) Alzheimer’s Disease Knowledge Test (v) SF-36 General Health (vi) Self-Efficacy Scale (vii) Family Assessment Device (viii) Multidimensional Scale of Perceived Support
Length: 52 weeks. Description: all participants received an informational binder with local resources and educational materials from the Alzheimer’s Association. Intervention: () a multicomponent, manualized program delivered by telephone, providing emotional support, directing caregivers to appropriate resources, encouraging caregivers to attend to their own physical, emotional, and social needs, and teaching caregivers strategies to cope with ongoing problems. Usual care: () standard care provided.
Caregivers who completed the intervention reported significantly lower perceived burden compared to caregivers in the control group. Intervention caregivers also reported significantly less severe reactions to memory and behavior problems, but there was no significant difference between the groups in reported depression. No other outcomes were significant.
Caregivers only Family caregivers of persons with dementia
(i) CES-D (ii) ZBI (iii) RMBPC (iv) Family Assessment Device (v) Self-Efficacy Questionnaire (vi) Positive Aspects of Caregiving Scale (vii) Euro QOL
Length: 6 months; data collected at baseline and 6 months. Intervention: () family intervention telephone tracking-caregiver: 6 telephone contacts distributed over 6 months that focused on providing dementia education, emotional support, directing caregivers to appropriate resources, encouraging caregivers to attend to their physical, emotional, and social needs, and teaching caregivers strategies to cope with ongoing problems. Comparison: () telephone contacts to provide supportive counseling only with identical frequency/timing of contacts. Content and process differed substantially.
The intervention group had significantly improved caregiver depressive symptoms and less severe reactions to care-recipient depressive behaviors compared with the comparison group.
In-person (initial visit for both intervention and comparison groups), telephone
Caregivers only Family caregivers of older adults with dementia
(i) Goal Attainment Scaling (ii) Researcher-Developed Questions regarding Satisfaction with Various Intervention Elements and Perceived Benefit
Length: 3 months, with 6 months postintervention follow-up. Intervention: () a telephone-based cognitive-behavioral therapy intervention with modules focused on utilization of social and professional support, problem-solving and coping with problem behavior of the patient, modifying dysfunctional thoughts, and expressing and processing emotions of role change and loss. Goal setting and attainment was included. Program consisted of 7 (60 minutes) therapeutic sessions; the first 4 sessions took place on a weekly basis, sessions 5-6 on a fortnightly basis, and session 7 monthly. Comparison: () A telephone intervention with psychologists who provided an equal number of training sessions in progressive muscle relaxation (PMR) for managing distress and anxiety associated with caregiving. Participants were also provided a CD program to follow. Usual care: () treatment as usual, including written educational material about dementia and dementia caregiving with the addresses of local self-help organizations that was dispersed to all groups.
Caregivers in the intervention group reported significant progress toward personally identified goals. Both groups reported high satisfaction and benefit of the interventions, but the intervention group rated the intervention even more helpful, reported a higher amount of fulfilled expectations, showed a higher percentage of willingness to recommend the intervention, and expressed a more intense desire to participate in such a trial again than the comparison group.
In-person (initial session for both intervention and comparison group), telephone
Caregivers only Family caregivers of persons with dementia
(i) CES-D (German) (ii) Gießener Beschwerde-Bogen-24 (iii) Visual Analog Scales
Length: 3 months; data collected at baseline (prerandomization), 3- & 6-month postintervention. Intervention: () educative and resource materials plus seven 1-hour therapeutic telephone sessions; the first session in-person, sessions 2-4 weekly, sessions 5-6 every 2 weeks, and session 7 a month later. Treatment control: () educative and resource materials plus training in progressive muscle relaxation in addition to CBT. First session in-person at caregiver’s home, with 6 subsequent phone sessions at same frequency as intervention. Usual care: () educative and resource materials only.
The intervention group showed short-term effects in improved well-being compared with the treatment control and the untreated control groups. In comparison to the untreated controls, the intervention was effective in decreasing body complaints at posttreatment and in improving perceived health at a 6-month follow-up. The intervention group also showed improvements in depressive symptoms at a 6-month follow-up as compared to the treatment control group.
Caregivers only White and African American female family caregivers of persons with Alzheimer’s and related dementias
(i) CES-D (ii) ZBI (iii) Kaye’s Gain Through Group Involvement Scale
Length: 6 months. Intervention: () a telephone support group intervention based upon stress process theory, providing emotional support and validation, and promoting mutual coping assistance among the participants. Usual care: () standard care.
No large or statistically significant differences were noted between the intervention and control groups at 6 months on the outcome measures. There were no significant main effects of treatment or treatment intensity (# of sessions attended), but there was a significant interaction effect showing that older caregivers receiving the intervention reported lower depression at 6 months than those in the control group (although depression scores were higher compared to baseline, for both groups). Number of sessions attended was not associated with depression, caregiver burden, or perceived gains at 6 months. More frequent session attendance was predicted by younger age, spousal (wife) relationship, and being African American.
Study reported significant improvement in at least one target outcome in the intervention group as compared to the control/comparison group. CESD: Center for Epidemiological Studies-Depression Scale; PHQ: Patient Health Questionnaire; BCOS: Bakas Caregiving Outcomes Scale; BRFSS: Behavioral Risk Factor Surveillance System; RMBPC: Revised Memory and Behavioral Problem Checklist; ZBI: Zarit Burden Interview; PG-13: Prigerson Inventory of Complicated Grief-Short Form; CHAMPS: Community Health Activities Model Program for Seniors; SF-36: Short Form 36; CSI: Caregiver Strain Index; MedMaIDE: Medication Management Instrument for Deficiencies in the Elderly; ECI: Experience of Caregiving Inventory; CPMQ: Caregiver Pain Medicine Questionnaire; TBI: traumatic brain injury; PART-O: Participation Assessment with Recombined Tools-Objective; SF-12: Short Form 12; JHDCNA: Johns Hopkins Dementia Care Needs Assessment; SPSIR: Social Problem-Solving Inventory-Revised; SWLS: Satisfaction with Life Scale; PSS: Perceived Stress Scale; MOS: Medical Outcomes Study; PILL: Pennebaker Inventory of Limbic Languidness Scale.
