Table 2 Characteristics of review studies (k = 60)
Author (year) | No. of studies (search period) | Databases | Review method | Interventions | Major findingsa |
|---|---|---|---|---|---|
Abrahams et al., 2018 [14] | 22 RCT (up to Sept, 2015) | CINAHL, MEDLINE, PubMed, PsycINFO, OTseeker, EMBASE, Cochrane Library | Systematic review, meta-analysis | Multicomponent interventions | Burden (− 0.23), depression (− 0.21), self-reported health (0.24), social support (0.26) |
Remarks: The authors claimed that only studies with CGs and CRs coresiding were included – a criterion clearly not met by the included studies. Moreover, not all interventions were clearly multicomponent. | |||||
Backhouse et al., 2017 [15] | 14 RCT (up to 2015) | MEDLINE, Cochrane Library, EMBASE, PsycINFO; HMIC, SPP, ProQuest, ICTRP | Systematic review, meta-analysis | Care coordination delivered by a single professional | Burden (− 0.54) ne: Mood, QoL, social support |
Bernardo et al., 2018 [16] | 8 RCT, NRSI and QS (2006–2015) | Web of Science, MEDLINE, CINAHL, PsycINFO and 4 other databases | Systematic review | Occupational therapeutic interventions with a focus on physical and social environmental modifications | ↓ Burden, overload ↑ Sense of competence |
Remarks: 1 study focused on institutionalized CRs was excluded. | |||||
Boots et al., 2014 [17] | 12 RCT and NRSI (Jan, 1988-Jan, 2013) | PubMed, PsycINFO, CINAHL, Web of Science, Cochrane Library | Systematic review | Internet-based interventions | ↓ Burden, depression ↑ Sense of competence, self-efficacy |
Brodaty & Arasaratnam, 2012 [18] | 23 RCT and NRSI (no period specified) on interventions with CR BPSD as outcome | MEDLINE, EMBASE, PubMed, PsycINFO, Scopus | Meta-analysis | Community-based non-pharmacological interventions for CR delivered with involvement of CG | Overall beneficial effect on a range of outcomes (e.g., burden, behavioral bother, self-efficacy, and confidence in managing BPSD) (0.15) |
Chien et al., 2011 [19] | 30 RCT and NRSI (1998–2009) | MEDLINE, Cochrane Library, PubMed | Systematic review, meta-analysis | Support groups and psychoeducationb | Burden (−0.23), depression (− 0.40), mental health (0.44) Social outcomes (inc. social support, QoL and relationship with CR) (0.40) |
Remarks: The theme of the review was support group interventions but > 80% of the interventions were psychoeducation groups. | |||||
Clarkson et al., 2018 [20] | 68 RCT, NRSI and QS (up to Apr, 2014) | PubMed, Cochrane Library, PsycINFO, CINAHL and 2 other databases | Systematic review | Home support programs (inc. education, advice, behavioral management, psychological support, environmental modification, and care coordination) | ↓ Burden ↑ Well-being |
Remarks: 2 studies solely focused on CRs were excluded. | |||||
Collins & Kishita, 2018 [21] | 12 RCT and NRSI (up to Dec, 2016) | PsycARTICLES, PsyINFO, MEDLINE Complete, Scopus, Web of Science, ProQuest | Meta-analysis | Mindfulness- and acceptance-based interventions | Depression (post-intervention − 0.98, follow-up − 0.71), burden (post-intervention − 0.66, follow-up − 0.53) |
Cooper et al., 2007 [22] | 24 RCT and NRSI (up to June, 2005) with CG anxiety as outcome | Allied and Complementary Medicine, British Nursing Index, CINAHL, EMBASE, MEDLINE, PsycINFO | Systematic review | Group CBT | ↓ Anxiety |
Behavioral management techniques | ne: Anxiety | ||||
Exercise interventions | ne: Anxiety | ||||
Multicomponent interventions | ne: Anxiety | ||||
Respite | ne: Anxiety | ||||
Relaxation and yoga | ↓ Anxiety | ||||
Remarks: Psychoeducational interventions with CBT components were also included in the group CBT category. One of the two studies on relaxation and yoga [76] was in fact a psychoeducational program with 17% of the time allocated to progressive muscle relaxation and autogenic training. | |||||
