Effectiveness of Internet-Based Psychoeducation in Reducing Caregiver Burden in Dementia: A Clinical Trial
Abstract
Objective: This study aimed to assess the impact of online psychoeducational training on reducing the psychological burden of caregivers of patients with moderate to severe dementia. Caring for such patients, especially by non-professional caregivers, poses significant mental and physical challenges. Internet-based interventions offer a practical and innovative solution to help alleviate this burden.
Method: This clinical trial was conducted in 2023 in Kashan, Iran, with 84 caregivers of patients with moderate to severe dementia. Participants were divided into two groups: an intervention group (n = 42) and a control group (n = 42). The intervention group received a 20-session online psychoeducational program over eight weeks, while the control group received routine care. Caregiver burden was measured using the Zarit Burden Interview (ZBI) before, immediately after, and three months after the intervention. Data analysis included independent t-tests and repeated measures ANOVA.
Results: Baseline characteristics of caregivers in both groups were homogeneous in most variables, except for education level, which differed significantly (P = 0.006). Repeated measures of the general linear model (GLM) analysis revealed a significant reduction in caregiver burden in the intervention group (P = 0.014). Within-group analysis showed that the burden significantly decreased immediately after the training. Although a slight increase was observed at the three-month follow-up, it remained lower than the baseline (P < 0.001).
Conclusion: Online psychoeducational training significantly reduces the psychological burden of dementia patient caregivers, with sustained effectiveness over a three-month follow-up. These findings support the integration of digital psychoeducation as a viable alternative or complement to traditional interventions, particularly in resource-limited or high-need settings.
2. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health. 2022;7(2):e105–e25.
3. Cohen G, Russo MJ, Campos JA, Allegri RF. Living with dementia: increased level of caregiver stress in times of COVID-19. Int Psychogeriatr. 2020;32(11):1377–81.
4. The Lancet Public H. Reinvigorating the public health response to dementia. Lancet Public Health. 2021;6(10):e696.
5. Farina N, Page TE, Daley S, Brown A, Bowling A, Basset T, et al. Factors associated with the quality of life of family carers of people with dementia: A systematic review. Alzheimers Dement. 2017;13(5):572–81.
6. Pulsford D, Duxbury J, Carter B. Personal qualities necessary to care for people with dementia. Nurs Stand. 2016;30(37):38–44.
7. Leocadie MC, Morvillers JM, Pautex S, Rothan-Tondeur M. Characteristics of the skills of caregivers of people with dementia: observational study. BMC Fam Pract. 2020;21(1):149.
8. Dai Y, Zhao J, Li S, Zhao C, Gao Y, Johnson CE. Caregivers' Dementia Knowledge and Care Approach in Residential Aged Care Facilities in China. Am J Alzheimers Dis Other Demen. 2020;35:1533317520937096.
9. Aguglia E, Onor ML, Trevisiol M, Negro C, Saina M, Maso E. Stress in the caregivers of Alzheimer's patients: an experimental investigation in Italy. Am J Alzheimers Dis Other Demen. 2004;19(4):248–52.
10. Sanders AE. Caregiver Stress and the Patient With Dementia. Continuum (Minneap Minn). 2016;22(2 Dementia):619–25.
11. Sheehan OC, Haley WE, Howard VJ, Huang J, Rhodes JD, Roth DL. Stress, Burden, and Well-Being in Dementia and Nondementia Caregivers: Insights From the Caregiving Transitions Study. Gerontologist. 2021;61(5):670–9.
12. Whitebird RR, Kreitzer M, Crain AL, Lewis BA, Hanson LR, Enstad CJ. Mindfulness-based stress reduction for family caregivers: a randomized controlled trial. Gerontologist. 2013;53(4):676–86.
13. Ponce CC, Ordonez TN, Lima-Silva TB, Dos Santos GD, Viola LF, Nunes PV, et al. Effects of a psychoeducational intervention in family caregivers of people with Alzheimer's disease. Dement Neuropsychol. 2011;5(3):226–37
14. Brodaty H, Donkin M. Family caregivers of people with dementia. Dialogues Clin Neurosci. 2009;11(2):217–28.
15. Cheng ST, Li KK, Losada A, Zhang F, Au A, Thompson LW, et al. The effectiveness of nonpharmacological interventions for informal dementia caregivers: An updated systematic review and meta-analysis. Psychol Aging. 2020;35(1):55–77.
