Dataset Information

Quality of family relationships and outcomes of dementia: a systematic review.

ABSTRACT:

Objectives

To evaluate the association between the quality of relationship between a person with dementia and their family carer and outcomes for the person with dementia.

Design

Systematic review.

Eligibility criteria

Cohort studies of people with clinically diagnosed dementia and their main carers. Exposures of interest were any elements of relationship quality, for example, attachment style, expressed emotion and coping style. Our primary outcome was institutionalisation, and secondary outcomes were hospitalisation, death, quality of life and behavioural and psychiatric symptoms of dementia ('challenging behaviour').

Data sources

MEDLINE, Embase, Web of Science, PsycInfo, the Cochrane Library and Opengrey were searched from inception to May 2017.

Study appraisal and synthesis methods

The Newcastle-Ottawa Scale was used to assess risk of bias. A narrative synthesis of results was performed due to differences between studies.

Results

Twenty studies were included. None of the studies controlled for all prespecified confounding factors (age, gender, socioeconomic status and severity of dementia). Reporting of results was inadequate with many studies simply reporting whether associations were 'statistically significant' without providing effect size estimates or CIs. There was a suggestion of an association between relationship factors and global challenging behaviour. All studies evaluating global challenging behaviour provided statistical evidence of an association (most P values below 0.02). There was no consistent evidence for an association for any other outcome assessed.

Conclusions

There is currently no strong or consistent evidence on the effects of relationship factors on institutionalisation, hospitalisation, death or quality of life for people with dementia. There was a suggestion of an association between relationship factors and challenging behaviour, although the evidence for this was weak. To improve our ability to support those with dementia and their families, further robust studies are needed.

Prospero registration number

CRD42015020518.

SUBMITTER: Edwards HB

PROVIDER: S-EPMC5780722 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Quality of family relationships and outcomes of dementia: a systematic review.

Edwards Hannah B HB Ijaz Sharea S Whiting Penny F PF Leach Verity V Richards Alison A Cullum Sarah J SJ Cheston Richard Il RI Savović Jelena J

BMJ open 20180121 1

<h4>Objectives</h4>To evaluate the association between the quality of relationship between a person with dementia and their family carer and outcomes for the person with dementia.<h4>Design</h4>Systematic review.<h4>Eligibility criteria</h4>Cohort studies of people with clinically diagnosed dementia and their main carers. Exposures of interest were any elements of relationship quality, for example, attachment style, expressed emotion and coping style. Our primary outcome was institutionalisation ...[more]

PMID: 29358414

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Project description:BackgroundHospice care was initially designed for seriously ill individuals with cancer. Thus, the model and clinicians were geared toward caring for this population. Despite the proportion of persons living with dementia (PLWD) receiving hospice care substantially increased over the past 10 years, and their longer lengths of stay, established hospice interventions for this population are scarce. No systematic review has previously evaluated those interventions that do exist. We synthesized hospice intervention studies for PLWD, their families, and hospice professionals by describing the types of interventions, participants, outcomes, and results; assessing study quality; and identifying promising intervention strategies.MethodsA systematic review was conducted using a comprehensive search of five databases through March 2021 and follow-up hand searches. Included studies were peer-reviewed, available in English, and focused on hospice interventions for persons with dementia, and/or care partners, and clinicians. Using pre-determined inclusion and exclusion criteria, data was extracted guided by the Cochrane Checklist, and quality was assessed using a 26-item Consolidated Standards of Reporting Trials (CONSORT) Checklist.ResultsThe search identified 3235 unique studies in total, of which 10 studies met inclusion criteria. The search revealed three types of interventions: clinical education and training, usual care plus care add-on services, and "other" delivered to 707 participants (mostly clinicians). Five studies included underrepresented racial and ethnic groups. Outcomes measured knowledge and skills, psychosocial and health outcomes, feasibility, and acceptability, with significant improvements in six studies. Study quality was reflective of early-stage research with clinical education and training strategies showing deliberate progression towards real-world efficacy testing.ImplicationsHospice interventions for PLWD are sparse and in early-phase research. More research is needed with rigorous designs, diverse samples, and outcomes considering the concordance of care.

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Dataset Information

Quality of family relationships and outcomes of dementia: a systematic review.

Objectives

Design

Eligibility criteria

Data sources

Study appraisal and synthesis methods

Results

Conclusions

Prospero registration number

Publications

Quality of family relationships and outcomes of dementia: a systematic review.

Similar Datasets

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