Corbett et al., 2012 [23] | 13 RCT (2001–2008) | Cochrane Library, EMBASE, MEDLINE, PsycINFO | Systematic review, meta-analysis | Provision of information and advice | ne: Burden/stress QoL (0.36) |
Dam et al., 2016 [24] | 29 RCT, NRSI and QS from 39 articles (Jan, 1988-May, 2015 | PubMed, PsycINFO, CINAHL, Web of Science, Cochrane Library | Systematic review | Support groups, befriending/peer support, mobilizing informal support networks, remote support interventionsB | ↑ Social support, social satisfaction ne: Burden, depression, self-esteem, QoL |
Remarks: Family counseling programs were also included. Support interventions often omitted social support outcomes. Evidence on improved social support was derived mainly from qualitative studies. Based on quantitative studies, support groups had no effect, whereas remote support and network mobilization (inc. family counseling) interventions yielded mixed results. | |||||
Deeken et al., 2018 [25] | 33 RCT (up to Aug, 2018) | PubMed, PsycINFO, Cochrane Library | Meta-analysis | Multimodal technology-based interventions | Burden (− 0.20), depression (− 0.31) Inconclusive: Behavioral bother |
Telephone intervention | ne: Burden Depression (−0.24) | ||||
Computer/web-based interventions | ne: Burden, depression | ||||
All interventions combined | Burden (−0.13), depression (− 0.20) | ||||
Egan et al., 2018 [26] | 8 RCT (up to Sept, 2016) | PubMed, Cochrane Library, CINAHL, Web of Science, PsycINFO, EMBASE | Systematic review | Internet-based interventions | ↓ Depression, anxiety, stress ne: Behavioral bother, knowledge, coping, QoL Inconclusive: Self-efficacy |
Eggenberger et al., 2013 [27] | 4 RCT and NRSI (up to Jan, 2010) | MEDLINE, AMED, EMBASE, PsycINFO, CINAHL, Cochrane Library, Gerolit, Web of Science | Systematic review | Communication skills interventions | ↓ Communication problems ↑ Skills and knowledge about communication |
Remarks: 8 studies focused on institutionalized CRs were excluded. | |||||
Elvish et al., 2013 [28] | 20 RCT, NRSI and QS (2005–2011) on psychological interventions | MEDLINE, PsycINFO, ERIC, PubMed | Systematic review | Psychoeducation with-skill building | ↓ Depression ↑ Well-being, QoL |
Multicomponent interventions | ↓ Depression ↑ Social support, well-being | ||||
Technology-based | ↓ Burden, depression ↑ Social support, well-being | ||||
Gallagher-Thompson & Coon, 2007 [29] | 19 RCT and NRSI (1980–2005) on psychological interventions | MEDLINE, PsycINFO, ERIC, PubMed | Systematic review | Psychoeducation with skill building | Distress (−0.81) |
CBT-based psychotherapy and counseling | Distress (−1.20) | ||||
Multicomponent interventions | Depression (−0.33) | ||||
Godwin et al., 2013 [30] | 5 RCT from 8 articles (1990-May, 2012) | Medline, PsycINFO, EBSCO | Systematic review | Technology-driven interventions | ↓ Depression, anxiety ne: Social support |
Remarks: 3 studies based on the same RCT were merged, and 1 meta-analytic study was removed. | |||||
Greenwood et al., 2016 [31] | 4 RCT and NRSI (up to 2014) | MEDLINE, EMBASE, Cochrane Library, PsycINFO, CINAHL Plus and 2 other databases | Systematic review | Multicomponent interventions delivered by healthcare professionals | ↓ Burden, depression |
Remarks: All interventions were delivered by healthcare providers in general practice. | |||||
Hopkinson et al., 2019 [32] | 25 RCT and NRSI (up to Jan, 2017) | MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Library | Systematic review, meta-analysis | CBT | Depression (post-intervention − 0.34; follow-up − 0.99), stress (post-intervention − 0.36); effects driven by group programs only ne: Anxiety, QoL |
Remarks: Psychoeducation and multicomponent interventions with CBT components were included, as was a study testing psychodynamic group psychotherapy. | |||||
