Mindfulness-based intervention for stress reduction of family caregivers of people with dementia : a systematic review and meta-analysis

Abstract

Caring for people with dementia (PWD) poses a lot of challenges to family caregivers. Mindfulness-based intervention (MBI) is a newly adopted psychosocial intervention through an integration of the mind and body to reduce stress of the participants (caregivers). This study aims to determine whether and to what extent MBI for family caregivers of PWD can reduce their stress. Electronic databases including MEDLINE, CINAHL, Cochrane Library, PsycINFO, EMBASE, and the Web of Science were searched for relevant studies published between 1990 and 2016. All randomized controlled trials (RCTs) and quasi-experimental studies evaluating the effects of MBI on reducing stress in family caregivers of PWD were eligible for inclusion in this review. Five studies were included. Of these, three trials involving 144 participants were eligible for the meta-analysis. The analysis showed that stress levels dropped significantly after the MBI. The findings showed a significantly more favorable effect of MBI with the standardized mean difference with a moderate aggregated effect size of 0.57 (95% CI [0.23, 0.92], overall effect Z = 3.25 at p = 0.001). This effect was only found immediately after the MBI but not in the follow-up sessions. In conclusion, the available evidence suggests that MBI seems to be effective at reducing stress among family caregivers of PWD. However, it should be noted that the number of studies involved was small (n = 5), as were the sample sizes, and no sustained effect was found. Multi-center RCTs of the effects of MBI involving larger and more diverse samples of family caregivers of PWD are recommended before any clear conclusion can be reached.