The efficacy of telephone use to assist and improve the wellbeing of family caregivers of persons with chronic diseases: a systematic review

Background The experience of being a caregiver for a person with a chronic disease may cause self-negligence, increased duties and responsibilities, health issues, anxiety, depression and lifestyle-related changes for the caregiver. This means that caring may become a stress factor that impacts negatively on the caregiver and may overload them. Given the impact chronic diseases have on the quality of life of people and their families, it is important to establish interventions that are more efficient and less expensive than standard or routine care to promote the wellbeing of family caregivers. Despite studies that demonstrate the usefulness of the telephone in the delivery of health interventions, there is to date no summary of evidence on the effectiveness of its use. Therefore, addressing this gap in the literature is important for health professionals, in order to allow them to make evidence-based decisions regarding the use of the telephone in the delivery of interventions to improve the wellbeing of family caregivers of people with chronic diseases. Objective The objective of this systematic review was to synthesize the best available evidence on the efficacy of interventions delivered using the telephone to improve the wellbeing of family caregivers of people with chronic diseases. Inclusion criteria Type of studies This review included randomized controlled trials that met the inclusion criteria. Only randomized controlled trials were considered because the results of such studies generate the strongest conclusions on the efficacy of interventions. Types of participants This review considered studies that included family caregivers of people with chronic diseases in their sample, regardless of the disease type, severity and duration of care. Types of intervention Any studies that evaluated psycho-educational, psychosocial and psychotherapeutic interventions delivered using the telephone to reinforce the personal strengths, resources and coping skills of caregivers in order to improve their wellbeing in the physical, psychological and spiritual domains were evaluated for inclusion eligibility. Search strategy The search strategy used for the review focused on finding relevant studies, published and unpublished in the Portuguese, English and Spanish languages, published since 1995. The search was done between April 2013 and October 2013 in the databases: CINAHL, MEDLINE/Pubmed, Cochrane Central Register of Controlled Trials (CENTRAL), PSYCRITIQUES (PsycINFO and Psycharticles), ProQuest, IBECS and LILACS, ISI Web Knowledge, Science Direct and Scopus. For unpublished studies the search included: ProQuest Dissertations and Theses, Cybertesis, Biblioteca Digital de Teses e Dissertaçoes, ADT, Diva, RCAAP- Repositório Cientfico de Acesso Aberto de Portugal, Theses Canada, Ethos, DART-Europe E-Theses Portal and National ETD Portal. Methodological quality Two reviewers independently appraised each article that met the inclusion criteria for methodological quality. For this purpose, the standardized critical appraisal tool from JBI-MAStARI was used. Data collection Quantitative data were extracted from papers included in the review using the standardized data extraction tool from JBI-MAStARI. Data synthesis The data extracted from the included studies was synthesized into a narrative summary. The heterogeneity of interventions, outcome measures and timing of reassessment prevented the conduct of a meta-analysis. Results Three studies comparing an intervention delivered by telephone with usual care, or with the same intervention delivered face to face at home, met the criteria for the review. The participants in the included studies were all dementia caregivers. In two of the three included studies, after completion of the telephone intervention, caregivers showed significantly lower perceived burden. Conclusion The strength of the evidence provided by the three studies was weak and highlights the need for further large randomized controlled trials to assess the efficacy of interventions using the telephone to improve the quality of life of family caregivers of people with chronic disease.

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