Objectives: Caregivers of patients with dementia are at a greater risk of developing burden, strain and psychiatric morbidity in the form of depression. Psychotherapeutic interventions are essential in order to facilitate their role and improve their emotional state. This study presents a randomised controlled trial of a combined group intervention, including psychoeducational program and group psychotherapy intervention using Cognitive Behavioural Therapy, aiming to evaluate its effectiveness in psychological health of caregivers in Greece.
Method: Ninety seven caregivers were randomly allocated to an experimental group (58 participants) which participated in a 6-month programme- and a control group (54 participants) which did not receive any kind of intervention (was in a wait list). Psychosocial assessment was performed for anxiety, depression and burden.
Results: According to the analysis which was performed by protocol statistically significant differences were found between the experimental and the control group in levels of anxiety [F(1.94)=20.94, p<0.001], depression [F(1.94)=36.93, p<0.001] and sense of burden [F(1.94)=51.44, p<0.001]. The difference was in benefit of the experimental group.
Conclusion: Combined intervention for caregivers can have protective effects on their sense of burden, depression and anxiety symptoms.
Acton, G. J., & Kang, J. (2001). Interventions to reduce the burden of caregiving for an adult with dementia: a meta-analysis. Research in Nursing & Health, 24 (5), 349-360.
Aneshensel, C. S., Pearlin, L. I., Mullan, J. T., Zarit, S. H., & Whitlatch, C. J. (1995). Profiles in caregiving: The unexpected career. San Diego: Academic Press.
Baklavas, G., Kosmidis, M., Giannakou, M., & Roussi, P. (2009). Data analysis Depression Scale in clinical population. Paper presented at the 5th PanHellenic Data Analysis Conference, Rethimno, Crete.
Bandura, A. (1988). Self-efficacy conception of anxiety. Anxiety Research, 1, 77-98.
Bandura, A., & Adams, N. E. (1977). Analysis of self-efficacy theory of behavioral change. Cognitive Therapy and Research, 1, 287-310.
Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. New York.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of consulting and clinical psychology, 56 (6), 893-897.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). The Beck Depression Inventory Second Edition Manual. San Antonio: Psychological Corporation.
Brodaty, H., & Donkin, M. (2009). Family caregivers of people with dementia. Dialogues in Clinical Neuroscience, 11(2), 217-28.
Brodaty, H., Roberts, K., & Peters, K. (1994). Quasi-experimental evaluation of an educational model for dementia caregivers. International Journal of Geriatric Psychiatry, 9(3), 195-204.
Burns, D. (1981). Feeling good: The new mood therapy. New York: New American Library.
Burks, V., Lund, D., & Hill, R. (1991). Factors associated with attendance at caregiver support group meetings. Activities, Adaptation & Aging, 15, 93-108.
Callahan, C. M., Boustani, M. A., Unverzagt, F. W., Austrom, M. G., Damush, T. M., Perkins, A. J., Fultz, B. A., Hui, S. L., Counsell, S. R., & Hendrie, H. C. (2006). Effectiveness of collaborative care for older adults with Alzheimer disease in primary care: a randomized controlled trial. JAMA : the journal of the American Medical Association, 295(18), 2148-2157.
Chu, H., Yang, C. Y., Liao, Y. H., Chang, L. I., Chen, C. H., Lin, C. C., & Chou, K. R. (2010). The effects of support group on dementia caregivers’ burden and depression. Journal of Aging and Health, 23(2), 228-241.
Clark, D. A., & Beck, A. T. (1999). Cognitive theories and therapy. London: Cambridge University Press.
Connell, C. M., Janevic, M. R., Gallant, M. P. (2001). The costs of caring: impact of dementia on family caregivers. Journal of geriatric psychiatry and neurology, 14(4) 179-87.
Cooke, D. D., McNally, L., Mulligan, K. T., Harrison, M. J., & Newman, S. P. (2001). Psychosocial interventions for caregivers of people with dementia: systematic review. Aging & Mental Health, 5, 120-135.
Coon, D. W., Thompson, L., Steffen, A., Sorocco, K., & Gallagher-Thompson, D. (2003). Anger and depression management: psychoeducational skill training interventions for women caregivers of a relative with dementia. The Gerontologist, 43(5), 678–89.
Cuijpers, P. (2005). Depressive disorders in caregivers of dementia patients: a systematic review. Aging Mental Health, 9(4), 325-30.
Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition (DSM IV). (1994). International Classification of Diseases. World Health Organization.
Dröes, R., Meiland, F., Schmitz, M., Van Tilburg, W. (2004). Effect of combined support for people with dementia and caregivers versus regular day care on behaviour and mood of persons with dementia: results from a multi-centre implementation study. International Journal of Geriatric Psychiatry, 19, 673-684.
Etters, L., Goodall, D., & Harrison, B. E. (2008). Caregiver burden among dementia patient caregivers: a review of the literature. Journal of the American Academy of Nurse Practitioners, 20 (8), 423-8.
