Non-pharmacological interventions for caregivers ... - Update Software

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Mant 2000 (Continued) Reason for missing data reported: not reported Missing data balanced between groups: yes Statistical methods used to deal with missing data: none reported Judgement: insufficient reporting of attrition to permit judgement i.e. no reasons for missing data provided Selective reporting (reporting bias) Low risk The majority of pre-specified outcomes have been reported Pierce 2004 Methods RCT Participants Source: participants were first-time stroke survivors recruited from 4 rehabilitation centres and discharged home to 1 of 2 Midwestern states, USA during the period May 2002 to December 2004 Definition of caregiver: not stated Carers’ inclusion criteria: age ≥ 21 years; person responsible for providing day-to-day care for stroke survivor; must be able to read, write and understand English; must have a telephone and television to facilitate MSN TV and Internet access Caregivers’ exclusion criteria: none stated Stroke survivors’ inclusion criteria: being discharged to home in the northern Ohio or southern Michigan areas Stroke survivors’ exclusion criteria: none stated Number of caregivers randomised: 103 Number of caregivers in intervention group: 51 Number of caregivers in comparator group: 52 Number of caregivers assessed at final follow-up: 73 Number of caregivers in intervention group: 36 Number of caregivers in comparator group: 37 Mean age of caregivers: not stated % male caregivers: 24.7% Interventions Title: caring-web Characteristics: web-based education and support in the home setting. The web-based support consisted of: (1) linked websites about stroke and caring, (2) customised educational information or tips specific to caregivers needs, (3) an email forum with access to a nurse specialist and multidisciplinary for advice or information, (4) facilitation of non-structured email discussion Intervention provided by: not applicable Intervention delivered: via the Internet to the home setting Dose/frequency/timing of intervention: not applicable Intervention length: 1 year Co-intervention: unclear Title: non-web user group Characteristics: unclear Intervention provided by: unclear Intervention delivered: unclear Dose/frequency/timing of intervention: unclear Non-pharmacological interventions for caregivers of stroke survivors (Review) Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 30
Pierce 2004 (Continued) Outcomes CES-D; SWLS; survivors’ health care service use Timing of assessment: every 3 months. Stroke survivors’ health service use, every 2 weeks Notes Risk of bias Bias Authors’ judgement Support for judgement Random sequence generation (selection bias) Low risk “A block randomisation list with four blocks of equal sizes was generated using a SAS code.” Allocation concealment (selection bias) High risk “There was no concealed allocation, it was not blind.” Blinding (performance bias and detection bias) All outcomes Incomplete outcome data (attrition bias) All outcomes High risk “No, in this study the interviewers knew who was in web or non-web group, as the questionnaire asked if the subject had problems using the Internet and the web-based equipment and control group, as the questionnaire. The study coordinator was not blinded to the allocation. The investigators were blinded to allocation.” High risk 9/51 (18%) participants in the experimental group and 12/52 (23%) in the comparator group were lost to follow-up. A further 6/51 (12%) participants in the experimental group and 3/52 (6%) participants comparator group were expelled from trial because of lack of adherence Reason for missing data: includes immediate drop-out following assignment, death of care recipient, transfer of care recipient to nursing home care, dissolution of care receiver/care recipient partnership, caregiver illness, change of address, drop-out due to time constraints Statistical methods used to deal with missing data: none reported Judgement: imbalance in numbers and reasons for missing data across intervention groups, particularly in relation to refusal to participate postrandomisation and the need for expulsions Selective reporting (reporting bias) Low risk All study’s pre-specified outcomes have been reported Yoo 2007 Methods RCT Participants Source: carers (all of whom were family members) of stroke patients admitted to a neurosurgery ward of a university hospital, Seoul, Korea Definition of caregiver: not stated Caregivers’ inclusion criteria: unclear Caregivers’ exclusion criteria: none stated Stroke survivors’ inclusion criteria: unclear Non-pharmacological interventions for caregivers of stroke survivors (Review) Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 31
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