The Impact of Technology-Based Interventions on Informal Caregivers of Stroke Survivors: A Systematic Review.
OBJECTIVE
This article is a systematic review of the impact of technology-based intervention on outcomes related to care providers for those who survived a stroke.


METHODS
Literature was identified in the PubMed, PsycINFO, Scopus, and Cochrane databases for evidence on technology-based interventions for stroke survivors' caregivers. The search was restricted for all English-language articles from 1970 to February 2015 that implied technology-based interventions. This review included studies that measured the impact of these types of approaches on one or more of the following: depression and any of the following-problem-solving ability, burden, health status, social support, preparedness, and healthcare utilization by care recipient-as secondary outcomes. Telephone or face-to-face counseling sessions were not of interest for this review. The search strategy yielded five studies that met inclusion criteria: two randomized clinical trials and three pilot/preliminary studies, with diverse approaches and designs.


RESULTS
Four studies have assessed the primary outcome, two of which reported significant decreases in caregivers' depressive symptoms. Two studies had measured each of the following outcomes-burden, problem-solving ability, health status, and social support-and they revealed no significant differences following the intervention. Only one study assessed caregivers' preparedness and showed improved posttest scores. Healthcare services use by the care recipient was assessed by one study, and the results indicated significant reduction in emergency department visits and hospital re-admissions.


CONCLUSIONS
Despite various study designs and small sample sizes, available data suggest that an intervention that incorporates a theoretical-based model and is designed to target caregivers as early as possible is a promising strategy. Furthermore, there is a need to incorporate a cost-benefit analysis in future studies.
1 Department of Public Health, University of Miami Miller School of Medicine , Miami, Florida.|2 Department of Medicine, King Saud University , Riyadh, Saudi Arabia .
Abdulkarim Yousef
AY
Aldehaim
1 Department of Public Health, University of Miami Miller School of Medicine , Miami, Florida.|3 Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University , Alkharj, Saudi Arabia .
Faisal F
FF
Alotaibi
4 Department of Aging, University of Florida , Gainesville, Florida.|5 Geriatric Research, Education, and Clinical Center and Extended Care and Research Services , North Florida/South Georgia Veterans Health System, Gainesville, Florida.
Constance R
CR
Uphold
6 Geriatric Research, Education, and Clinical Center and Extended Care and Research Services, Bruce W. Carter Department of Veterans Affairs Medical Center , Miami, Florida.|7 The Geriatrics Institute, Department of Medicine, University of Miami Miller School of Medicine , Miami, Florida.
Stuti
S
Dang
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000458:organization & administration* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009729:Nursing; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D011369:Professional-Patient Relations; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D019145:Rehabilitation Nursing / Q000458:organization & administration*; D018570:Risk Assessment; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000451:nursing*; D017741:Survivors; D013685:Telecommunications / Q000295:instrumentation*
e-health; telecommunications; telehealth; telemedicine; teleneurology