The Effects of Integrated Face-to-face Rehabilitation and Telerehabilitation on the Well-being of Family Caregivers

This controlled, non-randomized study (n=180) explores how participating in rehabilitation services for family caregivers affects the caregivers' mood, perceived quality of life, perceived burden of family care, and overall health. Rehabilitation services for family caregivers funded by the Social Insurance Institution of Finland (Kela) include two 5-day periods of face-to-face rehabilitation and a 12-week telerehabilitation period, which is based on The Own Path internet intervention and takes place between the face-to-face rehabilitation periods. The observed changes are compared to participating in two other services: 1) Social Holidays for family caregivers and 2) Kela's rehabilitation services for family caregivers and the family members they are caring for (care recipients).

Study Overview

• Status: Completed
• Conditions: Informal Caregivers; Caregivers; Family Caregivers
• Intervention / Treatment: Other: Integrated face-to-face rehabilitation and telerehabilitation; Other: Social Holidays; Other: Face-to-face rehabilitation

• Study Type: Observational
• Enrollment (Actual): 195

Contacts and Locations

Study Locations

• Finland
  • Helsinki, Finland, 00250
    • The Social Insurance Institution of Finlad

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Those starting in one of the following services during April 2022 and January 2023:

1. the Kela's integrated face-to-face rehabilitation and telerehabilitation service for family caregivers,
2. the MTLH's face-to-face Social Holidays for family caregivers or
3. the Kela's face-to-face rehabilitation services for family caregivers and care recipients

Description

Inclusion Criteria:

• family caregiver
• being 18 years of age or older
• providing daily care for an adult family member

• participating in one of following:

  1. the Kela's integrated face-to-face rehabilitation and telerehabilitation service for family caregivers,
  2. the MTLH's face-to-face Social Holidays for family caregivers or
  3. the Kela's face-to-face rehabilitation services for family caregivers and care recipients
• willingness to participate in the study

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Integrated face-to-face rehabilitation and telerehabilitation; Participation in integrated face-to-face rehabilitation and telerehabilitation services for family caregivers organized by the Social Insurance Institution of Finland (Kela)	Other: Integrated face-to-face rehabilitation and telerehabilitation; Kela´s integrated face-to-face rehabilitation and telerehabilitation services for family caregivers include two 5-day periods of face-to-face rehabilitation and a 12-week telerehabilitation period between them. It is for those over the age of 18 who work as family caregivers on a daily basis and need support, tools, and coaching to understand and overcome the challenges posed by the care situation. Individual goals based on the GAS method are set, evaluated, and adjusted during the rehabilitation. The service, provided free of charge, is carried out in a Finnish rehabilitation centre and online over a period of 8 months, and it is implemented by a multidisciplinary team of rehabilitation experts. During the 12-week telerehabilitation period, the service providers utilise The Own Path, an acceptance and commitment therapy -based guided web intervention found beneficial for older Finnish family caregivers (Lappalainen et al. 2021). Telerehabilitation is independent of time and place.
Social Holidays; Participation in face-to-face Social Holidays for family caregivers organized by Maaseudun Terveys- ja Lomahuolto (MTLH), a non-profit organization	Other: Social Holidays; MTLH's Social Holidays for family caregivers are 5-day holidays in a Finnish hotel, spa, sports institute, or rehabilitation centre. The theme, content, and level of available assistance in Social Holidays vary, and the rehabilitation concept is lighter than that of Kela's rehabilitation services. Social Holidays include full-board accommodation and holiday activities, e.g. lectures, group discussions, instructed exercise, and a pampering treatment. MTLH organises Social Holidays for family caregivers as well as family caregivers and care recipients. The participants cover their travel expenses and pay a fixed sum of €125. Other than that, Social Holidays are provided free of charge. Social Holidays are intended for family caregivers who need recreational activities, rest, and peer support.
Face-to-face rehabilitation; Participation in face-to-face rehabilitation services for family caregivers and the care recipients organized by Kela	Other: Face-to-face rehabilitation; Kela's rehabilitation services for family caregivers and the care recipients include three 5-day periods of face-to-face rehabilitation, which are carried out in a Finnish rehabilitation centre over a 10-month period and implemented by a multidisciplinary team of rehabilitation experts. The rehabilitation services for family caregivers and the care recipients are provided free of charge. The service is intended for persons over the age of 18 who work as family caregivers on a daily basis with or without family caregiver support and who need support, tools, and coaching to understand and overcome the challenges posed by the care situation. Individual goals based on the GAS method are set, evaluated, and adjusted during the rehabilitation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in mood at 5 months and 8 months	assessed with the Beck's Depression Inventory (BDI-21)	Baseline (pre-intervention), 5 months (after the intervention), 8 months (3-month follow-up)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in Quality of life (QoL) at 5 months and 8 months	assessed with the World Health Organization Quality of Life Instrument (WHOQOL-BREF)	Baseline (pre-intervention), 5 months (after the intervention), 8 months (3-month follow-up)
Change from baseline in overall health at 5 months and 8 months	assessed with the Patient-Reported Outcomes Measurement Information System (PROMIS) survey	Baseline (pre-intervention), 5 months (after the intervention), 8 months (3-month follow-up)
Individual goal achievement	assessed with the Goal Attainment Scaling method (GAS)	5 months (after the intervention)
Change from baseline in perceived burden of family care (I) at 5 months and 8 months	assessed with the Carers of Older People in Europe (COPE) index	Baseline (pre-intervention), 5 months (after the intervention), 8 months (3-month follow-up)
Change from baseline in perceived burden of family care (II) at 5 months and 8 months	assessed with the Adult Social Care Outcomes Toolkit (ASCOT) questionnaire	Baseline (pre-intervention), 5 months (after the intervention), 8 months (3-month follow-up)

Collaborators and Investigators

• Sponsor: Social Insurance Institution, Finland
• Investigators: Principal Investigator: Saija Karinkanta, PhD, The Social Insurance Institution of Finland (Kela)

Publications and helpful links

General Publications

• Lappalainen P, Pakkala I, Lappalainen R, Nikander R. Supported Web-Based Acceptance and Commitment Therapy for Older Family Caregivers (CareACT) Compared to Usual Care. Clin Gerontol. 2022 Jul-Sep;45(4):939-955. doi: 10.1080/07317115.2021.1912239. Epub 2021 Apr 15.

Study record dates

Study Major Dates

• Study Start (Actual): April 11, 2022
• Primary Completion (Actual): August 31, 2023
• Study Completion (Actual): August 31, 2023

Study Registration Dates

• First Submitted: June 7, 2012
• First Submitted That Met QC Criteria: December 22, 2022
• First Posted (Actual): January 10, 2023

Study Record Updates

• Last Update Posted (Estimated): December 4, 2024
• Last Update Submitted That Met QC Criteria: November 29, 2024
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Keywords: rehabilitation; effects; effectiveness; telerehabilitation; family caregivers; informal caregivers; family caregivers burden
• Other Study ID Numbers: SocialII

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No