Home-based educational interventions for family caregivers of older adults after stroke: a scoping review

Saucedo-Pahua, Gerardo; Caetano, Gideany Maiara; Jiménez-González, María de Jesús; Fhon, Jack Roberto Silva

doi:10.1590/1980-220X-REEUSP-2023-0339en

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Sumário

REVIEW • Rev. esc. enferm. USP 58 • 2024 • https://doi.org/10.1590/1980-220X-REEUSP-2023-0339en copy

Home-based educational interventions for family caregivers of older adults after stroke: a scoping review

Intervenções educativas domiciliares para cuidadores familiares de idosos pós-AVC: revisão de escopo

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To map home-based educational interventions for family caregivers of older adults after stroke.

Method:

Scoping review based on the JBI methodology, carried out on May 23, 2023. The Rayyan application and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews were used.

Results:

Of the 1,705 studies, nine published from 2006 to 2020 were included: 44% of interventions were theoretical-practical educational; 77.7% were randomized clinical trials; and the “in-person” intervention (56%) was the most common, carried out by nurses in 88.9% of cases. Three to 15 42-minute sessions were carried out. The educational contents were organized into ten categories, divided into education aimed at caring for older adults and self-care for caregivers.

Conclusion:

Identified educational interventions strengthen participants’ knowledge and skills in areas such as education, care, communication, self-management, rehabilitation and nutrition as well as self-care to safely assist older adults in their activities of daily living.

DESCRIPTORS
Stroke; Caregivers; Aged; Education, Nonprofessional

Databases	Search strategy	Retrieved files
PubMed	Caregiver* AND education AND (stroke OR hemiplegia)	537
CINAHL	(MH “Hemiplegia”) OR TI (hemiplegia or hemiparesis or hemiparetic or hemiplegic OR hemiplegias) OR AB (hemiplegia or hemiparesis or hemiparetic or hemiplegic OR hemiplegias) OR (MHxxx “Stroke”) OR TI (stroke or “cerebrovascular accident” or cva or “cerebral vascular event” or cve or “transient ischaemic attack” or tia) OR AB (stroke or “cerebrovascular accident” or cva or “cerebral vascular event” or cve or “transient ischaemic attack” or tia) AND (MH “Caregivers/ED”) OR TI ((caregiver* OR carer) AND education) OR AB ((caregiver OR carer*) AND education) AND Restringir por SubjectAge: – all adult	228
Scopus	TITLE-ABS-KEY-AUTH (caregiver* AND education AND (stroke OR hemiplegia)) AND TITLE-ABS-KEY-AUTH (“INTERVENTION”)	302
ERIC	“family caregiver” AND education AND stroke	02
Science Direct	(Caregiver OR carer) AND “educational intervention” AND (stroke OR hemiplegia)	20
VHL (BDENF, LILACS, IBECS)	(family caregiver) AND ((education OR intervention)) AND ((stroke OR hemiplegia)) AND (db:(“BDENF” OR “LILACS” OR “IBECS”))	46
PsycInfo	Any Field: “family caregiver” AND Any Field: education AND Any Field: stroke	19
EMBASE	(‘family caregiver’/exp OR ‘family caregiver’) AND (‘education’/exp OR education) AND (‘cerebrovascular accident’/exp OR ‘cerebrovascular accident’) AND (home OR domiciliar OR outpatient	281
CAPES Thesis and Dissertation Catalog	(educação OR intervenção) AND “cuidadores familiares”	31
NDLTD Database	“family caregiver” AND (education OR intervention) AND (stroke OR hemiplegia) AND (elder* OR aged OR older OR senior OR geriatr*)	17
Google Scholar	“family caregiver” AND (education OR intervention) AND (stroke OR hemiplegia) AND (elder* OR aged OR older OR senior OR geriatr*) AND Filetype: doc OR RTF OR PDF OR html	191