16. Egan KJ, Pinto-Bruno Á C, Bighelli I, Berg-Weger M, van Straten A, Albanese E, et al. Online Training and Support Programs Designed to Improve Mental Health and Reduce Burden Among Caregivers of People With Dementia: A Systematic Review. J Am Med Dir Assoc. 2018;19(3):200–6.e1.
17. Wang Y, Lin Y, Chen J, Wang C, Hu R, Wu Y. Effects of Internet-based psycho-educational interventions on mental health and quality of life among cancer patients: a systematic review and meta-analysis. Support Care Cancer. 2020;28(6):2541–52.
18. Harrer M, Apolinário-Hagen J, Fritsche L, Salewski C, Zarski AC, Lehr D, et al. Effect of an internet- and app-based stress intervention compared to online psychoeducation in university students with depressive symptoms: Results of a randomized controlled trial. Internet Interv. 2021;24:100374.
19. Easom L, Wang K, Alston G. Increasing self-efficacy and knowledge in carer training: Hispanic versus Caucasian. Nurs Open. 2020;7(1):180–5.
20. Crellin NE, Orrell M, McDermott O, Charlesworth G. Self-efficacy and health-related quality of life in family carers of people with dementia: a systematic review. Aging Ment Health. 2014;18(8):954–69.
21. Prasko J, Kamaradova D, Jelenova D, Ociskova M, Sedlackova Z. Development of the internet based psychoeducation for patients with bipolar affective disorder. Neuro Endocrinol Lett. 2013;34(5):426–35.
22. Rotondi AJ, Anderson CM, Haas GL, Eack SM, Spring MB, Ganguli R, et al. Web-based psychoeducational intervention for persons with schizophrenia and their supporters: one-year outcomes. Psychiatr Serv. 2010;61(11):1099–105.
23. Fung HW, Chan C, Chien WT, Chong YY, Ross CA. The Acceptability and Potential Benefits of a Web-Based Psychoeducation Program for People with Pathological Dissociation: A Pilot Evaluation Study. J Trauma Dissociation. 2023;24(1):95–110.
24. Harrer M, Apolinário-Hagen J, Fritsche L, Drüge M, Krings L, Beck K, et al. Internet- and App-Based Stress Intervention for Distance-Learning Students With Depressive Symptoms: Protocol of a Randomized Controlled Trial. Front Psychiatry. 2019;10:361.
25. Goto Y, Suematsu M, Imaizumi T, Suzuki Y. Preliminary study of the effect of the web application on caregiver burden in dementia and behavioural and psychological symptoms of dementia. Nagoya J Med Sci. 2024;86(3):383–91.
26. Sharifan F, Farhoudi F, Akbarzadeh F, Bimorgh MS, Emadzadeh A. The effect of educating caregivers of the elderly with cognitive disorders using mobile application on the care burden. Journal of Fundamentals of Mental Health. 2021.
27. Xie Y, Shen S, Liu C, Hong H, Guan H, Zhang J, et al. Internet-Based Supportive Interventions for Family Caregivers of People With Dementia: Randomized Controlled Trial. JMIR Aging. 2024;7:e50847.
28. SALEHI NS, Azami M, Motamedi F, SEDIGHI B, SHAHESMAILI A. The effect of web-based information intervention in caregiving burden in caregivers of patients with dementia. 2017.
29. Yu Y, Xiao L, Ullah S, Meyer C, Wang J, Pot AM, et al. The effectiveness of internet-based psychoeducation programs for caregivers of people living with dementia: a systematic review and meta-analysis. Aging Ment Health. 2023;27(10):1895–911.
| Files | ||
| Issue | Articles in Press | |
| Section | Original Article(s) | |
| Keywords | ||
| Jalal Mirabdollah Fateme Mehrzad Habibollah Rahimi Behnam Shariati Fatemeh Sadat Ghoreishi | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
