The Effectiveness of Intervention for Family Caregiver's Role Transition: A Systematic Review

Background: As aging population, patients with chronic disease increased as well as long term care needs. There is no doubt that care responsibility falls on informal caregivers. During transitional process of becoming a family caregiver who suffered from physio-psycho-social dilemma, such as frustration, depressive, limited social life, feeling exhausted, sibling fractured relationships, loss of control, and feeling alone. Therefore, appropriate interventions are needed for role transition to becoming a caregiver. As a clinical nursing staff, we have the responsibility to helping family of ventilator dependent patients role transition successfully and becoming a competent caregiver.

Purpose: The purpose of this systematic review was to find the effective strategies for family caregiver role transition; and to find outcome indicators of successful caregiver role transition.

Method: A systematic review approach was used to search articles. Caregiver/caregiving and transition were keywords, and PubMed, CINAHL, PsycInfoo, Cochrane Library and Airiti Library databases were searched. Inclusion criteria were fulltext articles available online, intervention study and published in English. A total of 225 potential articles were selected, 36 articles were duplicated. Remained 189 articles were read the title and abstract, and excluded un-related articles. Finally, nine articles were selected and appraised.

Results: Study population included stroke, Alzheimer disease and elderly patient’s caregiver. Intervention strategies could be categorized to care knowledge and skill instruction, coping skill training, counseling and transferring, and continuous follow-up. Interventions implemented during hospitalization and lasted one month to one year after discharge. Outcome indicators could be categorized to patient indicators (health status, functional status, quality of life, self-care ability), caregiver indicators (cognitive, behaviour, physiological and psychological indicators) and healthcare services utilization indicators (unplanned readmission, emergency visit, institutionalization and cost). These studies revealed positive effects on outcome indicators, such as patient’s functional status, self care ability, caregivers’ knowledge, burden, depression symptom, discharge preparation, unplanned readmission and emergency visits.

Conclusion: The intervention strategies have positive effects on caregiver’s role transition. Unique and individualized interventions should be designed according to patient’s disease and needs.