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Title: Understanding the experience of dementia carers
Author: Robertson, Sarah
Awarding Body: University of Liverpool
Current Institution: University of Liverpool
Date of Award: 2020
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Background: Family caregivers are essential to the healthcare system. However, they frequently experience negative psychological consequences and clinically significant levels of depression, anxiety and stress. Evidence suggests psychological interventions are effective in promoting the emotional health of dementia caregivers. However, we know little about the mechanisms underpinning therapeutic change. We conducted a systematic realist synthesis to build a theory to explain how interventions work using a context-mechanismoutcome framework. Improving our understanding of mechanisms will enable service providers to tailor appropriate interventions for carers in diverse contexts. Methods: We conducted a systematic review informed by realist methodology. We searched EMBASE, PsychInfo, CINAHL and grey literature using the following terms: dementia, caregiver, psychological intervention and mechanism. We included papers with psychological interventions that had a significant effect on desired outcomes, that outlined the process of change. We will describe an iterative process that has involved stakeholder expertise and feedback, in line with realist quality standards. Results: Searches returned 967 papers. Papers were screened, and 27 empirical papers were included. We identified conceptual models underpinning change, the key ingredients creating therapeutic change and the resources involved. These were synthesised into four context-mechanism-outcome frameworks to guide evidence based, service delivery. Conclusions: The mechanisms of change presented offer service providers a model for tailoring specific interventions to the needs of each caregiver. Realist methodologies can help us better understand research findings and provide us with the best opportunity to influence policy and improve outcomes for people affected by dementia.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral