Skip to main content
Log in

Balneotherapy with a psychoeducation program for the promotion of a balanced care in family caregivers of older adults

  • Original Paper
  • Published:
International Journal of Biometeorology Aims and scope Submit manuscript

Abstract

This study aimed to analyze the efficacy of an intervention program for informal caregivers of elderly dependent that combined balneotherapy with group psychoeducation (BT-PE) based on the balanced care model. The BT-PE intervention (N = 124) was compared with a comparison group only exposed to balneotherapy (BT) (N = 76). The two modalities included both primary and secondary informal caregivers. A three-way mixed ANOVA was conducted to determine the effects of two between-subjects´ factors (intervention group and caregiver type) and one within-subjects´ factor (time) on burden, depression, anxiety, maladjustment and care satisfaction. Results showed less burden and more care satisfaction in both primary and secondary caregivers participating in the BT-PE program after the interventions. Primary caregivers also showed lower levels of maladjustment in the experimental group at post-intervention. Although depressive symptoms and anxiety decreased significantly in both intervention groups, BT-PE did not show lower scores compared with the application of sole BT. The relevance of caregivers´ psychoeducation on the balanced care model and its combination with balneotherapy is highlighted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

Data is available in the following link https://osf.io/rmw3p/?view_only=d69cbf1a985f464991a7e2784da93490

References

  • Antonelli M, Davide D (2018) Effects of balneotherapy and spa therapy on levels of cortisol as a stress biomarker: a systematic review. Int J Biometeorol 62:913–924. https://doi.org/10.1007/s00484-018-1504-8

    Article  Google Scholar 

  • Arce C, Andrade EM, Seone G (2000) Problemas semánticos en la adaptación del POMS al castellano [Spanish adaptation of the Profile of Mood States (POMS)]. Psicothema 12(S2):47–51

    Google Scholar 

  • Barbosa A, Figueiredo D, Sousa L, Demain S (2011) Coping with the caregiving role: differences between primary and secondary caregivers of dependent elderly people. Aging Ment Health 15(4):490–499. https://doi.org/10.1080/13607863.2010.543660

    Article  Google Scholar 

  • Beck AT, Steer RA (1993) Beck Depression Inventory. Manual. The Psychological Corporation, San Antonio

  • Blain H, Bernard PL, Canovas G, Raffort N, Desfour H, Soriteau L, Noguès M, Camuzat T, Mercier J, Dupeuron A, Quéré I, Laffont I, Hérisson C, Solimene H, Bousquet J (2016) Combining balneotherapy and health promotion to promote active and healthy ageing: the Balaruc-MACVIA-LR® approach. Aging Clin Exp Res 28(6):1061–1065. https://doi.org/10.1007/s40520-016-0596-4

    Article  CAS  Google Scholar 

  • Cheleschi S, Gallo I, Tenti S (2020) A comprehensive analysis to understand the mechanism of action of balneotherapy: why, how, and where they can be used? Evidence from in vitro studies performed on human and animal simples. Int J Biometeorol 21:1–15. https://doi.org/10.1007/s00484-020-01890-4

    Article  Google Scholar 

  • Dilekçi E, Özkuk K, Kaki B (2019) Effect of balneotherapy on pain and fatigue in elderly with knee osteoarthritis receiving physical therapy: a randomized trial. Int J Biometeorol 63:1555–1568. https://doi.org/10.1007/s00484-019-01768-0

    Article  Google Scholar 

  • Do YK, Norton EC, Stearns SC, Van Houtven CH (2015) Informal care and caregiver’s health. Health Econ 24(2):224–237. https://doi.org/10.1002/hec.3012

    Article  Google Scholar 

  • Echeburúa E, de Corral P, Fernández-Montalvo J (2000) Escala de inadaptación (EI): Propiedades psicométricas en contextos clínicos [Maladjustment Scale EI: psicometric properties in clinical contexts]. Análisis y Modificación de Conducta 26(107):326–338

    Google Scholar 

  • Finkel S, Czaja SJ, Martinovich Z, Harris C, Pezzuto D, Schulz R (2007) E-care: A telecommunications technology intervention for family caregivers of dementia patients. Am J Geriatr Psychiatry 15:443–448. https://doi.org/10.1097/JGP.0b013e3180437d87

    Article  Google Scholar 

  • Gálvez I, Torres-Piles S, Ortega-Rincón E (2018) Balneotherapy, immune system, and stress response: a hormetic strategy? Int J Mol Sci 19(6):1687. https://doi.org/10.3390/ijms19061687

    Article  CAS  Google Scholar 

  • Giusti P, Cima L, Tinello A, Cozzi F, Targa L, Lazzarin P, Todesco S (1990) Stress hormones liberated by fangotherapy. ACTH and beta-endorphin levels under heat stress. Fortschr Med 108(32):601–603

    CAS  Google Scholar 

  • Gonçalves-Pereira M, Zarit SH, Cardoso AM, Alves da Silva J, Papoila AL, Mateos R (2020) A comparison of primary and secondary caregivers of persons with dementia. Psychol Aging 35(1):20–27. https://doi.org/10.1037/pag0000380

