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- Title
Enhancing the quality of life of dementia caregivers from different ethnic or racial groups: a randomized, controlled trial.
- Authors
Belle SH; Burgio L; Burns R; Coon D; Czaja SJ; Gallagher-Thompson D; Gitlin LN; Klinger J; Koepke KM; Lee CC; Martindale-Adams J; Nichols L; Schulz R; Stahl S; Stevens A; Winter L; Zhang S; Resources for Enhancing Alzheimer's Caregiver Health II Investigators; Belle, Steven H; Burgio, Louis
- Abstract
<bold>Background: </bold>Caring for a family member with dementia is extremely stressful, contributes to psychiatric and physical illness among caregivers, and increases the risk for caregiver death. Finding better ways to support family caregivers is a major public health challenge.<bold>Objective: </bold>To test the effects of a structured multicomponent intervention on quality of life and clinical depression in caregivers and on rates of institutional placement of care recipients in 3 diverse racial or ethnic groups.<bold>Design: </bold>Randomized, controlled trial.<bold>Setting: </bold>In-home caregivers in 5 U.S. cities.<bold>Participants: </bold>212 Hispanic or Latino, 219 white or Caucasian, and 211 black or African-American caregivers and their care recipients with Alzheimer disease or related disorders.<bold>Intervention: </bold>Caregivers within each racial or ethnic group were randomly assigned to an intervention or to a control group. The intervention addressed caregiver depression, burden, self-care, and social support and care recipient problem behaviors through 12 in-home and telephone sessions over 6 months. Caregivers in the control group received 2 brief "check-in" telephone calls during the 6-month intervention.<bold>Measurements: </bold>The primary outcome was a quality-of-life indicator comprising measures of 6-month caregiver depression, burden, self-care, and social support and care recipient problem behaviors. Secondary outcomes were caregiver clinical depression and institutional placement of the care recipient at 6 months.<bold>Results: </bold>Hispanic or Latino and white or Caucasian caregivers in the intervention group experienced significantly greater improvement in quality of life than those in the control group (P < 0.001 and P = 0.037, respectively). Black or African-American spouse caregivers also improved significantly more (P = 0.003). Prevalence of clinical depression was lower among caregivers in the intervention group (12.6% vs. 22.7%; P = 0.001). There were no statistically significant differences in institutionalization at 6 months.<bold>Limitations: </bold>The study used only a single 6-month follow-up assessment, combined heterogeneous cultures and ethnicities into a single group, and excluded some ethnic groups.<bold>Conclusions: </bold>A structured multicomponent intervention adapted to individual risk profiles can increase the quality of life of ethnically diverse dementia caregivers. ClinicalTrials.gov identifier: NCT00177489.
- Publication
Annals of Internal Medicine, 2006, Vol 145, Issue 10, p727
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-145-10-200611210-00005