The Impact of Educational Intervention on the Anxiety of Family Caregivers of the Elderly with Dementia: A Randomized Controlled Tri

Document Type: Original Article


1 Student Research Committee,Shiraz University of Medical Sciences, Shiraz, Iran;

2 Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

3 Department of Neurology, school of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran


Background: Due to the increasing population of elderly and the consequent increase in the number
of chronic diseases such as dementia, the psychological complications such as anxiety in the family
caregivers increase. The aim of this study was to determine the effect of educational intervention on
the anxiety of family caregivers of the elderly people with dementia.
Methods: This randomized controlled trial was performed in the elderly Neurology Clinics in Shiraz
from May to August 2017. This study was conducted on 70 families with elderly people with dementia
who were randomly divided into an intervention (receiving in groups for seven sessions of educational
intervention) and a control group (Conventional care). Data collection tool was Spielberger’s Anxiety
Inventory (40-items, score=20-80). Data were analyzed by SPSS version 21 using ANOVA test with
repeated measures and independent t-test.
Results: One and three months after the interventions, the mean scores of anxiety in the intervention
group were 70.51±3.78 and 70.31±3.43 and in the control groups they were 76.45±3.45 and 76.22±5.08
respectively. The results showed significant differences between the two groups regarding anxiety
after the intervention (P<0.001).
Conclusion: Educational programs held to promote and maintain the physical and mental health of
caregivers could reduce the anxiety of family caregivers of the elderly with dementia


  1. Yuan Q, Tan TH, Wang P, et al. Staging dementia based on caregiver reported patient symptoms: Implications from a latent class analysis. Plos One. 2020;15:e0227857.
  2. Prince M, Bryce R, Albanese E, et al. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimer’s & Dementia. 2013;9:63-75.
  3. Goren A, Montgomery W, Kahle-Wrobleski K, et al. Impact of caring for persons withAlzheimer’s disease or dementia on caregivers’ health outcomes: findings from a community based survey in Japan. Bio Med Central Geriatrics. 2016;16:122.
  4. Zwerling JL, Cohen JA, Verghese J. Dementia and caregiver stress. Neurodegenerative Disease Management Journal. 2016;6:69-72.
  5. Srivastava G, Tripathi RK, Tiwari SC, et al. Caregiver burden and quality of life of key caregivers of patients with dementia. Indian Journal of Psychological Medicine. 2016;38:133-6.
  6. Anand R, Gill KD, Mahdi AA. Therapeutics of Alzheimer’s disease: past, present and future. Neuropharmacology. 2014;76:27-50.
  7. Malak RE, Krawczyk-Wasielewska A, Głodowska K, et al. Condition of informal caregivers in long-term care of people with dementia. Annals of Agricultural and Environmental Medicine. 2016;23:491-4.
  8. Boltz M, Chippendale T, Resnick B, Galvin JE. Anxiety in family caregivers of hospitalized persons with dementia: contributing factors and responses. Alzheimer Disease & Associated Disorders. 2015;29:236-41.
  9. Sharma N, Chakrabarti S, Grover S. Gender differences in caregiving among family-caregivers of people with mental illnesses. World Journal of Psychiatry. 2016;6:7-17.
  10. Marta MR, Manuel MG, Teresa CM. Psychiatric symptoms and caregiver distress in patients with moderate to severe Alzheimer’s disease treated with memantine. Journal of Neurology and Neuroscience. 2011;2(1).
  11. Ask H, Langballe EM, Holmen J, et al. Mental health and wellbeing in spouses of persons with dementia: the Nord-Trondelag health study. BMC Public Health. 2014;14:413.
  12. Martín-Carrasco M, Ballesteros-Rodríguez J, Domínguez-Panchón AI, et al. Interventions for caregivers of patients with dementia. Actas Espanolas De Psiquiatria. 2014;42:300-14.
  13. VanBruggen S, Gussekloo J, Bode C, et al. Problems experienced by informal caregivers with older care recipients with and without cognitive impairment. Home Health Care Services Quarterly. 2016;35:11-24.
  14. Pereira LS, Soares SM. Factors influencing the quality of life of family caregivers of the elderly with dementia. Ciencia & Saude Coletiva. 2015;20:3839-51.
  15. Xie H, Cheng C, Tao Y, et al. Quality of life in Chinese family caregivers for elderly people with chronic diseases. Health and Quality of Life Outcomes. 2016;14:99.
  16. Shim SH, Kang HS, Kim JH, Kim DK. Factors associated with caregiver burden in dementia: 1-year follow-up study. Psychiatry Investigation. 2016;13:43-9.
  17. Waelde LC, Thompson L, Gallagher-Thompson D. A pilot study of a Yoga and meditation intervention for Dementia caregiver stress. Journal of Clinical Psychology. 2004;60:677–87.
  18. Kvaal K, Ulstein I, Nordhus IH, Engedal K. The Spielberger state-trait anxiety inventory (STAI): the state scale in detecting mental disorders in geriatric patients. International Journal of Geriatric Psychiatry. 2005;20:629-34.
  19. Fallahi Khesht-Masjedi M, Omar Z, Kafi Masoleh SM. Psychometrics properties of the Persian version of Beck Anxiety Inventory in North of Iranian adolescents. International Journal of Educational and Psychological Researches. 2015;1:145-53.
  20. Ebersole P, Touhy TA, Hess P, et al. Toward healthy aging: human needs & nursing response. 7th ed. US: Mosby; 2008.
  21. Ayshah Hassan S, Sahranavard M. Investigation of Construct Validity of State Anxiety Inventory among Iranian 8th Grade Students. Asian Journal of Applied Sciences. 2015;8:63-70
  22. Ravari A, Mirzaei T, Salamizadeh A, AskariMajdabadi H. Effect of the spiritual care training on anxiety reduction in home caregivers of the elderly with Alzheimer disease. Koomesh Journal. 2017;19:467-74. [In Persian]
  23. Chien WT, Lee IY. Randomized controlled trial of a dementia care program for families of home-resided older people with dementia. Journal of Advanced Nursing. 2011;67:774–87.
  24. Hosseini RS, Bastani F, Sayahi S, et al. Effect of education-counseling program on general health of women caregiver of elderly with Alzheimer. Shahrekord University of Medical Sciences Journal. 2012;13:83-92. [In Persian]
  25. Fathani M, AfzalAghaee M, Tadayonfar M. Evaluation of the effect of designated educational intervention on the improvement of quality of life in caregivers of patients with chronic heart failure. Journal of Babol University of Medical Sciences. 2016;18:20-5. [In Persian]
  26. Nidich S, Nidich RJ, Salerno J, et al. Stress reduction with the transcendental meditation program in caregivers: A Pilot Study. International Archives of Nursing and Health Care. 2015;1(1).
  27. Faronbi JO, Faronbi GO, Ayamolowo SJ, Olaogun AA. Caring for the seniors with chronic illness: The lived experience of caregivers of older adults. Archives of Gerontology and Geriatrics. 2019;82:8-14.
  28. Takai M, Takahashi M, Iwamitsu Y, et al. The experience of burnout among home caregivers of patients with dementia: relations to depression and quality of life. Archives of Gerontology and Geriatrics. 2009;49:e1-5.