Cognitive-behavioral intervention for homebound caregivers of persons with dementia

Citation Chang, B. L. (1999). Cognitive-behavioral intervention for homebound caregivers of persons with dementia. Nursing Research, 48(3), 173-182.

Design Experiment

Purpose The purpose of this study was to examine the effects of an 8-week cognitive behavioral (C-B) intervention tailored to the specific deficits of persons with dementia (PWDs) on selected outcomes for homebound caregivers and the functional status of the PWD.

Hypothesis The following hypotheses were investigated: Caregivers within the cognitive-behavioral (C-B) group would report less burden, more satisfaction, less anxiety, and less depression over time (at baseline, 4 weeks, 8 weeks, and 12 weeks). Caregivers within the attention-only (A-O) group would report an increase in burden, decrease in satisfaction, an increase in anxiety, and more depression over time. The C-B group would report significantly less burden, greater satisfaction, less anxiety, and less depression than the A-O group, controlling for baseline caregiver physical well-being, anxiety, depression, and care recipient functional and mental status as appropriate. Caregivers in the C-B group would show a significant increase in the use of a problem focused coping strategy over time. PWDs in the C-B group would show significant improvement in their functional status over time.

Participants The participants of this study were caregiver-care recipient dyads (N= 65), randomly assigned to the intervention and control groups. PWD had to: have significant dressing and eating problems and a MMSE (Mini Mental State Exam) score of less than 21.

Outcome / Dependent Variables Caregiver coping strategies, perceptions of burden and satisfaction, and emotional (including depression and anxiety) and physical health.

Procedure At level 1 of the intervention, caregivers watched videotapes demonstrating assisted modeling behavior (dressing and eating). At level 2, nurses followed up with caregivers weekly reinforcing the use of behaviors learned from videotapes (the 2-level intervention was called the Nurseline video assisted modeling program NVAMP).

Outcomes There was significant interaction between intervention and caregiver depression, anxiety and emotion-focused coping strategies.

Author Chang, B. L.