Title: Benefits of a Multidisciplinary Educational Intervention for Caregivers of Highly Complex Chronic Patients.
Funded by: Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC).
Granted amount: €8,500.00
Duration: 2 years (2025-2026).
Principal Investigators: María Paula Martín Andrade (PI), Yolanda Álvarez Pérez (Co-PI).
Associated Researchers: Aroa Camejo Guerra, Dolores María Ruano López, Apolonia Rosales Hernández, Elizabeth Govindani León, Alberto López García, Raquel del Rosario Medina Ponce, Francisca Rosa Guerra Cabrera, Andrea Duarte Díaz, Juan José Suárez Sánchez, Francisco J. Navarro Vázquez, Beatriz Candela Angulo.
Background:
The increase in life expectancy leads to a higher prevalence of chronic diseases, comorbidities, dependency, and, consequently, a rise in the complexity of care that caregivers (caregivers) must provide for this population. This often leads to caregiver overload and role burnout. In response to this situation, nurse-led workshops for caregivers are part of the work done as link nurses. Between January 2023 and March 2024, a quasi-experimental study with a control group was conducted to confirm whether these interventions improve caregivers’ mental health, quality of life, and health literacy. The results would support the need for a more extensive study.
Reasons justifying this project include:
Clinical Relevance: The results suggest that the group educational intervention may improve caregivers’ quality of life. Significant findings include reductions in anxiety and depression levels, better knowledge, and the impact of caregiving, which deserve further investigation. Perceived overload is a relevant issue in health and well-being.
Impact on Clinical Practice: The intervention could have practical implications for health professionals working with caregivers. Identifying effective strategies to sustain long-term benefits is crucial for optimizing care for highly complex chronic patients.
Methodological Aspects and Biases: The lack of randomization in assigning caregivers to groups, the sample size, which suffered significant losses during the intervention and follow-up, require more detailed evaluation. This project addresses aspects such as randomization and stratification by sociodemographic characteristics, as well as verifying caregivers’ active participation in recorded workshops, which could help ensure real implementation of the intervention and prevent participant loss. The proposal involves a more rigorous design to ensure valid and generalizable results.
In conclusion, a larger study would help deepen the beneficial effects of the group educational intervention and provide practical recommendations for caregiver support. This project addresses methodological limitations and evaluates strategies to maintain long-term benefits and the possible generalization of findings.
Objectives:
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General Objective: To deepen the beneficial effects of the group educational intervention and provide practical recommendations for the care of caregivers of patients with highly complex chronic conditions.
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Specific Objectives:
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To train caregivers to manage caregiving through a group intervention;
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To assess the impact of the group intervention on caregivers’ overload levels, quality of life, anxiety/depression, and perceived social support, as well as their health literacy;
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To evaluate the usefulness and acceptability of the group educational intervention for caregivers.
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Methods:
To achieve these objectives, a randomized controlled trial (RCT) will be conducted with an intervention group (IG) and a control group (CG) consisting of caregivers of patients with highly complex chronic conditions (HCC). The CG will consist of those receiving usual care (no intervention or attendance at standard caregiver workshops in the Gran Canaria Health Area). The IG will receive a 21-session structured workshop (in-person and/or online). Additionally, three months after the workshop ends, the IG will receive reinforcement over a two-month period. This reinforcement will consist of 21 formative pills, which will highlight key ideas from the sessions (available on the Government of the Canary Islands’ Moodle platform) and follow-up phone calls every 15 days.
Caregiver overload (measured with the reduced Zarit Caregiver Burden Scale), anxiety and depression levels (Goldberg Scale), quality of life (EQ-5D-5L), family caregiver quality of life (ICUB97-R scale), perceived social support (DUKE-UNC-11 questionnaire), and health literacy (custom-made care knowledge questionnaire) will be assessed before and after the workshop sessions, after the formative reinforcement pills, and follow-up phone calls, and three months post-intervention. The CG will have access to the workshop contents and formative pills after completing the post-intervention evaluation.
Applicability:
Implementing this study will evaluate how much caregivers improve their mental health, health literacy, perceived social support, and the care they provide to highly complex chronic patients after participating in these workshops.
If favorable results are obtained in evaluating the effectiveness of the workshops, it would create a scenario for transferring this intervention to other Primary Care Health Centers (ZBS) in the Canary Islands, where caregivers could benefit from its effects.
Contact Person: Yolanda Álvarez Pérez (yolanda.alvarezperez@sescs.es)