The effectiveness of a hybrid mindfulness-based intervention in reducing stress among informal caregivers of people with dementia : a randomized controlled trial

Abstract

Background and Objectives: Informal caregivers of people with dementia experience significant caregiving stress. Mindfulness-based interventions are effective approaches for alleviating caregiving stress. However, traditional mindfulness training is intensive and challenging to attend due to the substantial caregiving responsibilities of this population, leading to issues with program attrition and adherence. To address this limitation, a novel Mindfulness-Based Dementia Care Program (MBDCP) was developed by simplifying traditional mindfulness training and utilizing a hybrid delivery model tailored to the needs of dementia caregivers. This study aimed to evaluate the effectiveness of the MBDCP in reducing caregiving stress compared with a brief education program. Research Design and Methods: A single-blinded, parallel-group randomized controlled trial was conducted with 127 dementia caregivers (MBDCP: n=64; Control: n=63) recruited from three community care centers in Hong Kong. The MBDCP included six weekly 90-min sessions delivered through face-to-face and online formats. Outcomes were assessed at baseline, postintervention, and 6-month follow-up. The primary outcome was perceived stress, whereas secondary outcomes included heart rate variability, mindfulness, depressive symptoms, caregiving burden, dyadic relationships, and neuropsychiatric symptoms of care recipients. Results: MBDCP significantly improved perceived stress, depressive symptoms, trait mindfulness, and heart rate variability compared with the control group. No significant effects were observed on caregiving burden, dyadic relationships, positive caregiving aspects, or neuropsychiatric symptoms. Discussion and Implications: The MBDCP effectively reduced stress and improved psychophysiological outcomes in dementia caregivers. These findings highlight the potential of simplified, hybrid mindfulness training to enhance accessibility and effectiveness for this population.