Effectiveness of technology-based psychosocial interventions for improving health-related outcomes of family caregivers of stroke survivors: A systematic review and meta-analysis

J Clin Nurs. 2024 Nov;33(11):4207-4226. doi: 10.1111/jocn.17370. Epub 2024 Jul 17.

Abstract

Aim: To synthesize evidence regarding the effectiveness of technology-based psychosocial interventions in improving health-related outcomes among family caregivers of stroke survivors.

Design: A systematic review and meta-analysis was reported by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Methods: Randomized controlled trials that investigated the effects of psychosocial interventions delivered through information and communication technologies on self-efficacy, caregiving competence, caregiver burden, perceived social support, anxiety, depression, health-related quality of life and cost-effectiveness were included. Two researchers independently selected studies, extracted data, and appraised the quality of the included studies. Subgroup analysis, sensitivity analysis, and narrative synthesis were conducted.

Data sources: Ten electronic databases (PubMed, CENTRAL, Web of Science, Scopus, CINHAL, Embase, Institution of Electrical Engineers Xplore, Ovid Medline, PsycINFO, ProQuest Dissertations and Thesis) were searched up to February 2023.

Results: Nineteen studies involving 1717 participants fulfilled the eligibility criteria. Technology-based psychosocial interventions significantly improved self-efficacy (SMD = .62), caregiving competence (SMD = .55), depression (SMD = -.25) and anxiety (SMD = -.35). However, perceived social support, caregiver burden, and health-related quality of life did not show significant improvements. Subgroup analyses revealed that the interventions, lasting from 4 to 6 weeks and encompassing comprehensive contents, exhibited larger effect sizes. None of the studies measured cost-effectiveness.

Conclusion: The technology-based psychosocial interventions are effective in enhancing self-efficacy and caregiving competence, as well as alleviating anxiety, and depression among family caregivers of stroke survivors. Future research should investigate interventions delivered through various digital platforms using well-designed RCTs with in-depth qualitative data collection and measurement of health and cost-effectiveness outcomes.

Impact: Through psychosocial interventions, healthcare providers in clinical and community settings, particularly nurses, could incorporate technologies into current stroke care practices.

Patient or public contribution: It is not applicable as this is a systematic review.

Registration: The protocol was registered on PROSPERO (CRD42023402871).

Keywords: caregiver burden; caregiving competence; family caregivers; self‐efficacy; stroke survivors; systematic review; technology‐based psychosocial interventions.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Anxiety / psychology
  • Caregivers* / psychology
  • Depression / psychology
  • Humans
  • Psychosocial Intervention* / methods
  • Quality of Life / psychology
  • Randomized Controlled Trials as Topic
  • Self Efficacy
  • Social Support
  • Stroke / nursing
  • Stroke / psychology
  • Survivors