Hurley et al., 2014 [33] | 8 RCT and NRSI (2004–2012) | PsycINFO, MEDLINE, Scopus, EMBASE | Systematic review | Meditation-based interventions | ↓ Burden, depression |
Jensen et al., 2015 [34] | 7 RCT (Feb, 2010-Feb, 2013) | MEDLINE, EMBASE, PsycINFO, CINAHL, AgeLine, CENTRAL, ERIC | Systematic review, meta-analysis | Educational interventions | Burden (− 0.52), depression (− 0.37) Inconclusive: QoL |
Jütten et al., 2018 [35] | 60 RCT and NRSI (Jan, 2002-Jan, 2017) | MEDLINE, PsycINFO, PsycARTICLES, Psychology and Behavioral Science Collections, Cochrane Library, EMBASE | Meta-analysis | Nonpharmacological interventions in general but excluding dyadic interventions, respite, case management and nursing interventionsb | Burden (− 0.20), stress (− 0.18), depression (− 0.19), QoL (0.36), sense of competence (0.31) ne: Anxiety |
Kaddour et al., 2019 [36] | 14 RCT from 12 articles (up to July, 2017) | PsycINFO, MEDLINE, CINAHL, Scopus, Open Grey, ProQuest and 3 other databases | Meta-analysis | Low-intensity CBT-based interventions | Burden (− 0.53), distress (− 0.33), depression (− 0.27), anxiety (− 0.35) |
Remarks: Psychoeducation and multicomponent interventions with CBT components were also included. One intervention [77] branded as psychoeducation in Kishita et al. [37] was classified as CBT-based intervention in this review. | |||||
Kishita et al., 2018 [37] | 30 RCT (2006–2016) | MEDLINE, PsycINFO, Scopus, Cochrane Library | Systematic review, meta-analysis | Psychoeducation with-skill building | Burden (− 0.18) ne: Depression, QoL |
CBT-based psychotherapeutic interventions | ne: Burden Depression (− 0.15), anxiety (− 0.38) | ||||
Remarks: Psychoeducation and multicomponent interventions with CBT components were also included. | |||||
Kor et al., 2018 [38] | 5 RCT (1990–2016) | MEDLINE, CINAHL, Cochrane Library, PsycINFO, EMBASE, Web of Science | Systematic review, meta-analysis | Mindfulness-based interventions | Depression (− 0.62), stress (− 0.57) |
Lamotte et al., 2017 [39] | 3 RCT and NRSI (1990–2016) | PubMed, Cochrane Library, EMBASE, Google Scholar | Systematic review | Dyadic exercise interventions | ↓ Burden (no effect in one RCT) |
Remarks: 1 study without CG outcome was excluded. | |||||
Laver et al., 2017 [40] | 38 RCT (2008-Oct, 2015) | MEDLINE, EMBASE, PsycINFO | Systematic review, meta-analysis | CG-only interventions | ne: Burden, depression, QoL |
Dyadic interventions | ne: Burden, QoL Depression (− 0.33) | ||||
All interventions combined | Behavioral bother (−0.26), QoL (0.24) | ||||
Remarks: 2 studies focused on institutionalized CRs were excluded. No significant differences were found between dyadic and CG-only interventions. Moreover, all interventions, inc. psychoeducation, support groups, family counseling, etc. were regarded as multicomponent by the authors. We dropped the term “multicomponent” to avoid confusion. | |||||
Li et al., 2013 [41] | 8 RCT (up to July, 2011) on whether coping mediated intervention effects | EMBASE, MEDLINE, PsycINFO, Web of Science, Cochrane Library, CINAHL, AMED | Systematic review, meta-analysis | Group coping skills intervention | Depression (−0.91), dysfunctional coping (− 0.39) |
Group coping skills intervention with behavioral activation | Depression (−0.30), positive coping (0.28), dysfunctional coping (− 0.26) | ||||
Remotely delivered intervention | ↓ Depression (no pooled effect size) ne: Coping Inconclusive: Anxiety | ||||
Lins et al., 2014 [42] | 11 RCT, NRSI and QS (May, 2011-Feb, 2013) | ALOIS, Cochrane Library | Systematic review, meta-analysis | Telephone counseling | Depression (−0.32) ne: Burden, self-efficacy, social support |
Telephone counseling with video sessions and a workbook | Inconclusive: self-efficacy | ||||
