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Self-management support interventions for informal caregivers of people with dementia: a systematic meta review.

Huis in het Veld, J.G., Verkaik, R., Mistiaen, P., Meijel, B. van, Francke, A. Self-management support interventions for informal caregivers of people with dementia: a systematic meta review. European Journal of Palliative Care: 2015 269. Abstract. 14th World Congress of the European Association for Palliative Care: Building Bridges. 8-10 mei 2015, Copenhagen.
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Background
Dementia is a life-threatening disease, requiring a palliative care approach where supporting informal caregivers in managing the symptoms and problems related to the dementia should be part of. However, it is not clear which self-management support interventions are most effective.

Aims
To synthesise evidence from previous systematic reviews on self-management support interventions for informal caregivers of persons with dementia.

Methods
This systematic meta-review followed the PRISMA Statement. Searches were conducted in Pubmed, CINAHL, Cochrane Library, Embase and PsycINFO. A two-step selection was performed:
(1) screening based on titles/abstracts and
(2) screening based on full-text.

Methodological quality was assessed by the Quality Assessment Checklist for reviews. Interventions were grouped using an earlier developed categorisation of self-management, covering 5 intervention targets:
(1) relationship with family,
(2) maintaining an active lifestyle,
(3) psychological wellbeing,
(4) techniques to cope with memory changes and
(5) information about dementia.

Results
10 systematic reviews were included. Strong evidence exists for self-management support interventions focusing on family relationship in relieving caregiver burden. There is moderate evidence that self-management support interventions targeting psychological wellbeing contribute to a reduction of depressive symptoms. Last, strong evidence was found that interventions targeting ‘information about dementia’ increase well-being, and moderate evidence was found for a decrease of depression.

Conclusion
This meta-review indicates that self-management support interventions by health care professionals have positive effects on various outcomes of informal caregivers of people with dementia.

Funding
The Netherlands Organization for Health Research and Development (ZonMw).