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Centre for Policy on Ageing | |
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Clinical effectiveness of a manual based coping strategy programme (START, STrAtegies for RelaTives) in promoting the mental health of carers of family members with dementia
— pragmatic randomised controlled trial | | Author(s) | Gill Livingston, Penny Rapaport, Martin Knapp |
| Journal title | British Medical Journal, vol 347, 25 October 2013 |
| Publisher | British Medical Association, 25 October 2013 |
| Pages | pp f6276 (14 pp) |
| Source | www.bmj.com |
| Keywords | Dementia ; Family care ; Therapy ; Stress ; Performance ; Clinical surveys ; Evaluation. |
| Annotation | A randomised, parallel group, superiority trial. aimed to assess and test whether a manual-based coping strategy compared with treatment as usual reduces depression and anxiety symptoms in carers of family members with dementia. Participants were 260 carers of family members with dementia in three mental health community services and one neurological outpatient dementia service in London and Essex. 173 were randomised to the intervention and 87 to treatment as usual. The manual based coping intervention comprised eight sessions, delivered by supervised psychology graduates to the carers. The programme consisted of psychoeducation about dementia, carers' stress, and where to get emotional support; understanding behaviours of the family member being cared for, and behavioural management techniques; changing unhelpful thoughts; promoting acceptance; assertive communication; relaxation; planning for the future; increasing pleasant activities; and maintaining skills learnt. Carers practised these techniques at home, using the manual and relaxation CDs. Mean total scores on the Hospital Anxiety and Depression Scale HADS) were lower in the intervention group than in the treatment as usual group over the eight month evaluation period: adjusted difference in means -1.80 points (95% confidence interval -3.29 to -0.31; P=0.02) and absolute difference in means -2.0 points. Carers in the intervention group were less likely to have case level depression (odds ratio 0.24, 95% confidence interval 0.07 to 0.76) and there was a non-significant trend towards reduced case level anxiety (0.30, 0.08 to 1.05). Carers' quality of life was higher in the intervention group (difference in means 4.09, 95% confidence interval 0.34 to 7.83) but not for the recipient of care (difference in means 0.59, -0.72 to 1.89). Carers in the intervention group reported less abusive behaviour towards the recipient of care compared with those in the treatment as usual group (odds ratio 0.47, 95% confidence interval 0.18 to 1.23), although this was not significant. This manual-based coping strategy was effective in reducing affective symptoms and case level depression in carers of family members with dementia. The carers' quality of life also improved. (OFFPRINT) (RH) |
| Accession Number | CPA-131101524 A |
| Classmark | EA: P6:SJ: LO: QNH: 5H: 3G: 4C * |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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