Liu et al., 2017 [43] | 7 RCT (up to Apr, 2017) | Cochrane Library, MEDLINE, PsycINFO, EMBASE, CINAHL | Systematic review, meta-analysis | Mindfulness-based interventions | Depression (−0.58), stress (− 0.33), QoL (0.38) ne: Burden, anxiety |
Llanque & Enriquz, 2012 [44] | 9 RCT and NRSI (2000–2011) on interventions for Hispanic CGs | Google Scholar, Social Gerontology, Health Source: Nursing/ Academic Edition, MEDLINE, PsycARTICLES, CINAHL, PubMed | Systematic review | Psychoeducation (with psychotherapeutic components), family therapy, telecommunication interventions, telephone support groups, multicomponent interventions, etc.b | ↓ Depression |
Remarks: 1 study without CG outcome was excluded. | |||||
Maayan et al., 2014 [45] | 4 RCT (1989–2009) | ALOIS, Cochrane Library | Systematic review, meta-analysis | Respite service providing home support | ne: Depression |
Remarks: It is noteworthy that respite was found to have no effect on any outcome but other outcomes are not listed here because they were assessed only once. | |||||
McKechnie et al., 2014 [46] | 14 RCT and NRSI (Jan, 2000-Sept, 2012) | MEDLINE, PsycINFO, CINAHL Plus | Systematic review | Computer-mediated interventions | ↓ Burden, depression, anxiety ne: Self-reported health, social support Inconclusive: Mental health, self-efficacy |
Remarks: Reported results based on a subset of high- and medium-quality studies only. | |||||
Morris et al., 2018 [47] | 18 RCT, NRSI and QS (from 2010) | CINAHL Plus, MEDLINE, PsycINFO | Systematic review | Communication skills training | ↓ Burden, depression, anxiety ↑ Knowledge, communication skills |
Nguyen et al., 2019 [48] | 11 RCT and NRSI (period not specified) | MEDLINE, EMBASE, CINAHL, ProQuest, PsycINFO | Systematic review, meta-analysis | Communication skills training | ↑ Communication ↓ Psycho-physiological states, inc. stress, burden, distress, depression and anxiety (pooled effect sizes not provided separately for informal CGs) |
Remarks: 6 studies focused on institutionalized CRs and/or formal CGs were excluded. | |||||
Olazarán et al., 2010 [49] | 91 RCT (up to Sept, 2008) | MEDLINE, PsycINFO, CINAHL, EMBASE, Lilacs, Cochrane Library | Systematic review, meta-analysis | Psychoeducation (individual sessions) | ne: Mood |
Psychoeducation (group sessions) | ne: Mood, well-being | ||||
Support via electronic devices | ne: Mood | ||||
Multicomponent interventions | ne: Mood, well-being, QoL | ||||
Remarks: 108 studies of CR-focused interventions were excluded. | |||||
Orgeta et al., 2014 [50] | 4 RCT (1997–2001) | MEDLINE, EMBASE, PubMed, PsycINFO, Scopus, Cochrane Library | Systematic review | Interventions for CG physical activity | Burden (−0.22) ne: Depression, anxiety, stress |
Parra-Vidales et al., 2017 [51] | 7 NRSI and QS (2010–2015) | PubMed, PsycINFO, Scopus, SciELO, Psicodoc | Systematic review | Online psychoeducation | ↓ Depression, stress ↑ Self-efficacy/competence, knowledge ne: QoL |
Petriwskyj et al., 2016 [52] | 3 RCT, NRSI and QS (1990–2015) | CINAHL, PsycINFO, Web of Science, PubMed, EMBASE and 6 other databases | Systematic review | Interventions promoting resilience | ne: resilience |
Piersol et al., 2017 [53] | 36 RCT and NRSI (Jan, 2006-Apr, 2014) | MEDLINE, PsycINFO, CINAHL, OTseeker, Cochrane Library | Systematic review | Case management | ↓ Burden ↑ Well-being |
Group interventions | ↓ Burden, distress ↑ Well-being, self-efficacy, mental health | ||||
CBT-based interventions | ↓ Depression, anxiety, stress | ||||
Psychoeducation | ↓ Burden, depression ↑ QoL, well-being, self-efficacy | ||||
Other single-component interventions (e.g., mindfulness-based, communication skills training, exercises programs) | ↓ Burden/stress, depression, guilt ↑ Communication skills, well-being, mental health, hope, self-efficacy, relationship with CR | ||||
