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      E-care 4 caregivers – an online intervention for nonprofessional caregivers of patients with depression: study protocol for a pilot randomized controlled trial

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          Abstract

          Background

          Nonprofessional caregivers are highly important in the everyday life of patients with depression. Yet, they may experience increased levels of burden, stress, depression, and anxiety. Therefore, there is a need for interventions that relieve symptoms and are accessible and time-efficient. This paper describes the protocol of a pilot study to evaluate (1) the feasibility of an online self-management intervention, E-care 4 caregivers, for the nonprofessional caregiver of patients with depression, and (2) the initial effects of E-care 4 caregivers on psychological distress, subjective burden, symptoms of anxiety and depression, and quality of life.

          Methods/design

          The study is a randomized controlled trial in which we are comparing the E-care 4 caregivers online intervention with a wait list control group. Eighty-four nonprofessional caregivers of patients with depression aged 18 years or older are being recruited from among the general population. Feasibility is determined by semistructured telephone interviews evaluating the subjects’ satisfaction with the intervention and by using a questionnaire on the user-friendliness of the system. The primary outcome measure used to examine the initial effects of the intervention is psychological distress. Secondary outcome measures are subjective burden, symptoms of anxiety and depression, level of mastery, and quality of life. Assessments will be done at baseline and 6 weeks later. Statistical analysis of the effects of the intervention will be carried out on the basis of the intention-to-treat principle.

          Discussion

          E-care 4 caregivers could potentially benefit nonprofessional caregivers, as well as patients and professionals indirectly.

          Trial registration

          Netherlands Trial Register identifier: NTR5268. Registered on 30 June 2015.

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          Most cited references17

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          The CONSORT statement: revised recommendations for improving the quality of reports of parallel group randomized trials

          To comprehend the results of a randomized controlled trial (RCT), readers must understand its design, conduct, analysis and interpretation. That goal can only be achieved through complete transparency from authors. Despite several decades of educational efforts, the reporting of RCTs needs improvement. Investigators and editors developed the original CONSORT (Consolidated Standards of Reporting Trials) statement to help authors improve reporting by using a checklist and flow diagram. The revised CONSORT statement presented in this paper incorporates new evidence and addresses some criticisms of the original statement. The checklist items pertain to the content of the Title, Abstract, Introduction, Methods, Results and Discussion. The revised checklist includes 22-items selected because empirical evidence indicates that not reporting the information is associated with biasedestimates of treatment effect or the information is essential to judge the reliability or relevance of the findings. We intended the flow diagram to depict the passage of participants through an RCT. The revised flow diagram depicts information from four stages of a trial (enrolment, intervention allocation, follow-up, and analysis). The diagram explicitly includes the number of participants, for each intervention group, included in the primary data analysis. Inclusion of these numbers allows the reader to judge whether the authors have performed an intention-to-treat analysis. In sum, the CONSORT statement is intended to improve the reporting of an RCT, enabling readers to understand a trial's conduct and to assess the validity of its results.
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            The Zarit Burden Interview: a new short version and screening version.

            The purpose of the study was to develop a short and a screening version of the Zarit Burden Interview (ZBI) that would be suitable across diagnostic groups of cognitively impaired older adults, and that could be used for cross-sectional, longitudinal, and intervention studies. We used data from 413 caregivers of cognitively impaired older adults referred to a memory clinic. We collected information on caregiver burden with the 22-item ZBI, and information about dependence in activities of daily living (ADLs) and the frequency of problem behaviors among care recipients. We used factor analysis and item-total correlations to reduce the number of items while taking into consideration diagnosis and change scores. We produced a 12-item version (short) and a 4-item version (screening) of the ZBI. Correlations between the short and the full version ranged from 0.92 to 0.97, and from 0.83 to 0.93 for the screening version. Correlations between the three versions and ADL and problem behaviors were similar. We further investigated the behavior of the short version with a two-way analysis of variance and found that it produced identical results to the full version. The short and screening versions of the ZBI produced results comparable to those of the full version. Reducing the number of items did not affect the properties of the ZBI, and it may lead to easier administration of the instrument.
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              Economic evaluations of Internet interventions for mental health: a systematic review.

              Internet interventions are assumed to be cost-effective. However, it is unclear how strong this evidence is, and what the quality of this evidence is.
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                Author and article information

                Contributors
                l.bijker@vu.nl
                a.m.kleiboer@vu.nl
                h.riper@vu.nl
                p.cuijpers@vu.nl
                t.donker@vu.nl
                Journal
                Trials
                Trials
                Trials
                BioMed Central (London )
                1745-6215
                11 April 2016
                11 April 2016
                2016
                : 17
                : 193
                Affiliations
                [ ]Department of Clinical Psychology, Faculty of Movement and Behavioral Sciences, Vrije Universiteit Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands
                [ ]EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
                Article
                1320
                10.1186/s13063-016-1320-6
                4827207
                27068807
                a1023cd2-9514-4ac2-9cb4-12d7673571e8
                © Bijker et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 26 October 2015
                : 30 March 2016
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100003143, Fonds Psychische Gezondheid;
                Award ID: 2014-6819
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100006509, VSB Fonds;
                Award ID: 20141096
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100003142, Fonds NutsOhra;
                Award ID: 1303-065
                Award Recipient :
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2016

                Medicine
                e-mental health,randomized controlled trial,pilot study,feasibility,caregivers,depression,prevention,burden,psychological distress

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