Efficacy of a psychoeducational intervention in caregivers of people with intellectual disabilities: A randomized controlled trial (EDUCA-IV trial).

BACKGROUND: People with intellectual disabilities (ID) are usually cared for by their own parents, families or informal caregivers. Caring for a person with ID can have a negative impact on caregivers' mental health (burden, depression, anxiety). The main aim of the EDUCA-IV trial was testing the efficacy of a psychoeducational intervention program (PIP) versus standard practice and to see whether the PIP intervention would reduce the caregiver's burden at post-intervention (4 months) and at follow-up (8 months). METHOD: This was a multi-centre randomised controlled trial including 194 caregivers (96 randomised to PIP, 98 to control condition). PIP intervention consists of 12 weekly group sessions. The control group received treatment as usual. Primary outcomes measured included the Zarit Burden Interview (ZBI). Secondary outcomes were caregivers' mental health (GHQ-28), anxiety (STAI) and depression (CES-D). RESULTS: The decrease of ZBI scores was not significant at 4 months. There was significant decrease in the GHQ scores at 4 and 8 months. CES-D showed relevant results at follow-up. Intention to treat analyses showed similar results. CONCLUSIONS: The PIP intervention seems not to be effective reducing burden, but appears to have a positive result on general mental health. The program was well received and valued by caregivers.

Estudio de eficacia de una intervención psicoeducativa para la reducción de la sobrecarga del cuidador principal de personas con discapacidad intelectual: análisis de línea base del estudio EDUCA-IV / No disponible

La sobrecarga del cuidador es un aspecto importante en la asistencia a personas con dependencia. Está documentado su impacto sobre la salud tanto del cuidador como de la persona cuidada. Objetivo: estudiar la sobrecarga de cuidadores de personas con discapacidad intelectual y desarrollar una herramienta de intervención, para la prevención o reducción de dicha sobrecarga. La herramienta de intervención (EDUCA-DIS) se basa en la encuesta realizada a 244 familias que cuidan a personas con discapacidad intelectual y en las intervenciones psicoeducativas del programa EDUCA. Métodos: análisis de la línea base del estudio experimental multicéntrico, prospectivo y aleatorizado. Se recogieron datos de 183 cuidadores en 7 centros de atención diurna. La variable principal fue la sobrecarga del cuidador (ZBI). Las variables secundarias fueron el estado de salud mental del cuidador (GHQ-28), el estado de ánimo (CES-D) y el estado de ansiedad (STAI); Se recogieron datos del estado conductual y funcional de la persona cuidada mediante el ICAP. Resultados: El perfil del cuidador principal fue una mujer adulta, que convive con el familiar con un nivel de sobrecarga leve-moderado. Los datos del nivel de distress indicaron que la puntuación más baja está en la subescala de depresión y la más alta en la subescala de ansiedad/ insomnio. El nivel de sobrecarga del cuidador correlacionó negativamente con la capacidad de independencia de la persona atendida, tanto por estado funcional como por la gravedad de problemas de conducta. Conclusiones: el cuidador de la persona con discapacidad presenta síntomas de malestar emocional y es necesario un abordaje de esta problemática asistencial

Caregiver burden is a relevant issue in dependent's assistance. It is well documented its impact in caregiver’s and patient’s health. Aim: EDUCA-IV project study the caregiver burden of mental disability patients and the development of a intervention program to diminish the caregiver burden. The program was based on the surveys of 244 families of patients with intelectual disability and on the previous EDUCA programs. Methods: baseline analyses of a multicentre randomized control trial. Data was obtained from 183 caregivers of 7 daycare centres. Principal outcome was caregiver burden (ZBI-22). Secondary outcomes were mental health (GHQ-28), depression (CES-D), and anxiety (STAI). Behavioural and functionality data of patients were obtained with ICAP questionnaire. Results: Caregiver profile was an adult woman who lives with the patient and shows a low moderate level of burden. GHQ-28 results indicate that caregivers are affected of insomnia/anxiety symptoms. Caregiver burden correlates negatively with the level of independency of patient. Conclusions: Caregivers of intellectual disability patient show burden and psychological distress. It is necessary to act and implement an interventional program