Life In The Slower Lane

Here is the standardised PICO analysis for the thirty-fourth uploaded article:

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Full Title

Interventions to support family caregivers of people with advanced dementia at the end of life in nursing homes: A mixed-methods systematic review

Authors: Silvia Gonella, Gary Mitchell, Laura Bavelaar, Alessio Conti, Mariangela Vanalli, Ines Basso, Nicola Cornally

Journal: Palliative Medicine, 2022; 36(2): 268–291

DOI: 10.1177/02692163211066733

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Type of Study

Mixed-methods systematic review using the Joanna Briggs Institute (JBI) convergent integrated approach

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PICO Summary

Population (P)

• Family caregivers (e.g. spouses, adult children, close relatives) of people with advanced dementia living in nursing homes
• End-of-life phase defined as the final weeks or months of life
• Participants across 11 studies included caregivers, healthcare professionals, and nursing home staff

Intervention (I)

• Caregiver-level interventions to provide information, emotional support, or education, including:
  1. Ongoing face-to-face discussions with healthcare providers
  2. Written informational booklets on comfort care in dementia
  3. Structured psychoeducational programs (e.g. 10-week group sessions)
  4. Family meetings with or without psychological or educational support
  5. Personalised support via email or in-person with trained dementia professionals

Comparison (C)

• No formal comparator; included studies had varied controls (e.g. comparison groups, usual care, or pre/post evaluation)

Outcomes (O)

Primary outcomes:

• Improved emotional preparedness, decision-making confidence, and caregiver empowerment
• Reduced caregiver stress and burden in multi-session psychoeducational programs
• Enhanced understanding of the disease, dying trajectory, and care preferences

Secondary outcomes:

• Written materials increased comprehension and supported verbal discussions
• Regular, tailored meetings more effective than one-off sessions
• Single structured meetings had no significant impact on depression or life satisfaction 

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Findings Summary

Three integrated findings were identified:

1. Ongoing end-of-life discussions that provide emotional support, foster shared decision-making, and deepen caregiver-provider partnerships are vital.
2. Face-to-face discussions, supported by written materials, should be tailored in timing and delivery to caregiver preferences and cultural context.
3. Structured psychoeducational programs and regular meetings—ideally with professionals skilled in psychological support—can promote caregiver empowerment, resilience, and self-care. These are superior to one-time discussions or written information alone.

The authors recommend integrating peer interaction and hybrid models (e.g. combining face-to-face discussion with written or digital resources) into future intervention designs .

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