Video-based coping skills to reduce health risk and improve psychological and physical well-being in Alzheimer's disease family caregivers

Abstract

Objective: To determine whether video-based coping skills (VCS) training with telephone coaching reduces psychosocial and biological markers of distress in primary caregivers of a relative with Alzheimer's disease or related dementia (ADRD).

Methods: A controlled clinical trial was conducted with 116 ADRD caregivers who were assigned, alternately as they qualified for the study, to a Wait List control condition or the VCS training arm in which they viewed two modules/week of a version of the Williams LifeSkills Video adapted for ADRD family care contexts, did the exercises and homework for each module presented in an accompanying Workbook, and received one telephone coaching call per week for 5 weeks on each week's two modules. Questionnaire-assessed depressive symptoms, state and trait anger and anxiety, perceived stress, hostility, caregiver self-efficacy, salivary cortisol across the day and before and after a stress protocol, and blood pressure and heart rate during a stress protocol were assessed before VCS training, 7 weeks after training was completed, and at 3 months' and 6 months' follow-up.

Results: Compared with controls, participants who received VCS training plus telephone coaching showed significantly greater improvements in depressive symptoms, trait anxiety, perceived stress, and average systolic and diastolic blood pressures that were maintained over the 6-month follow-up period.

Conclusions: VCS training augmented by telephone coaching reduced psychosocial and biological indicators of distress in ADRD caregivers. Future studies should determine the long-term benefits to mental and physical health from this intervention.

Trial registration: http://www.clinicaltrials.gov; #NCT00396825.

Figures

Figure 1

Flow chart identifying the number of participants in each arm who completed each stage of the study and reasons for participants lost to follow-up.

Figure 2

Follow-up differences in mood scales for VCS treatment (filled circles) and Wait List control (open circles) groups. Mean values (SEM error bars) post-treatment for STAI Trait scale (a), CESD depressive symptoms scale (b), and Perceived Stress Scale (c), with statistical adjustment for baseline values.

Figure 3

Follow-up blood pressure averages for VCS treatment (filled circle) and Wait List control (open circle) groups. Mean values (SEM error bars) for systolic blood pressure (a) and diastolic blood pressure (b) with statistical adjustment for baseline values.