Gallagher-Thompson, D., Arean, P., Rivera, P., & Thompson, L. W. (2001). A psychoeducational intervention to reduce distress in Hispanic family caregivers: results of a pilot study. Clinical Gerontology, 23(1-2), 17–32.
Gallagher-Thompson, D., Gray, H. L., Dupart, T., Jimenez, D., & Thompson, L. W. (2008). Effectiveness of cognitive/behavioral small group intervention for reduction of depression and stress in Non-Hispanic White and Hispanic/Latino women dementia family caregivers: outcomes and mediators of change. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 26(4), 286-303.
Gallagher-Thompson, D., Wang, P. C., Liu, W., Cheung, V., Peng, R., China, D., & Thompson, L. W. (2010). Effectiveness of a psychoeducational skill training DVD program to reduce stress in Chinese American dementia caregivers: Results of a preliminary study. Aging & Mental Health, 14(3), 263-273.
Gaugler, J. E., Pearlin, L. I., Davey, A., & Zarit, S. H. (2000). Modelling caregiver adaptation over time: The longitudinal impact of behaviour problems. Psychology and Aging, 15, 437–450.
Gilliam, C. M., & Steffen, A. M. (2006). The relationship between caregiving self-efficacy and depressive symptoms in dementia family caregivers. Aging & Mental Health, 10(2), 79–86.
Gitlin, L. N., Belle, S. H., Burgio, L. D., Czaja, S. J., Mahoney, D., Gallagher-Thompson, D., Burns, R., Hauck, W. W., Zhang, S., Schulz, R., Ory, M. G., & REACH Investigators. (2003). Effect of multicomponent interventions on caregiver burden and depression: the REACH multisite initiative at 6-month follow-up. Psychology and aging, 18(3) 361-74.
Goodman, S. (1991). Patterns of participation in support groups for dementia caregivers. Clinical Gerontologist, 10, 23-34.
Gräbel, E., Trilling, A., Donath, C., & Luttenberger, K. (2010). Support groups for dementia caregivers – Predictors for utilization and expected quality from a family caregiver’s point of view: A questionnaire survey PART I. BMC Health Services Research, 10(219).
Hepburn, K. W., Tornatore, J., Center, B., & Ostwald, S. W. (2001). Dementia family caregiver training: affecting beliefs about caregiving and caregiver outcomes. Journal of the American Geriatrics Society, 49 (4), 450–457.
Joling, K. J., Van Marwijk, H. W., Smit, F., Van der Horst, H. E., Scheltens, P., Van De Ven, P. M., Mittelman, M. S., Van Hout, H. P. (2012). Does a family meetings intervention prevent depression and anxiety in family caregivers of dementia patients? A randomized trial. PLoS One. 7(1), e30936.
Jönsson, L., & Wimo, A. (2009). The cost of dementia in Europe: a review of the evidence, and methodological considerations. Pharmacoeconomics, 27(5), 391-403.
Ko, S. H., Lee, M. C., & Baumann, S. L. (2007). Reducing the burden of dementia in Korea. Nursing Science Quarterly, 20, 178-182.
Koutsampasopoulos, K., Ralli, F., Gavana, M., & Benos, A. (2008). Psychiatric morbidity and burden among caregivers: a cross sectional study in rural north Halkidiki (Greece). Annals of General Psychiatry, 7(1), 124.
Kramer, B. J. (2000). Husbands caring for wives with dementia: A longitudinal study of continuity and change. Health and Social Work, 25(2), 97-107.
Leszcz, M., & Kobos, J. C. (2008). Evidence-based Group Psychotherapy: Using AGPA’s Practice Guidelines to Enhance Clinical Effectiveness. Journal of clinical psychology: In session, 64 (11), 1238-1260.
Llanque, S. M., & Enriquez, M. (2012). Interventions for Hispanic Caregivers of Patients with Dementia: A Review of the Literature. American Journal of Alzheimer’s Disease & Other Dementias, 27 (1), 23-32.
Marriott, A., Donaldson, C., Tarrier, N., & Burns, A. (2000). Effectiveness of cognitive-behavioural family intervention in reducing the burden of care in caregivers of patients with Alzheimer's disease. The British journal of psychiatry: the journal of mental science, 176, 557–562.
Mitrani, V. B., Lewis, J. E., Feaster, D. J., Czaja, S. J., Eisdorfer, C., Schulz, R., & Szapocznik, J. (2006). The role of family functioning in the stress process of dementia caregivers. Gerontologist, 46(1), 97-105.
Mittelman, M. S., Brodaty, H., Wallen, A. S., & Burns, A. (2008). Caregivers benefit from counseling. American Journal of Geriatric Psychiatry, 16(11), 893-904.
Mittelman, M., & Roth, D. L. (2004). Sustained benefit of supportive intervention for depressive symptoms in caregivers of patients with Alzheimer's disease. The American Journal of Psychiatry, 161(5), 850.
Papastavrou, E., Kalokerinou-Anagnostopoulou, A., Alevizopoulos, G., Papacostas, S., Tsangari, H., & Sourtzi, P. (2006). The validity and reliability of the Zarit burden interview in Greek Cypriot caregivers of patients with dementia. Nosileftiki, 45(4), 439-449.