ID	Country	TEI	MD	MoD	Facilitator	ETR	No. S	Dosis	ST
Schure et al.(²⁶26. Schure LM, van den Heuvel ETP, Stewart RE, Sanderman R, de Witte LP, Meyboom-de Jong B. Beyond stroke: description and evaluation of an effective intervention to support family caregivers of stroke patients. Patient Educ Couns. 2006;62(1):46–55. doi: http://doi.org/10.1016/j.pec.2005.05.015. PubMed PMID: 16023823. https://doi.org/10.1016/j.pec.2005.05.01... )	United States	Theoretical/practical	N/d	In-person	Nurses	Intervention manual	8	120 m	10 W
McLennon et al.(²⁷27. McLennon SM, Hancock ED, Redelman K, Scarton LJ, Riley E, Sweeney B, et al. Comparing treatment fidelity between study arms of a randomized controlled clinical trial for stroke family caregivers. Clin Rehabil. 2016;30(5):495–507. doi: http://doi.org/10.1177/0269215515585134. PubMed PMID: 25952589. https://doi.org/10.1177/0269215515585134... )	United States	Educational/guidance	RCT	Telephone line	Nurses	Intervention manual	9	23 m	N/d
Baltar et al.(³⁰30. Baltar C, Girardi LM. Efeito da intervenção educativa SHARE na sobbrecarga de cuidadores familiares de idosos após acidente vascular cerebral: ensaio clínico randomizado [tesis]. Porto Alegre: Universidade Federal do Rio Grande do Sul; 2017.)	Brazil	Theoretical/práctica	RCT	In-person	Nurses	Intervention manual	3	40 m	4 W
Fu et al.(³²32. Fu B, Mei Y, Lin B, Guo Y, Zhang Z, Qi B, et al. Effects of a benefit-finding intervention in stroke caregivers in communities. Clin Gerontol. 2022;45(5):1317–29. doi: http://doi.org/10.1080/07317115.2020.1765062. PubMed PMID: 32496892. https://doi.org/10.1080/07317115.2020.17... )	China	Theoretical/practical	RCT	In-person	Nurses, psychologists, doctors	Intervention manual	9	45 m	9 W
LeLaurin et al.(²⁸28. LeLaurin JH, Sypniewski C, Wing K, Freytes IM, Findley K, Uphold CR. Development, usability testing, and promotion of the English- and Spanish-language RESCUE stroke caregiver websites. Am J Health Educ. 2022;53(3):174–85. doi: http://doi.org/10.1080/19325037.2022.2048747. https://doi.org/10.1080/19325037.2022.20... )	United States	Theoretical	N/d	Website	Nurses	Website for caregivers	15	N/d	N/d
Patchwood et al.(³³33. Patchwood E, Woodward-Nutt K, Rhodes SA, Batistatou E, Camacho E, Knowles S, et al. Organising Support for Carers of Stroke Survivors (OSCARSS): a cluster randomised controlled trial with economic evaluation. BMJ Open. 2021;11(1):e038777. doi: http://doi.org/10.1136/bmjopen-2020-038777. PubMed PMID: 33436463. https://doi.org/10.1136/bmjopen-2020-038... )	United Kingdom	Educational/support	RCT	In-person	Nurses	Intervention manual – instructional videos	10	120 m	6 W
Elsheikh et al.(¹⁷17. Elsheikh MA, Moriyama M, Rahman MM, Kako M, El-Monshed AH, Zoromba M, et al. Effect of a tailored multidimensional intervention on the care burden among family caregivers of stroke survivors: a randomised controlled trial. BMJ Open. 2022;12(2):e049741. doi: http://doi.org/10.1136/bmjopen-2021-049741. PubMed PMID: 35168963. https://doi.org/10.1136/bmjopen-2021-049... )	Egypt	Theoretical	RCT	In-person/telephone line	Nurses	Online educational resource	10	120 m	26 W
Kottwitz et al.(³¹31. Kottwitz CCB, Fengler FL, Low G, Baltar C, Oliveira N, Girardi LM. Calidad de vida en cuidadores de adultos mayores sobrevivientes de accidentes cerebrovasculares en el sur de Brasil: ensayo clínico aleatorizado. Rev Latino-Am. Enfermagem. 2023;31:e3656. doi: http://doi.org/10.1590/1518-8345.5935.3656. https://doi.org/10.1590/1518-8345.5935.3... )	Brazil	Theoretical/practical	RCT	In-person	Nurses	Intervention manual	3	40 m	4 W
Quinn et al.(²⁹29. Quinn EB, LeLaurin JH, Eliazar-Macke ND, Orozco T, Montague M, Freytes IM, et al. Effect of a telephone and web-based problem-solving intervention for stroke caregivers on stroke patient activities of daily living: a randomized controlled trial. Clin Rehabil. 2023;37(8):1062–73. doi: http://doi.org/10.1177/02692155231157301. PubMed PMID: 36847253. https://doi.org/10.1177/0269215523115730... )	United States	Theoretical	RCT	Asynchronous phone line/online messaging	Nurses	Website for caregivers	9	N/d	N/d

