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Consistency of dementia caregiver intervention classification: an evidence-based synthesis

Published online by Cambridge University Press:  27 September 2016

Joseph E. Gaugler ,
Eric Jutkowitz ,
Tetyana P. Shippee  and
Michelle Brasure
Joseph E. Gaugler*
Affiliation:
Center on Aging, School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
Eric Jutkowitz
Affiliation:
Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
Tetyana P. Shippee
Affiliation:
Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
Michelle Brasure
Affiliation:
Minnesota Evidence-Based Practice Center, University of Minnesota, Minneapolis, Minnesota, USA
*
Correspondence should be addressed to: Joseph E. Gaugler, PhD, Long-Term Care Professor in Nursing, Center on Aging, School of Nursing, University of Minnesota, 6–153 Weaver-Densford Hall, 1331, 308 Harvard Street S.E., Minneapolis, MN 55455, USA. Phone: +612-626-2485; Fax: +612-625-7180. Email: gaug0015@umn.edu.
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Abstract

Background:

There are many systematic reviews and meta-analyses (SRs) of interventions for family caregivers of persons with Alzheimer's disease or a related dementia. A challenge when synthesizing the efficacy of dementia caregiver interventions is the potential discrepancy in how they are categorized. The objective of this study was to systematically examine inconsistencies in how dementia caregiver interventions are classified.

Methods:

We searched Ovid Medline®, Ovid PsycINFO®, Ovid Embase®, and the Cochrane Library to identify previous SRs published and indexed in bibliographic databases through January 2015. Following a graphical network analysis, open-coding of classification definitions was conducted. A descriptive analysis was then completed to examine classification consistency of individual interventions across SR grouping labels.

Results:

Twenty-three SRs were identified. A graphical network analysis revealed a significant amount of overlap in individual studies included across SRs, but stark differences in how reviews labeled or categorized them. The qualitative content analysis identified seven themes; one of these, content of the intervention, was used to compare classification consistency. When subjecting the classification of interventions to descriptive empirical analysis, extensive inconsistency was apparent.

Conclusions:

The substantial inconsistency in how dementia caregiver interventions are classified across SRs has hindered the science and practice of dementia caregiver interventions. Specifically, accurate reporting of intervention components and SRs would allow for more precise assessments of efficacy as well as a fuller determination of how caregiver interventions can best yield benefits for caregivers and persons with dementia.

Keywords

Alzheimer's diseasedementiacarersinterventionsrandomized controlled trialsystematic reviewsmeta-analysis
Type
Review Article
Information
International Psychogeriatrics , Volume 29 , Issue 1 , January 2017 , pp. 19 - 30
Copyright
Copyright © International Psychogeriatric Association 2016 

