Background: Informal caregivers provide ongoing practical and emotional support to meet the needs of stroke survivors. Over time, caregiving demands, stress, and lack of time for their own health and social activities can result in caregiver burden and impact the care and institutionalisation of the stroke survivor. Despite recently published reviews, the optimal length and type of intervention to reduce caregiver burden and strain remains unclear.
Aims: To understand the nature and effectiveness of interventions aimed at improving informal stroke caregiver outcomes (burden and strain).
Methods: This systematic review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. A search of CINHAL, MEDLINE, Embase, APA PsycInfo, and Web of Science was conducted, and studies were eligible if they included a health and wellbeing intervention targeting informal caregivers of stroke survivors, reported on caregiver burden or strain, were published in English, and used a Randomised Controlled Trial (RCT) design. The RoB2 was used to appraise methodological quality of included studies.
Results: This systematic review included 17 RCTs that qualified for meta-analysis, with six dyad and 11 caregiver only interventions. Interventions ranged from 4 days to 12 months, and sessions ranged from 3 to 24. The majority of studies incorporated an educational and/or support component (n=7). Other studies delivered psychoeducational programs (n=4), relaxation exercises (n=3), problem solving techniques (n=2), or reminiscence therapy (n=1). Notably, meta-analysis found no statistically significant effects on caregiver burden (d = 0.02, 95% CI [-0.36 to 0.39], p = 0.93) or strain (d = -0.07, 95% CI [-0.23 to 0.09], p = 0.41).
Conclusion: The limited number of studies, small sample sizes, and heterogeneity of studies made it difficult to determine the intervention efficacy on caregiver outcomes. Further high-quality research is required to identify the optimal format, content, and frequency for improving caregiver outcomes.