Transcultural influences in dementia care: observations from a psychosocial intervention study.
BACKGROUND
Various models of intervention for caregivers of patients with dementia have been described. There has been little direct comparison of cultural differences between countries and the effect any differences may exert on the outcome of caregiver interventions.


OBJECTIVE
The aims of the three-country study (USA, Australia and the UK) were to assess whether caregiver interventions can still be successful when anti-dementia drugs are provided to patients, and whether a caregiver intervention can be successfully implemented using the same methods in three different English-speaking countries. In this paper, the cultural differences and similarities between the three countries are examined.


METHODS
Randomised, controlled trial involving 158 patients and their caregivers (divided equally across three centres, New York, Sydney and Manchester) with all the patients receiving donepezil and the caregivers randomised to a caregiver intervention or treatment as usual.


RESULTS
There were few differences between countries in the main outcome measures, and no differences between the treatment-as-usual group and the intervention, but interesting cultural nuances were observed between groups. Despite these differences, the caregiver intervention was associated with positive results on caregiver depression across all the countries.


CONCLUSIONS
This first multinational carer intervention study has emphasised the similarities between the three countries whilst highlighting crucial differences which may be important when planning cross-cultural studies in the future. The positive results achieved on caregiver depression were replicated across the three centres.
University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. Alistair.burns@manchester.ac.uk
Alistair
A
Burns
Mary
M
Mittelman
Catherine
C
Cole
Julie
J
Morris
Jane
J
Winter
Sean
S
Page
Henry
H
Brodaty
D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000628:therapy; D001007:Anxiety / Q000150:complications / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D003376:Counseling; D003466:Cultural Characteristics; D003469:Culture; D003704:Dementia / Q000188:drug therapy / Q000523:psychology* / Q000628:therapy*; D003863:Depression / Q000150:complications / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009517:New South Wales; D009518:New York; D018697:Nootropic Agents / Q000627:therapeutic use; D009735:Nursing Homes; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012944:Social Support; D006113:United Kingdom
D018697:Nootropic Agents