Caregiving for adults with dementia has been documented by research to be a stressful and burdensome task. Over time the chronic stress associated with caregiving can result in deleterious outcomes such as depression, increased burden, and decreasing physical health. Intervention strategies designed to reduce the harmful effects of caregiving have been tested since the early 1980's. However, results of these studies have been conflicting and generally inconclusive. Therefore, there is a need to connect these studies via a systematic review and synthesis of literature. The purpose of this study is to use meta-analytic techniques to: 1) examine intervention strategies - support groups, counseling, respite care, skills training, case management, and multicomponent strategies used to deter the negative consequences of caregiving and 2) determine which variables - age, gender, ethnicity, socioeconomic status, subject recruitment, length of caregiving career, relationship to care receiver, functional status of care receiver, frequency of intervention, length of intervention, intensity of intervention, intervention approach, intervention focus, intervention leader, research design, research quality, and date of report publication - might be related to the intervention strategies and their outcomes. A rigorous literature search will be conducted to locate published and unpublished studies testing caregiving intervention strategies. Meta-analytic techniques will be used to calculate effect sizes for each intervention strategy. Each meta-analytic calculation will be adjusted for sample size, precision estimation, direction of effect, and pretest differences. Homogeneity analyses will be conducted on groups of effect sizes in order to determine homogeneity. Hedges and Olkin's analogue to the analysis of variance for effect sizes will be calculated to determine if there are differences between intervention strategies. A weighted least squares analysis will be performed to test the impact of intervention strategies and subject/intervention/study variables on outcomes. Expected outcomes of this study include: 1) a comprehensive description of effective caregiving intervention strategies; 2) information on subject/intervention/study variables which may influence the effect of intervention strategies on outcomes; and, 3) information concerning the quality of studies testing interventions for caregivers.
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| Acton, G J; Kang, J (2001) Interventions to reduce the burden of caregiving for an adult with dementia: a meta-analysis. Res Nurs Health 24:349-60 |
