Prevalence of depression and burden among informal caregivers of people with dementia and the effectiveness of mindfulness and acceptance based interventions at reducing these: two meta-analyses

Collins, Rebecca Naomi (2018) Prevalence of depression and burden among informal caregivers of people with dementia and the effectiveness of mindfulness and acceptance based interventions at reducing these: two meta-analyses. Doctoral thesis, University of East Anglia.

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Abstract

The primary aims of this thesis were to examine the prevalence of depression and burden among informal caregivers of people with dementia (PwD) and the effectiveness of mindfulness and acceptance based interventions (MABIs) at reducing these difficulties. The thesis consists of a meta-analysis on the prevalence of depression and burden among informal caregivers of PwD, a bridging chapter detailing the rationale behind the second meta-analysis set within the context of the first, a meta-analysis on the effectiveness of MABIs on depressive symptoms and burden among informal caregivers of PwD, an additional methodology chapter on the random-effects model, and an overall discussion and critical appraisal. The first meta-analysis identified 43 studies, examining a total of 16 911 participants. The adjusted pooled prevalence of depression was 31.2% (95% CI 27.7% to 35.0%) and burden was 49.3% (95% CI 37.2% to 61.5%). The second meta-analysis included 12 studies, providing data on 321 caregivers. MABIs proved largely and moderately effective at reducing depressive symptoms and burden among informal caregivers of PwD, respectively. There was, however, significant heterogeneity amongst almost all effect estimates reported. The first meta-analysis found the prevalence of depression differed according to the instrument used and the continent in which the study was conducted. The second meta-analysis was unable to explain the observed heterogeneity of effect sizes. Many of the included studies in the first and second meta-analysis were rated as having a ‘high risk’ of bias. The impact of heterogeneity and study quality is critically explored. The thesis indicates that there is a great need within this population for interventions that are effective at reducing burden and depressive symptoms, with MABIs appearing acceptable and beneficial. However, further higher quality research is needed to improve the robustness of the evidence bases and enable a meta-analysis to thoroughly examine and quantify moderator variables.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Gillian Aldus
Date Deposited: 16 Nov 2018 14:08
Last Modified: 26 Nov 2018 15:01
URI: https://ueaeprints.uea.ac.uk/id/eprint/68935
DOI:

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