Papastavrou, E., Kalokerinou, A., Papacostas, S. S., Tsangari, H., & Sourtzi, P. (2007). Caring for a relative with dementia: family caregiver burden. Journal of Advanced Nursing. 58(5), 446-457.
Papastavrou, E., Tsangari, H., Karayiannis, G., Papacostas, S., Efstathiou, G., & Sourtzi, P. (2011). Caring and coping: the dementia caregivers. Aging Mental Health, 15(6), 702-11.
Parker, D., Mills, S., & Abbey, J. (2008). Effectiveness of interventions that assist caregivers to support people with dementia living in the community: a systematic review. International journal of evidence-based healthcare, 6(2), 137-172.
Pearlin, L., Mullan, J., Semple, S., & Skaff, M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30(5), 583-594.
Pinquart, M., & Sörensen, S. (2006). Helping caregivers of persons with dementia: which interventions work and how large are their effects? International Psychogeriatrics, 18(4), 577-595.
Pinquart, M., & Sörensen, S. (2011). Spouses, adult children, and children-in-law as caregivers of older adults: a meta-analytic comparison. Psychology and aging, 26(1), 1-14.
Quayhagen, M. P., & Quayhagen, M. (2001). Testing of a cognitive stimulation intervention for dementia caregiving dyads. Neuropsychological Rehabilitation, 11, 319-332.
Reitz, C., Brayne, C., & Mayeux, R. (2011). Epidemiology of Alzheimer disease. Nature reviews. Neurology, 7(3), 137-152.
Schulz, R., O'Brien, A., Czaja, S., Ory, M., Norris, R., Martire, L. M., Belle, S. H., Burgio, L., Gitlin, L., Coon, D., Burns, R., Gallagher-Thompson, D., & Stevens, A. (2002). Dementia caregiver intervention research: in search of clinical significance. The Gerontologist, 42(5), 589-602.
Secker, D. L., & Brown, R. G. (2005). Cognitive behavioural therapy (CBT) for caregivers of patients with Parkinson’s disease: a preliminary randomised controlled trial. Journal of Neurology, Neurosurgery, and Psychiatry, 76(4), 491-497.
Selwood, A., Johnston, K., Katona, C., Lyketsos, C., & Livingston, G. (2007). Systematic review of the effect of psychological interventions on family caregivers of people with dementia. Journal of Affective Disorders, 101, 75–89.
Smits, C. H., De Lange, J., Dröes, R. M., Meiland, F., Vernooij-Dassen, M., & Pot, A. M. (2007). Effects of combined intervention programmes for people with dementia living at home and their caregivers: a systematic review. International journal of geriatric psychiatry, 22(12), 1181-1193.
Sörensen, S., Duberstein, P., Gill, D., & Pinquart, M. (2006). How effective are interventions with caregivers? An updated meta-analysis. The Gerontologist, 42, 356-372.
Sörensen, S., Pinquart, M., Duberstein, P. (2002). Dementia care: mental health effects, intervention strategies, and clinical implications. Lancet Neurology, 5(11), 961-973.
Stolley, J., Reed, D., & Buckwalter, K. C. (2002). Caregiving appraisal and interventions based on the progressively lowered threshold model. American Journal of Alzheimer's Disease and Other Dementias, 17(2), 110–120.
Van Vliet, D., De Vugt, M. E., Bakker, C., Koopmans, R. T., & Verhey, F. R. (2010). Impact of early onset dementia on caregivers: a review. International journal of geriatric psychiatry, 25(11), 1091-1100.
Varela, G., Varona, L., Anderson, K., & Sansoni, J. (2011). Alzheimer's care at home: a focus on caregivers strain. Professioni infermieristiche, 64(2), 113-7.
Wang, L. Q., & Chien, W. T. (2011). Randomised controlled trial of a family-led mutual support programme for people with dementia. Journal of clinical nursing, 20(15-16), 2362-2366.
Yalom, I., Brown, S., & Bloch, S. (1975). The written summary as a group psychotherapy technique. Archives of general psychiatry, 32(5), 605-613.
Yost, E. B., Beutler, L. E., Corbishley, M. A., & Allender, J. R. (1987). Chapter 2: The Structure of Group Cognitive Therapy with Older Adults. In Group Cognitive Therapy: A treatment Approach for Depressed Older Adults (14- 29). New York: Pergamon Press.
Zarit, S. H., Reever, K. E., & Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. The Gerontologist, 20(6), 649-655.
In-Text Citation: (Karagiozi et al., 2014)
To Cite this Article: Karagiozi, K., Papaliagkas, V., Giaglis, G., Papastavrou, E., Pattakou, V., & Tsolaki, M. (2014). Combined Intervention for Caregivers of Patients with Dementia: A Randomized Controlled Trial. International Journal of Academic Research in Psychology, 1(1), 8–25.
Copyright: © 2014 The Author(s)
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