Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 30, 2018
Open Peer Review Period: Dec 5, 2018 - Jan 30, 2019
Date Accepted: Sep 26, 2019
(closed for review but you can still tweet)
Effects of online self-management support of family caregivers to deal with behavior changes of the relative with dementia: a randomized controlled trial
ABSTRACT
Background:
Online contacts with a health professional have the potential to support family caregivers of people with dementia.
Objective:
To study the effects of an online self-management support intervention in helping family caregivers to deal with behavior changes of the relative with dementia. The intervention - involving among others personal e-mail contacts with a dementia nurse - was compared to online interventions without these e-mail contacts.
Methods:
A randomized controlled trial (RCT) was conducted with 81 family caregivers of people with dementia who live at home. Participants were randomly assigned to one of (1) a major self-management support intervention consisting of personal e-mail contacts with a specialist dementia nurse, online videos, and e-bulletins; or (2) a medium intervention consisting only of online videos and e-bulletins; or (3) a minor intervention consisting of only the e-bulletins. The primary outcome was family caregivers’ self-efficacy in dealing with behavior changes of the relative with dementia. Secondary outcomes were family caregivers’ reports of behavior problems in the people with dementia and the quality of the relationship between the family caregiver and the person with dementia. Measurements were performed at the baseline and at six (T1) and twelve weeks (T2) after the baseline. A mixed-model analysis was conducted to compare the outcomes of the three intervention arms.
Results:
Family caregivers participating in the major intervention involving e-mail contacts showed no statistically significant differences in self-efficacy after the intervention compared to the minor intervention involving only e-bulletins (difference -0.02, p-value 0.99). In the adjusted analysis, the medium intervention (involving videos and e-bulletins) showed a negative trend over time (difference -4.21, p=0.09) and at T1 (difference -4.71, p=0.07) compared to the minor intervention involving only e-bulletins. Neither were any statistical differences found between the intervention arms in terms of the reported behavior problems and the quality of the relationship between the family caregiver and the person with dementia.
Conclusions:
The expectation that an online self-management support intervention involving e-mail contacts would lead to positive effects and be more effective than online interventions without personal e-mail contacts was not borne out. One explanation might be related to the fact that not all family caregivers who were assigned to that intervention actually made use of the opportunity for personal e-mail contact. The online videos were also not always viewed. To obtain more definite conclusions, future research involving extra efforts to reach higher usage rates is required. Clinical Trial: Netherlands Trial Registry (NTR): NTR6237; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6237 (Archived by WebCite at http://www.webcitation.org/6v0S4fxTC)
Citation
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Copyright
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