Background: Caring for people with dementia is perceived as one of the most stressful and difficult forms of caring. Family caregivers always experience high levels of psychological burden and physical strain, so effective and practical support is essential. Internet-based supportive interventions can provide convenient and efficient support and education to potentially reduce the physical and psychological burden associated with providing care. Objective: This review aimed to (1) assess the efficacy of internet-based supportive interventions in ameliorating health outcomes for family caregivers of people with dementia, and (2) evaluate the potential effects of internet-based supportive intervention access by caregivers on their care recipients. Methods: An electronic literature search of the PubMed, EMBASE, Web of Science, CINAHL, Cochrane Library, and PsycINFO databases was conducted up to January 2020. Two reviewers (ML and YZ) worked independently to identify randomized controlled trials (RCTs) that met the inclusion criteria and independently extracted data. The quality of the included RCTs was evaluated using the approach recommended by the Cochrane Handbook for Systematic Reviews of Interventions. Standardized mean differences (SMDs) with 95% CIs were applied to calculate the pooled effect sizes. Results: In total, 17 RCTs met the eligibility criteria and were included in this systematic review. The meta-analysis showed that internet-based supportive interventions significantly ameliorated depressive symptoms (SMD=–0.21; 95% CI –0.31 to –0.10; P<.001), perceived stress (SMD=–0.40; 95% CI –0.55 to –0.24; P<.001), anxiety (SMD=–0.33; 95% CI –0.51 to –0.16; P<.001), and self-efficacy (SMD=0.19; 95% CI 0.05-0.33; P=.007) in dementia caregivers. No significant improvements were found in caregiver burden, coping competence, caregiver reactions to behavioral symptoms, or quality of life. Six studies assessed the unintended effects of internet-based supportive intervention access by caregivers on their care recipients. The results showed that internet-based supportive interventions had potential benefits on the quality of life and neuropsychiatric symptoms in care recipients. Conclusions: Internet-based supportive interventions are generally effective at ameliorating depressive symptoms, perceived stress, anxiety, and self-efficacy in dementia caregivers and have potential benefits on care recipients. Future studies are encouraged to adopt personalized internet-based supportive interventions to improve the health of family caregivers and their care recipients. Trial Registration: PROSPERO CRD42020162434; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=162434

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中文翻译：

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对痴呆症患者家庭照顾者的基于互联网的支持性干预：系统评价和荟萃分析。

背景：照顾痴呆症患者被认为是压力最大，最困难的照顾方式之一。家庭护理人员始终承受着很高的心理负担和身体压力，因此有效和实际的支持至关重要。基于Internet的支持性干预措施可以提供便捷有效的支持和教育，以潜在地减轻与提供护理相关的身体和心理负担。目的：本综述旨在（1）评估基于互联网的支持性干预措施改善痴呆症患者家庭照护者的健康状况的效果，以及（2）评估护理者基于互联网的支持性干预措施对其护理的潜在影响收件人。方法：对PubMed，EMBASE，Web of Science，CINAHL，Cochrane图书馆和PsycINFO数据库的运行截止到2020年1月。两名审查员（ML和YZ）独立工作，以鉴定符合纳入标准并独立提取数据的随机对照试验（RCT）。使用《 Cochrane干预系统回顾手册》推荐的方法评估纳入的RCT的质量。应用具有95％CI的标准化平均差异（SMD）来计算合并效应的大小。结果：总共有17个RCT符合资格标准，并被纳入系统评价。荟萃分析显示，基于互联网的支持性干预措施显着改善了抑郁症状（SMD = –0.21； 95％CI –0.31至–0.10； P <.001），感知压力（SMD = –0.40； 95％CI –0.55至–0.24； P <.001），焦虑症（SMD = -0.33； 95％CI –0.51至–0.16； P <。001）和痴呆症护理人员的自我效能感（SMD = 0.19; 95％CI 0.05-0.33; P = .007）。照料者负担，应对能力，照料者对行为症状的反应或生活质量均未见明显改善。六项研究评估了看护者对其接受者基于互联网的支持性干预访问的意外影响。结果表明，基于互联网的支持性干预措施对受护理者的生活质量和神经精神症状有潜在的好处。结论：基于Internet的支持性干预措施通常可以有效改善痴呆症照护者的抑郁症状，感知的压力，焦虑和自我效能感，并且对接受治疗者具有潜在的好处。鼓励今后的研究采用基于互联网的个性化支持性干预措施，以改善家庭护理人员及其护理对象的健康状况。试用注册：PROSPERO CRD42020162434；https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=162434

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