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Long-Term Outcomes of the Benefit-Finding Group Intervention for Alzheimer Family Caregivers: A Cluster-Randomized Double-Blind Controlled Trial

Contact Information

Keywords

Sheung-Tak Cheng, PhD, takcheng@eduhk.hk

Dementia caregiving; cluster-randomized controlled trial; depression; positive aspects of caregiving.

Abstract

Objectives: To examine the effects of the group benefit-finding therapeutic intervention (BFT) for Alzheimer family caregivers up to 10-month follow-up. Methods: This was a cluster-randomized double-blind controlled trial in social centers and clinics. Participants included 129 caregivers. Inclusion criteria were 1) primary caregiver aged 18 years and older and without cognitive impairment, 2) providing 14 or more care hours per week to a relative with mild-to-moderate Alzheimer disease, and 3) scoring 3 or more on the Hamilton Depression Rating Scale. Exclusion criterion was care-recipient having parkinsonism or other forms of dementia. BFT (using cognitive reappraisal to find positive meanings) was evaluated against two forms of psychoeducation as controls-standard and simplified (lectures only) psychoeducation. All interventions had eight weekly sessions of 2 hours each. Primary outcome was depressive symptoms, whereas secondary outcomes were global burden, role overload, and psychological well-being. Measures were collected at baseline, postintervention, and 4- and 10-month follow-up. Results: Mixed-effects regression showed that BFT's effect on depressive symptoms conformed to a curvilinear pattern, in which the strong initial effect leveled out after postintervention and was maintained up to 10-month follow-up; this was true when compared against either control group. The effect on global burden was less impressive but moderate effect sizes were found at the two follow-ups. For psychological well-being, there was an increase in the BFT group at 4-month follow-up and a return to baseline afterward. No effect on role overload was found. Conclusion: Benefit-finding reduces depressive symptoms as well as global burden in the long-term and increases psychological well-being in the medium-term.

Citation

Cheng, S. T., Chan, W. C., & Lam, L. C. W. (2019). Long-Term Outcomes of the Benefit-Finding Group Intervention for Alzheimer Family Caregivers: A Cluster-Randomized Double-Blind Controlled Trial. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 27(9), 984–994. https://doi.org/10.1016/j.jagp.2019.03.013

DOI

10.1016/j.jagp.2019.03.013

Model

Human

Conent Area

Sheung-Tak Cheng

EWB-Related Construct

(1) goal pursuit; (2) life satisfaction; (3) positive affect; (5) sense of meaning

Study Design

Species or Study Population

(5) RCT

Sex (%Female)

standard psychoeducation:83.3%
simplified psychoeducation: 88.9%
benefit-finding intervention: 85.7%

Age (Mean, SD)

standard psychoeducation: 56.67, 11.14
simplified psychoeducation: 52.98, 10.67
benefit-finding intervention: 56.99, 10.86

Younger Controls?

No

Longitudinal Data?

Yes

Sample Size

129

Interventions

Benefit-Finding Group Intervention

Ethnicity (%white)

none stated (Hongkong)

Inclusion Criteria

The inclusion criteria were: 1) being a primary caregiver aged 18 years and older, without cognitive impairment, providing 14 or more care hours per week, and scoring 3 or more on the Hamilton Depression Rating Scale; and 2) the CR having mild-to-moderate Alzheimer disease operationalized by the National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer's Disease and Related Disorders Association criteria for possible Alzheimer disease or diagnosed by a physician, with stage of dementia confirmed by the Clinical Dementia Rating.

Exclusion Criteria

The exclusion criterion was parkinsonism or other forms of dementia in the CR.

EWB Measures

Ryff's Psychological Well-Being Scale

Non-EWB Behavioral
Measures

(1) Hamilton Depression Rating Scale
(2) Multidimensional Functional Assessment Questionnaire,
(3) Zarit Burden Interview: caregiver burden
(4) Pearlin's 4-item:Burden

Physiological Measures

N/A

Brain IMaging Modality

Brain IMaging Paradigm

N/A

Brain Region/Circuit

N/A

Biological Measures

N/A

Other Neural Measures

Data Availability?

No

Data Avalability Details

N/A

Diagnostic Measures

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