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References

Boots, L. M., de Vugt, M. E., van Knippenberg, R. J., Kempen, G. I. and Verhey, F. R. (2014). A systematic review of Internet-based supportive interventions for caregivers of patients with dementia. International Journal of Geriatric Psychiatry, 29, 331–344. doi:10.1002/gps.4016 [doi]Google Scholar
Brasure, M. et al. (2015). Nonpharmacologic Interventions for Agitation and Aggression in Dementia. Comparative Effectiveness Review. Minneapolis: University of Minnesota. Prepared by the Minnesota Evidence-Based Practice Center under Contract No. 290-2012-00016-I.Google Scholar
Burgio, L. D. and Gaugler, J. E. (2016). Caregiving for the chronically ill: state of the science and future directions. In Burgio, L. D., Gaugler, J. E. and Hilgeman, M. M. (eds.), The Spectrum of Family Caregiving for Adults and Elders with Chronic Illness (pp. 258–278). New York: Oxford University Press.CrossRefGoogle Scholar
Charlesworth, G. M. (2001). Reviewing psychosocial interventions for family carers of people with dementia. Aging & Mental Health, 5, 104–106. doi: 10.1080/13607860120038401 [doi]CrossRefGoogle ScholarPubMed
Charmaz, K. (2004). Grounded theory. In Nagy Hesse-Biber, S. and Leavy, P. (eds.) Approaches to Qualitative Research. A Reader on Theory and Practice (pp. 496–521) New York: Oxford University Press.Google Scholar
Chodosh, J. et al. (2007). Caring for patients with dementia: how good is the quality of care? results from three health systems. Journal of the American Geriatrics Society, 55, 1260–1268. doi:JGS1249 [pii]CrossRefGoogle ScholarPubMed
Cooper, C., Balamurali, T. B., Selwood, A. and Livingston, G. (2007). A systematic review of intervention studies about anxiety in caregivers of people with dementia. International Journal of Geriatric Psychiatry, 22, 181–188.CrossRefGoogle ScholarPubMed
Corbett, A. et al. (2012). Systematic review of services providing information and/or advice to people with dementia and/or their caregivers. International Journal of Geriatric Psychiatry, 27, 628–636. doi:http://dx.doi.org/10.1002/gps.2762 Google Scholar
Czaja, S. J., Schulz, R., Lee, C. C., Belle, S. H. and REACH Investigators. (2003). A methodology for describing and decomposing complex psychosocial and behavioral interventions. Psychology and Aging, 18, 385–395. doi:10.1037/0882-7974.18.3.385 [doi]CrossRefGoogle ScholarPubMed
Eggenberger, E., Heimerl, K. and Bennett, M. I. (2013). Communication skills training in dementia care: a systematic review of effectiveness, training content, and didactic methods in different care settings. International Psychogeriatrics, 25, 345–358. doi:10.1017/S1041610212001664 [doi]CrossRefGoogle Scholar
Elvish, R., Lever, S., Johnstone, J., Cawley, R. and Keady, J. (2013). Psychological interventions for carers of people with dementia: a systematic review of quantitative and qualitative evidence. Counselling and Psychotherapy Research, 13, 106–125 CrossRefGoogle Scholar
Gaugler, J. E. and Burgio, L. D. (2016). Caregiving for individuals with Alzheimer's disease and related disorders. In Burgio, L. D., Gaugler, J. E. and Hilgeman, M. M. (eds.), The Spectrum of Family Caregiving for Adults and Elders with Chronic Illness (pp. 15–57). New York: Oxford University Press.CrossRefGoogle Scholar
Gaugler, J. E., Potter, T. and Pruinelli, L. (2014). Partnering with caregivers. Clinics in Geriatric Medicine, 30, 493–515. doi:S0749-0690(14)00038-X [pii].CrossRefGoogle ScholarPubMed
Gitlin, L. N. and Hodgson, N. (2015). Caregivers as therapeutic agents in dementia care: the evidence-base for interventions supporting their role. In Gaugler, J. E. and Kane, R. L. (eds.), Family Caregiving in the New Normal (pp. 305–356). San Diego: Academic Press.CrossRefGoogle Scholar
Gitlin, L. N., Marx, K., Stanley, I. H. and Hodgson, N. (2015). Translating evidence-based dementia caregiving interventions into practice: state-of-the-science and next steps. Gerontologist, 55, 210–226. doi: 10.1093/geront/gnu123 [doi].CrossRefGoogle ScholarPubMed
Griffin, J. M. et al. (2013). Effectiveness of Family and Caregiver Interventions on Patient Outcomes Among Adults with Cancer or Memory-Related Disorders: A Systematic Review. Washington, DC: Veterans Health Administration.Google ScholarPubMed
Hurley, R. V., Patterson, T. G. and Cooley, S. J. (2014). Meditation-based interventions for family caregivers of people with dementia: a review of the empirical literature. Aging & Mental Health, 18, 281–288.CrossRefGoogle ScholarPubMed
Jensen, M., Agbata, I. N., Canavan, M. and McCarthy, G. (2015). Effectiveness of educational interventions for informal caregivers of individuals with dementia residing in the community: systematic review and meta-analysis of randomised controlled trials. International Journal of Geriatric Psychiatry, 30, 130–143. doi:10.1002/gps.4208 [doi].CrossRefGoogle ScholarPubMed
