title: A randomized controlled trial of a home-based training programme to decrease depression in family caregivers of persons with dementia.
abstract: OBJECTIVE
  The aim of this study was to explore distinct trajectories of caregivers' depressive symptoms and the effects of a training programme on these trajectories over 18 months after the programme.
  
  
  BACKGROUND
  Overall effects of caregiver-training programmes on family caregivers' depressive symptoms have been reported, but few studies explored distinct courses of changes in caregivers' depressive symptoms and followed up intervention effects on these distinct courses.
  
  
  METHODS
  Randomized clinical trial.
  
  
  METHODS
  Family caregivers (n = 116) were randomly assigned into experimental (n = 57) and control (n = 59) groups. The experimental group received the training programme with telephone consultation and the control group received written educational materials and social telephone follow-ups. Caregivers' depressive symptoms were assessed from June 2009 - March 2012 by self-completed questionnaires before, at 2 weeks and 3, 6, 12 and 18 months after the intervention. Groups of individual trajectories were distinguished using group-based trajectory modelling.
  
  
  RESULTS
  Caregivers' depressive symptoms fell into three stable trajectories: non-depressed, mildly blue and depressed. After controlling for covariates, caregivers who received the caregiver-training programme were less likely than those who did not experience persistent depressive symptoms (b = -1·92, odds ratio = 0·15, P < 0·05).
  
  
  CONCLUSIONS
  Depressive symptoms of family caregivers of persons with dementia were relatively stable and followed three distinct courses: non-depressed, mildly blue and depressed. Therefore, caregivers' depressive symptoms should be assessed as early as possible. Caregivers in the experimental group had a lower probability of persistent depressive symptoms than caregivers in the control group. Therefore, this training programme can be used by healthcare providers for persons with dementia and their caregivers.
  
  
  BACKGROUND
  NCT02667951.
authors.affiliation: School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan.
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Kuo
authors.affiliation: Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
authors.forename: Huei-Ling
authors.initials: HL
authors.lastname: Huang
authors.affiliation: School of Public Health and Institute of Gerontology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Jersey
authors.initials: J
authors.lastname: Liang
authors.affiliation: Division of Neurology, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: Yam-Ting
authors.initials: YT
authors.lastname: Kwok
authors.affiliation: Dementia Center, Department of Neurology, Chang Gung University and Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Wen-Chuin
authors.initials: WC
authors.lastname: Hsu
authors.affiliation: School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Pei-Ling
authors.initials: PL
authors.lastname: Su
authors.affiliation: School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Traumatological Division, Department of Orthopedics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Yea-Ing L
authors.identifier: http://orcid.org/0000-0002-9697-535X
authors.initials: YL
authors.lastname: Shyu
mesh_terms: D017028:Caregivers / Q000193:education / Q000523:psychology*; D003863:Depression / Q000517:prevention & control*; D005190:Family / Q000523:psychology*; D006699:Home Care Services; D006801:Humans; D010353:Patient Education as Topic / Q000458:organization & administration*
keywords: caregiving; dementia; depressive symptoms; family caregivers; home-based training programme; longitudinal study; nurse education; nursing home care; randomized controlled trial; trajectory group