Remarks: 7 papers reporting systematic reviews or meta-analyses were excluded. The category “psychoeducation” was originally labeled idiosyncratically as “multicomponent psychoeducational intervention” but the word “multicomponent” is dropped here to avoid misunderstanding. Group interventions included support groups, family meetings, etc. | |||||
Pinquart & Sörensen, 2006 [12] | 123 RCT and NRSI (1982–2005) | PsycINFO, MEDLINE, Ageline, PsyINDEX | Meta-analysis | Psychoeducation with CG active participation | Burden (−0.20), depression (− 0.36), SWB (0.21), ability/knowledge (0.55) |
Psychoeducation-information only | Knowledge/ability (0.28) ne: Burden, depression, SWB | ||||
CBT | Burden (−0.36), depression (− 0.70) ne: SWB, knowledge/ability | ||||
Counseling/case management | Burden (−0.50) ne: Depression, knowledge/ability, SWB | ||||
Support interventions | ne on outcomes (except one study with an effect on well-being) | ||||
Respite | Burden (−0.26), depression (− 0.12), SWB (0.27) ne: Knowledge/ability | ||||
Multicomponent interventions | ne on any outcome (except for institutionalization of CR) | ||||
Miscellaneous (e.g., life review) | ne on any outcome | ||||
Remarks: 4 studies solely focused on CRs were excluded. | |||||
Powell et al., 2008 [54] | 15 RCT and NRSI (up to Aug, 2007) | MEDLINE, EMBASE, CINAHL, PsycINFO, AMED | Systematic review | Technology-based interventions | ↓ Burden, depression |
Rausch et al., 2017 [55] | 5 RCT and NRSI (up to Apr, 2016) | PubMed, PsycINFO, CINAHL | Systematic review | Dyadic interventions inc. group reminiscence, art viewing, art making; training individualized activities | ↑ Mood, confidence (QS only) |
Remarks: 2 studies without CG outcomes were excluded. | |||||
Schoenmakers et al., 2010 [56] | 26 RCT and NRSI (1980–2007) | MEDLINE, EMBASE, Cochrane Library and 2 other databases | Systematic review, meta-analysis | Home care programs (inc. psychosocial interventions, respite, telephone support, and case management) | ne: Burden, depression (except for respite which was found to increase burden) |
Scott et al., 2016 [57] | 4 RCT and NRSI (from 1995) | PsycINFO, Cochrane Library, Scopus, MEDLINE | Systematic review, meta-analysis | Technology-based CBT | Depression (−0.21) |
Remarks: Psychoeducation and multicomponent interventions with CBT components were also included. | |||||
Selwood et al., 2007 [58] | 62 RCT and NRSI (up to July, 2003) on psychological interventions | Cochrane Library | Systematic review | Educational interventions | ne: Burden/stress, psychological health |
Group training in coping skills | ↓ Burden, depression | ||||
Individual training in coping skills | ↓ Distress, depression | ||||
Group behavior management techniques (BMT) | ne: Burden, depression, or distress | ||||
Individual BMT (< 6 sessions) | ne Burden, depression, or distress | ||||
Individual BMT (≥6 sessions) | ne: Burden ↓ Depression (both post-intervention and follow-up) | ||||
Smith et al., 2014 [59] | 4 RCT, NRSI, and QS (up to Jan, 2013) | MEDLINE, EMBASE, PsycINFO, Social Policy and Practice, CINAHL Plus and 2 other databases | Systematic review | Peer support and befriending delivered by volunteers on an one-on-one basis | ne: Mental health, loneliness |
Smits et al., 2007 [60] | 25 RCT and NRSI (1992–2005) | MEDLINE, PsycINFO, EBM Reviews-Cochrane Library | Systematic review | Dyadic interventions | Inconclusive: Burden, depression, mental health, competence |
Tang et al., 2016 [61] | 14 RCT, NRSI and mixed-method (1995–2014) | CINAHL EBM Reviews, EMBASE, MEDLINE, PsycINFO and 3 other databases | Systematic review | Psychosocial interventions with self-efficacy as outcome | ↓ Burden ↑ Self-efficacy |
