Interventi educativi sui caregiver delle persone con demenza per la gestione dei sintomi comportamentali e psicologici: revisione sistematica della letteratura.

[Autom. eng. transl.] Introduction Behavioral and psychological symptoms (SCP) represent one of the crucial aspects in the management of people with dementia and one of the main risk factors for their institutionalization. Different types of intervention, complex and heterogeneous among them, aimed at the caregivers of people with dementia, have been shown to reduce the frequency or severity of SCPs. The objective of the systematic review is to evaluate the effectiveness of educational interventions, in which the presence of a nurse is foreseen, to increase the competence of the caregivers in the management of the SCPs, to improve the same or to reduce the institutionalization of the person with dementia. Methods A systematic literature review was conducted using MEDLINE. RCTs have been included which, through the use of validated scales, measure the effectiveness of educational, psychoeducational or multicomponent interventions, in which the educational component is predominant, aimed at caregivers or the caregiver-person dyad with dementia, compared to a group control not subjected to any structured educational intervention. The methodological quality of the studies was assessed using the Cochrane Risk of Bias Tool for RCTs. Results Of the 4,652 screened articles, 13 met the inclusion criteria and were included in the systematic review. Two studies have a low risk of bias. 10 studies address the intervention only to caregivers while three to the caregiver-patient dyad. The interventions last from one week to one year and include patients with dementia in different stages of progress. Although they share some common points, such as providing information on dementia and new coping strategies, the interventions are heterogeneous with each other, in some cases including non-educational components and based on different theoretical frameworks. Six studies measure a change in the caregiver's skills, always showing a significant improvement in the scales used to evaluate them. Of those measuring patient outcomes, three out of five show a significant reduction in SCPs, while two out of four show a reduction in the number of institutionalizations. Conclusions Although there is a general agreement on the effectiveness of educational interventions in improving the well-being of the caregiver, the effectiveness on behavioral symptoms and institutionalization of people with dementia is heterogeneous and depends on some specific characteristics of the studies, such as duration, educational component and method of delivery.