Effects of App-Based Mobile Interventions for Dementia Family Caregivers: A Systematic Review and Meta-Analysis.

ABSTRACT

BACKGROUND: Dementia was caregivers experience tremendous difficulties both physically and psychologically, leading to high levels of depression and caregiver burden. The advantage of mobile interventions has been recognized due to its freedom from time and space restrictions. OBJECTIVES: A systematic review and meta-analysis was conducted to evaluate effectiveness of app-based mobile interventions for dementia caregivers. METHOD: We searched nine different databases including CINAHL, the Cochrane Library, Embase, MEDLINE, PsycINFO, the ACM digital library, IEEE Xplore, KoreaMed, and RISS for publications on app-based mobile interventions targeting dementia caregivers published in English or Korean. Meta-analysis was conducted using Comprehensive Meta-Analysis (CMA) version 3.0. Standard mean difference (SMD) was used to estimate the effectiveness of the intervention on caregiver-related outcomes of caregiver burden, depression, stress, caregiving competency, and quality of life (QoL). RESULTS: Five studies (three randomized controlled trials and two quasi-experimental studies) with a total of 230 participants were included. Using a mobile device, interventions were used to provide information and feedback, perform monitoring, and conduct skill training. Pooled analysis showed favorable effects of app-based mobile interventions for caregivers on caregiver burden (SMD = -0.315, 95% CI -0.681 to 0.052), depression (SMD = -0.236, 95% CI -0.517 to 0.046), stress (SMD = -0.295, 95% CI -0.708 to 0.118), competency (SMD = 0.434, 95% CI 0.093-0.775), and QoL (SMD = 0.794, 95% CI 0.310-1.278). CONCLUSION: Types of mobile devices, lengths, and contents of interventions varied between included studies. Given that only five studies were included, the current meta-analysis could not confirm the effectiveness of app-based mobile interventions. However, this study suggests that app-based mobile interventions for dementia caregivers might have positive effects on diverse caregiving-related issues such as caregiver burden, depression, stress, competency, and QoL.