Preliminary Evidence for Lasting Benefits One Year Following Mindfulness Training Among Older Family Caregivers of Persons with Neurodegenerative Disease
Description
Objectives: Mindfulness training (MT) may enhance the wellbeing of family caregivers of persons with neurodegenerative disease. However, long-term benefits are unclear. The current mixed-methods study examined whether benefits associated with MT are maintained one-year following program completion. Methods: Family caregivers who participated in a randomized trial examining the benefits of MT relative to psychoeducation were re-contacted 12-months post program completion. Of the original 57 participants, 35 consented to participate in the telephone interview and 23 completed questionnaires that tapped into perceived distress, depression, caregiver burden, and quality of life. Results: Univariate analyses failed to detect a significant between-groups difference at 12-months post program. Paired sample t-tests revealed maintenance of within-group benefits for distress and depressive symptoms in the MT group such that mean scores at 12 months did not differ from post-intervention scores but did differ from pre-intervention scores. Additional within-group gains were found for the MT group such that caregiver burden at 12 months significantly differed from pre- and post-intervention burden score. Thematic analysis of transcripts revealed four themes: Do what works and what fits; Moving beyond the program; Ability to return; and Continued struggle and need for support. Qualitative analyses suggest that continued practice of mindfulness maps onto perceptions of wellness one-year later. Conclusions: While MT has potential to support caregivers’ mental health and wellbeing 12 months following program completion, continued supports are required to facilitate continued practice.
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Study Protocol: Twelve-months following completion of the original study randomized study which evaluated the effects of Mindfulness-Based Stress Reduction (MBSR vs. psychoeducation and social support) on indices of wellbeing, participants were recontacted and invited to participate in a brief one-on-one interview with a trained research assistant and to complete a short battery of psychosocial questionnaires. Participants were told that the interview would be 30-minutes in length and the questionnaires would take no longer than 20 minutes to complete. Following provision of consent, participants were engaged in the semi-structured interview. Once the interview was complete, participants were mailed the questionnaire battery with a pre-stamped return envelope. The questionnaire battery included Centre for Epidemiological Studies Depression (Radloff, 1997), 10-item Perceived Stress Scale (Cohen et al., 1983), Burden Interview (Zarit et al., 1980) and the Quality-of-Life Scale (Flanagan, 1978). Before beginning the interview, participants were first asked whether they were still a caregiver and whether they continued to live with the care recipient. Participants were then asked three open-ended questions during the 30-minute interview session: (1) Please tell me about how you have been doing since completing the 8-week program. [Probe for physical and psychological well being]; (2) Have you continued using any of the techniques you learned from the 8-week program? [If yes, which ones and why? If no, what were the barriers?]; (3) Is there anything else that you would like to share with us? Qualitative interviews were conducted and transcribed by a trained research assistant. Quantitative Analysis: Mixed analysis of covariance, controlling for age, was conducted followed by subsequent univariate analyses at 12-month assessment to determine whether group differences were maintained at 12-months. Paired t-tests were also conducted to determine whether within-groups benefits were maintained at follow-up by comparing mean scores at 12-months to pre- and post-assessment scores. Given the relatively small sample size, a bootstrapping method was used, based on 5000 bootstrap samples. Interaction terms were considered statistically significant at p<.10 to address the small sample size and thus low power for testing interaction effects; all univariate tests were considered statistically significant at p<.05. Analyses were conducted using IBM SPSS Statistics v27.