Educational categories aimed at caring for older adults	Study that integrates the component
Educational categories aimed at caring for older adults	Schure et al.(²⁶26. Schure LM, van den Heuvel ETP, Stewart RE, Sanderman R, de Witte LP, Meyboom-de Jong B. Beyond stroke: description and evaluation of an effective intervention to support family caregivers of stroke patients. Patient Educ Couns. 2006;62(1):46–55. doi: http://doi.org/10.1016/j.pec.2005.05.015. PubMed PMID: 16023823. https://doi.org/10.1016/j.pec.2005.05.01... )	McLennon et al.(²⁷27. McLennon SM, Hancock ED, Redelman K, Scarton LJ, Riley E, Sweeney B, et al. Comparing treatment fidelity between study arms of a randomized controlled clinical trial for stroke family caregivers. Clin Rehabil. 2016;30(5):495–507. doi: http://doi.org/10.1177/0269215515585134. PubMed PMID: 25952589. https://doi.org/10.1177/0269215515585134... )	Baltar et al.(³⁰30. Baltar C, Girardi LM. Efeito da intervenção educativa SHARE na sobbrecarga de cuidadores familiares de idosos após acidente vascular cerebral: ensaio clínico randomizado [tesis]. Porto Alegre: Universidade Federal do Rio Grande do Sul; 2017.)	Fu et al.(³²32. Fu B, Mei Y, Lin B, Guo Y, Zhang Z, Qi B, et al. Effects of a benefit-finding intervention in stroke caregivers in communities. Clin Gerontol. 2022;45(5):1317–29. doi: http://doi.org/10.1080/07317115.2020.1765062. PubMed PMID: 32496892. https://doi.org/10.1080/07317115.2020.17... )	LeLaurin et al.(²⁸28. LeLaurin JH, Sypniewski C, Wing K, Freytes IM, Findley K, Uphold CR. Development, usability testing, and promotion of the English- and Spanish-language RESCUE stroke caregiver websites. Am J Health Educ. 2022;53(3):174–85. doi: http://doi.org/10.1080/19325037.2022.2048747. https://doi.org/10.1080/19325037.2022.20... )	Patchwood et al.(³³33. Patchwood E, Woodward-Nutt K, Rhodes SA, Batistatou E, Camacho E, Knowles S, et al. Organising Support for Carers of Stroke Survivors (OSCARSS): a cluster randomised controlled trial with economic evaluation. BMJ Open. 2021;11(1):e038777. doi: http://doi.org/10.1136/bmjopen-2020-038777. PubMed PMID: 33436463. https://doi.org/10.1136/bmjopen-2020-038... )	Elsheikh et al.(¹⁷17. Elsheikh MA, Moriyama M, Rahman MM, Kako M, El-Monshed AH, Zoromba M, et al. Effect of a tailored multidimensional intervention on the care burden among family caregivers of stroke survivors: a randomised controlled trial. BMJ Open. 2022;12(2):e049741. doi: http://doi.org/10.1136/bmjopen-2021-049741. PubMed PMID: 35168963. https://doi.org/10.1136/bmjopen-2021-049... )	Kottwitz et al.(³¹31. Kottwitz CCB, Fengler FL, Low G, Baltar C, Oliveira N, Girardi LM. Calidad de vida en cuidadores de adultos mayores sobrevivientes de accidentes cerebrovasculares en el sur de Brasil: ensayo clínico aleatorizado. Rev Latino-Am. Enfermagem. 2023;31:e3656. doi: http://doi.org/10.1590/1518-8345.5935.3656. https://doi.org/10.1590/1518-8345.5935.3... )	Quinn et al.(²⁹29. Quinn EB, LeLaurin JH, Eliazar-Macke ND, Orozco T, Montague M, Freytes IM, et al. Effect of a telephone and web-based problem-solving intervention for stroke caregivers on stroke patient activities of daily living: a randomized controlled trial. Clin Rehabil. 2023;37(8):1062–73. doi: http://doi.org/10.1177/02692155231157301. PubMed PMID: 36847253. https://doi.org/10.1177/0269215523115730... )
Knowledge and education about stroke	X	X	X	X	X	X	X	X	X
Assistance and care in basic and instrumental activities of daily living	X	X	X	X	X	X	X	X	X
Effective communication	X		X	X	X		X	X	X
Self-management of health services			X	X	X	X		X	X
Physical and language rehabilitation			X		X		X	X	X
Nutrition/feeding			X	X	X			X	X
Risks prevention			X		X			X	X
Educational categories aimed at family caregivers
Self-care and well-being			X	X	X		X	X	X
Strategies to face challenges	X	X	X	X	X	X		X	X
Organization of the caregiver role	X		X		X	X	X	X	X

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E-mail: reeusp@usp.br

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[1] Corresponding author: María de Jesús Jiménez González Av. Ing. Barros Sierra, 201, Santa María del Refugio 38140 – Celaya, Guanajuato, México mj.jimenez@ugto.mx