Thompson et al., 2007 [62] | 44 RCT and NRSI (Nov. 2003-Oct, 2005) on information and support interventionsb | Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, SIGLE, ISTP, INSIDE and 17 other databases | Systematic review, meta-analysis | Technology-based support interventions | ne: Depression |
Support groups | ne: Burden | ||||
Group psychoeducation | ne: Burden Depression (−0.71) | ||||
Individual psychoeducation | ne: Depression, self-efficacy | ||||
Tretteteig et al., 2016 [63] | 19 NRSI, QS or mixed-method (up to 2013) | PubMed, Norwegian Electronic Health Library, AMED, EMBASE, MEDLINE, PsycINFO | Systematic review | Day care services | ↓ Burden, overload, depression ↑ Perceived support Inconclusive: Well-being |
Tyack & Camic, 2017 [64] | 7 RCT, NRSI, QS and mixed-method (period not specified) | PsycINFO, ASSIA, MEDLINE, CINAHL, Cochrane Library | Systematic review | Touchscreen (interactive computer-based) interventions | Inconclusive: Burden, well-being, relationship with CR |
Remarks: 9 studies without informal CGs were excluded. | |||||
Vandepitte et al., 2016 [65] | 17 RCT and NRSI (up to Jan, 2015) | PubMed, Web of Science | Systematic review | Respite | Inconclusive: Burden ne: Stress |
Vandepitte et al., 2016 [66] | 53 RCT and NRSI (up to Mar, 2015) | Web of Science, PubMed | Systematic review | Psychoeducation | ↓ Burden, depression ↑ Self-efficacy |
Respite | Inconclusive: Burden | ||||
Occupational therapy interventions | ↑ Self-efficacy | ||||
CBT | ↓ Depression, dysfunctional thoughts | ||||
Remarks: Psychoeducation and multicomponent interventions with CBT components were also included in the CBT category. | |||||
Vernooij-Dassen et al., 2011 [67] | 11 RCT (up to Apr, 2009) | Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and 2 other databases | Systematic review, meta-analysis | Cognitive reframing | Depression (−0.24), anxiety (− 0.21), stress/distress (− 0.24) ne: Burden, behavioral bother, coping/self-efficacy |
Remarks: CBT and psychoeducation were both included and analyzed together. | |||||
Waller et al., 2017 [68] | 34 RCT and NRSI (Jan, 1990-Dec, 2016) | MEDLINE, EMBASE, CINAHL, Cochrane Library | Systematic review | Computer (inc. tablet, website, e-mail or mobile app) interventions | ↓ Burden/stress, depression ↑ Mental health, knowledge, positive aspects of caregiving |
Telephone (inc. text messaging, telehealth, videophone) interventions | Inconclusive: Burden, depression, mental health, managing BPSD ne: Social support, self-efficacy, health, self-care | ||||
Multimodal (computer plus telephone) interventions | Inconclusive: Burden, depression, self-efficacy | ||||
Weinbrecht et al., 2016 [69] | 33 RCT (2005–2014) | MEDLINE, EMBASE, CENTRAL, PsycINFO, PsyINDEX | Meta-analysis | A range of intervention types (e.g., education, counseling, support group, communication skills, environmental modification, care coordination)B | Depression (post-intervention −0.13, follow-up − 0.29) |
Williams et al., 2019 [70] | 34 RCT (1999–2018) with burden as outcome | MEDLINE, PsycINFO, CINAHL | Systematic review, meta-analysis | Multicomponent interventions | Inconclusive: Burden |
Education/skills-based interventions | Inconclusive: Burden | ||||
Support and counselling | Inconclusive: Burden | ||||
Physical activity | ne: Burden | ||||
Wilson et al., 2017 [71] | 3 RCT and NRSI (from 1995-Sept, 2016) | MEDLINE, CINAHL Plus, EBSCO, PubMed, EMBASE, PsycINFO and 4 other databases | Systematic review, meta-analysis | Interventions targeting CG grief | ↓ Grief (2 out of 3 studies) |
Ying et al., 2018 [72] | 15 RCT (up to Jan, 2017) | PubMed, EMBASE, Cochrane Library, Web of Science, EBSCO, PsycINFO | Systematic review | Multicomponent interventions | ↑ Competence, knowledge, coping Inconclusive: Burden |
Remarks: Some CG-only interventions showed larger effects than dyadic programs. | |||||