Burden on family members: caring for frail elderly: a meta-analysis of interventions.

BACKGROUND Although multiple interventional approaches to reduce perceived burden among caregivers of the frail elderly have been investigated for over a decade, the effectiveness of those interventions and the benefits of group versus individual interventions are largely unclear. OBJECTIVES This meta-analysis was undertaken to (a) assess the effectiveness of group and individual interventions on decreasing burden of caregivers of the frail elderly, and (b) identify factors with potential influence on the magnitude of the effects. METHOD Computerized literature searches and manual searches of published true and quasi-experimental studies with control groups were performed. A coding form was developed to record methodological and other study characteristics, including study design, attrition rate, and reliability and validity of the measures. RESULTS Eighteen group and eight individual interventional studies published from 1985 to 2000 were included. For group interventions, the sample size for individual studies ranged from 20 to 486, with a total of 1,970. The weighted mean effect size was 0.41 (95% CI: 0.32 to 0.51), indicating a significant positive treatment effect. A significant homogeneity test (Q(17) = 56.37, p <.0001) indicated that there were variations in effect sizes among the studies attributable to study characteristics. The effect size in the 11 true experimental studies was smaller (M: 0.26, 95% CI: 0.15 to 0.37) but still existed. For individual interventions, the sample sizes ranged from 16 to 168, with a total of 472. The weighted effect sizes were homogeneous with a mean of 0.48 (95% CI: 0.30 to 0.67), indicating a positive treatment effect. DISCUSSION Available evidence supports the premise that both group and individual interventions reduce perceived burden, however, this evidence is inconclusive. Further studies of large scale and high quality designs are needed.