title: A benefit-finding intervention for family caregivers of persons with Alzheimer disease: study protocol of a randomized controlled trial.
abstract: BACKGROUND
  Caregivers of relatives with Alzheimer's disease are highly stressed and at risk for physical and psychiatric conditions. Interventions are usually focused on providing caregivers with knowledge of dementia, skills, and/or support, to help them cope with the stress. This model, though true to a certain extent, ignores how caregiver stress is construed in the first place. Besides burden, caregivers also report rewards, uplifts, and gains, such as a sense of purpose and personal growth. Finding benefits through positive reappraisal may offset the effect of caregiving on caregiver outcomes.
  
  
  METHODS
  Two randomized controlled trials are planned. They are essentially the same except that Trial 1 is a cluster trial (that is, randomization based on groups of participants) whereas in Trial 2, randomization is based on individuals. Participants are randomized into three groups - benefit finding, psychoeducation, and simplified psychoeducation. Participants in each group receive a total of approximately 12 hours of training either in group or individually at home. Booster sessions are provided at around 14 months after the initial treatment. The primary outcomes are caregiver stress (subjective burden, role overload, and cortisol), perceived benefits, subjective health, psychological well-being, and depression. The secondary outcomes are caregiver coping, and behavioral problems and functional impairment of the care-recipient. Outcome measures are obtained at baseline, post-treatment (2 months), and 6, 12, 18 and 30 months.
  
  
  CONCLUSIONS
  The emphasis on benefits, rather than losses and difficulties, provides a new dimension to the way interventions for caregivers can be conceptualized and delivered. By focusing on the positive, caregivers may be empowered to sustain caregiving efforts in the long term despite the day-to-day challenges. The two parallel trials will provide an assessment of whether the effectiveness of the intervention depends on the mode of delivery.
  
  
  BACKGROUND
  Chinese Clinical Trial Registry (http://www.chictr.org/en/) identifier number ChiCTR-TRC-10000881.
authors: Department of Psychological Studies, Hong Kong Institute of Education, 10 Lo Ping Road, Tai Po, NT, Hong Kong. takcheng@ied.edu.hk
authors: Sheung-Tak
authors: ST
authors: Cheng
authors: Rosanna W L
authors: RW
authors: Lau
authors: Emily P M
authors: EP
authors: Mak
authors: Natalie S S
authors: NS
authors: Ng
authors: Linda C W
authors: LC
authors: Lam
authors: Helene H
authors: HH
authors: Fung
authors: Julian C L
authors: JC
authors: Lai
authors: Timothy
authors: T
authors: Kwok
authors: Diana T F
authors: DT
authors: Lee
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D000544:Alzheimer Disease / Q000628:therapy*; D017028:Caregivers / Q000193:education / Q000523:psychology*; D017281:Cost of Illness; D004311:Double-Blind Method; D004644:Emotions; D005195:Family Relations; D007722:Health Knowledge, Attitudes, Practice; D006723:Hong Kong; D006801:Humans; D010465:Perception; D012107:Research Design; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors