Problem-solving counseling for caregivers of the cognitively impaired: Effective for whom?

Citation Roberts, J., Browne, G., Milne, C., Spooner, L., Gafni, A., Drummond-Young, M., LeGris, J., Watt, S., LeClair, K., Beaumont, L., & Roberts, J. (1999). Problem-solving counseling for caregivers of the cognitively impaired: Effective for whom? Nursing Research, 48(3), 162-172.

Design Experiment.

Purpose The purpose of this study was to determine the effectiveness of individualized problem-solving counseling by nurses for caregivers and the expenditures of health care utilization.

Hypothesis The following questions were investigated: What is the prevalence of poor psychosocial adjustment and, specifically, psychological distress among caregivers of cognitively impaired adults. Is a 6-month problem-solving counseling intervention given by community nurses effective in reducing caregiver psychological distress, burden, and expenditures for health and social services, or improving social support, and coping methods. Is there an effect on health care utilization expenditures for caregivers who are receiving nurse counseling.

Participants The participants of this experiment were caregivers (N=77) of cognitively impaired adults living at home, randomly assigned to treatment (nurse counseling) and control groups (no counseling).

Outcome / Dependent Variables The dependent variables in this study were Caregivers' psychosocial adjustment to their relative's illness, psychological distress, burden, coping skills, and expenditures measured at 6 and 12 months.

Procedure The nurse counseling sessions (about 10) were given in the caregiver's home or by phone. Caregivers completed measures at baseline, 6 and 12 months to determine the effect of intervention.

Outcomes The following are some of the major outcomes of the study: There were no overall significant differences found between treatment and control groups at 6 and 12 months. Participants of the treatment group rated the nurse counseling helpful. Within the treatment group, participants who used logical analysis coping behaviors at baseline showed improved psychosocial adjustment and less psychological distress in the respective scales. In the control group, 50% of those with frequent logical analysis coping skills placed relative in an institution vs. 20% in treatment group. Caregiver psychosocial adjustment improved after placement, regardless of group (most important improvement noted).

Author Roberts, J., Browne, G., Milne, C., Spooner, L., Gafni, A., Drummond-Young, M., LeGris, J., Watt, S., LeClair, K., Beaumont, L., & Roberts, J.