title: Benefit-finding intervention for Alzheimer caregivers: conceptual framework, implementation issues, and preliminary efficacy.
abstract: OBJECTIVE
  To describe an intervention promoting benefit-finding in Alzheimer caregivers, to discuss key issues in implementation and ways to resolve them, and to examine whether the intervention reduced burden and depression in a small randomized trial.
  
  
  METHODS
  Twenty-five caregivers were randomized into benefit-finding and psychoeducation groups. Both groups had eight weekly sessions. Outcome measures including role overload, Zarit Burden Interview, and Hamilton depression scale were collected at baseline and after treatment. Results were analyzed using analysis of covariance. Additionally, the challenges of implementing such interventions, some of which related to cultural issues, were analyzed qualitatively.
  
  
  RESULTS
  Controlling for pretest, the benefit-finding group had lower depression than the psychoeducation group at post-test, despite the fact that some caregivers found benefit-finding challenging. The two groups did not differ on overload and burden. However, within-group analysis suggested that both groups showed significant reductions in overload from pretest to post-test. In addition, we discussed participants' difficulties in grasping the technique of thought modification for benefit-finding, recording such exercises at home, and sharing their thoughts and experiences in groups. We described measures undertaken in the main trial to overcome these issues.
  
  
  CONCLUSIONS
  Cognitive approaches focusing on benefit-finding are feasible among Chinese caregivers, with preliminary evidence suggesting an effect on alleviating depression.
authors.affiliation: Department of Health and Physical Education, Hong Kong Institute of Education, Tai Po, N.T. takcheng@ied.edu.hk.
authors.forename: Sheung-Tak
authors.initials: ST
authors.lastname: Cheng
authors.affiliation: Department of Health and Physical Education, Hong Kong Institute of Education, Tai Po, N.T.
authors.forename: Rosanna W L
authors.initials: RW
authors.lastname: Lau
authors.affiliation: Department of Health and Physical Education, Hong Kong Institute of Education, Tai Po, N.T.
authors.forename: Emily P M
authors.initials: EP
authors.lastname: Mak
authors.affiliation: Department of Health and Physical Education, Hong Kong Institute of Education, Tai Po, N.T.
authors.forename: Natalie S S
authors.initials: NS
authors.lastname: Ng
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Shatin, N.T.
authors.forename: Linda C W
authors.initials: LC
authors.lastname: Lam
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000208:ethnology / Q000451:nursing* / Q000523:psychology; D044466:Asian People / Q000523:psychology* / Q000706:statistics & numerical data; D017028:Caregivers / Q000193:education / Q000523:psychology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D016730:Program Development; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D020377:Self Efficacy; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
keywords: Alzheimer’s disease; Caregiver burden; Hong Kong Chinese; Positive aspects of caregiving; Randomized controlled trial