Kolaczyk, E. D. and Csárdi, G. (2014). Statistical Analysis of Network Data with R. New York: Springer.CrossRefGoogle Scholar
Li, R., Cooper, C., Austin, A. and Livingston, G. (2013). Do changes in coping style explain the effectiveness of interventions for psychological morbidity in family carers of people with dementia? A systematic review and meta-analysis. International Psychogeriatrics, 25, 204–214. doi:10.1017/S1041610212001755 [doi].CrossRefGoogle ScholarPubMed
Lins, S. et al. (2014). Efficacy and experiences of telephone counselling for informal carers of people with dementia. Cochrane Database of Systematic Reviews, 9, CD009126. doi:10.1002/14651858.CD009126.pub2.Google Scholar
Maayan, N., Soares-Weiser, K. and Lee, H. (2014). Respite care for people with dementia and their carers. The Cochrane Database of Systematic Reviews, 1, CD004396. doi:10.1002/14651858.CD004396.pub3 [doi].Google Scholar
Maslow, K. (2012). Translating Innovation to Impact: Evidence-Based Interventions to Support People with Alzheimer's Disease and Their Caregiver at Home and in the Community. Washington, DC: Administration for Community Living.Google Scholar
Olazarán, J. et al. (2010). Nonpharmacological therapies in Alzheimer's disease: a systematic review of efficacy. Dementia and Geriatric Cognitive Disorders, 30, 161–178. doi:10.1159/000316119; 10.1159/000316119.CrossRefGoogle ScholarPubMed
Orgeta, V. and Miranda-Castillo, C. (2014). Does physical activity reduce burden in carers of people with dementia? a literature review. International Journal of Geriatric Psychiatry, 29, 771–783 CrossRefGoogle ScholarPubMed
Parker, D., Mills, S. and 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, 137–172. doi:10.1111/j.1744-1609.2008.00090.x [doi].Google ScholarPubMed
Pimouguet, C., Lavaud, T., Dartigues, J. F. and Helmer, C. (2010). Dementia case management effectiveness on health care costs and resource utilization: a systematic review of randomized controlled trials. Journal of Nutrition, Health & Aging, 14, 669–676.CrossRefGoogle ScholarPubMed
Pinquart, M. and Sörensen, S. (2006). Helping caregivers of persons with dementia: which interventions work and how large are their effects?. International Psychogeriatrics, 18, 577–595.CrossRefGoogle ScholarPubMed
Pusey, H. and Richards, D. (2001). A systematic review of the effectiveness of psychosocial interventions for carers of people with dementia. Aging & Mental Health, 5, 107–119.CrossRefGoogle ScholarPubMed
QSR International Pty Ltd. (2012). NVivo Qualitative Data Analysis Software, Version 10.Google Scholar
Schulz, R. (2001). Some critical issues in caregiver intervention research. Aging & Mental Health, 5, S112–S115 CrossRefGoogle ScholarPubMed
Schulz, R., Czaja, S. J., McKay, J. R., Ory, M. G. and Belle, S. H. (2010). Intervention taxonomy (ITAX): describing essential features of interventions. American Journal of Health Behavior, 34, 811–821. doi:10.5555/ajhb.2010.34.6.811 [pii].CrossRefGoogle ScholarPubMed
Selwood, A., Johnston, K., Katona, C., Lyketsos, C. and 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.CrossRefGoogle ScholarPubMed
Shea, B. J. et al. (2009). AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. Journal of Clinical Epidemiology, 62, 1013–1020. doi:10.1016/j.jclinepi.2008.10.009 [doi].CrossRefGoogle ScholarPubMed
Smith, R. and Greenwood N. (2014). The impact of volunteer mentoring schemes on carers of people with dementia and volunteer mentors: a systematic review. American Journal of Alzheimer's Disease and Other Dementias, 29, 8–17.CrossRefGoogle Scholar
Smits, C. H., de Lange, J., Droes, R. M., Meiland, F., Vernooij-Dassen, M. and 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, 1181–1193. doi:10.1002/gps.1805.CrossRefGoogle ScholarPubMed
Spijker, A. et al. (2008). Effectiveness of nonpharmacological interventions in delaying the institutionalization of patients with dementia: a meta-analysis. Journal of the American Geriatrics Society, 56, 1116–1128.CrossRefGoogle ScholarPubMed
Van't Leven, N. et al. (2013). Dyadic interventions for community-dwelling people with dementia and their family caregivers: a systematic review. International Psychogeriatrics, 25, 1581–1603. doi:10.1017/S1041610213000860 [doi].CrossRefGoogle ScholarPubMed
Vernooij-Dassen, M., Draskovic, I., McCleery, J. and Downs, M. (2011). Cognitive reframing for carers of people with dementia. The Cochrane Database of Systematic Reviews, 11, CD005318. doi:10.1002/14651858.CD005318.pub2.Google Scholar
Viswanathan, M. et al. (2012). Agency for Healthcare Research and Quality Methods Guide for Comparative Effectiveness Reviews. Bethesda, MD: Agency for Healthcare Research and Quality.Google Scholar
Wethington, E. and Burgio, L. D. (2015). Translational research on caregiving: missing links in the translation process. In Gaugler, J. E. and Kane, R. L. (eds.), Family Caregiving in the New Normal (pp. 193–210). San Diego, CA: Academic Press.CrossRefGoogle Scholar
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