Realist Review: Understanding Effectiveness of Intervention Programs for Dementia Caregivers.

PURPOSE: Caring for patients with dementia is a challenging issue entailing heavy responsibility. Many interventions for caregivers have been developed, but their effectiveness is not clear. This study aimed to examine how, why, and under what circumstances interventions for dementia caregivers affected their burden of caring.

METHODS: Primary research studies of interventions for caregivers of dementia patients conducted from 2008 to 2017 with an experimental or quasi-experimental design were retrieved from relevant databases. The context and mechanism for review of the study were derived from the previous literatures and initial theory. Next, 10 studies were analyzed into six contexts and seven mechanisms.

RESULTS: None of the studies included all the derived contexts while explaining in detail the mechanism of the intervention effectiveness. Among contexts, the variable of other family members requiring care was not included in all studies. Among the analyzed studies, no studies have applied repeated intervention. Most studies included only some variables of context and mechanism, and these variables did not directly explain the effectiveness of intervention. The effect of outcome variables was significant for each study and the effects of research intervention and national services could not be separately described.

CONCLUSION: We conclude that Korean culture's emphasis on relationships with others increases the burden of care. In context, Confucian norms and traditional femininity of Korea were reflected in the core. It is necessary to check the homogeneity of participants and the design of intervention in order to verify the effectiveness of the outcome variable of psychological burden.