    Article  Google Scholar 

  • Kamioka H, Nakamura Y, Yazaki T, Uebaba K, Mutoh Y, Okada S, Takahashi M (2006) Comprehensive health education combining hot spa bathing and lifestyle education in middle-aged and elderly women: one-year follow-up on randomized controlled trial of three- and six-month interventions. J Epidemiol 16(1):35–44. https://doi.org/10.2188/jea.16.35

    Article  Google Scholar 

  • Knight BG, Sayehg P (2010) Cultural values and caregiving: the updated sociocultural stress and coping model. J Gerontol B-Psychol 65:5–13. https://doi.org/10.1093/geronb/gbp096

    Article  Google Scholar 

  • Lawton MM, Moss M, Hoffman C, Perkinson M (2000) Two transitions in daughter’s caregiving careers. Gerontologist 40(4):437–448. https://doi.org/10.1093/geront/40.4.437

    Article  CAS  Google Scholar 

  • Limiñana-Gras RM, Colodro-Conde L, Cuéllar-Flores I, Sánchez-López MP (2016) Clinical efficacy of psychoeducational interventions with family caregivers. Educ Gerontol 42:17–46. https://doi.org/10.1080/03601277.2015.1065685

    Article  Google Scholar 

  • López J, Crespo M (2007) Intervenciones con cuidadores de familiares mayores dependientes: una revision [Interventions with informal caregivers of dependent older people: a review]. Psicothema 19:72–80

    Google Scholar 

  • López J, Crespo M (2008) Analysis of the efficacy of a psychotherapeutic program to improve the emotional status of caregivers of elderly dependent relatives. Aging Ment Health 12(4):451–461. https://doi.org/10.1080/13607860802224292

    Article  Google Scholar 

  • López J, López-Arrieta M, Crespo M (2005) Factors associated with the positive impact of caring for elderly and dependent relatives. Arch Gerontol Geriatr 41:81–94. https://doi.org/10.1016/j.archger.2004.12.001

    Article  Google Scholar 

  • Lopez J, Losada A, Romero-Moreno R, Márquez-González M, Martínez-Martín P (2012) Factors associated with dementia caregivers’ preference for institutional care. Neurología 27(2):83–89. https://doi.org/10.1016/j.nrleng.2012.03.004

    Article  CAS  Google Scholar 

  • Losada A, Márquez-González M, Romero-Moreno R, Mausbach BT, López J, Fernández-Fernández V, Nogales-González C (2015) Cognitive–behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for dementia family caregivers with significant depressive symptoms: results of a randomized clinical trial. J Consult Clin Psychol 83(4):760–772. https://doi.org/10.1037/ccp0000028

    Article  Google Scholar 

  • Martín M, Salvadó I, Nadal S, Salvadó I, Miji LC, Rico JM, Lanz P, Taussing MI (1996) Adaptación para nuestro medio de la escala de sobrecarga del cuidador de Zarit [Adaptation for our context of the Zarit Caregiver Burden Interview]. Revista de Gerontología 6:338–346

    Google Scholar 

  • Matzer F, Nagele E, Lerch N, Vajda C, Fazekas C (2018) Combining walking and relaxation for stress reduction—a randomized cross-over trial in healthy adults. Stress Health 34(2):266–277. https://doi.org/10.1002/smi.2781

    Article  Google Scholar 

  • McNair DM, Lorr M, Droppleman LF (1971) Manual for the profile of mood states. Educational and Industrial Testing Services, San Diego

  • Mittelman MS, Brodaty H, Wallen AS, Burns A (2008) A 3-country randomized controlled trial of a psychosocial intervention for caregivers combined with pharmacological treatment for patients with Alzheimer disease: effects on caregiver depression. Am J Geriatr Psychiatry 16:893–904. https://doi.org/10.1097/JGP.0b013e3181898095

    Article  Google Scholar 

  • Naumann J, Sadaghiani C (2014) Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: a qualitative systematic review and meta-analysis of randomized controlled trials. Arthritis Res Ther 16:141. https://doi.org/10.1186/ar4603

    Article  Google Scholar 

  • Ortiz MD, Martínez T (2013) Manual Cuidarelax. Unión Democrática de Pensionistas y Jubilados de España, Madrid. 

  • Özkuk K, Uysal B, Ateş Z, Ökmen BM, Sezer R, Dilek G (2018) The effects of inpatient versus outpatient spa therapy on pain, anxiety, and quality of life in elderly patients with generalized osteoarthritis: a pilot study. Int J Biometeorol 62(10):1823–1832. https://doi.org/10.1007/s00484-018-1584-5

    Article  Google Scholar 

  • Paúl C, Teixera L, Duarte N, Pires CL, Ribeiro O (2019) Effects of a community intervention program for dementia on mental health: the importance of secondary caregivers in promoting positive aspects and reducing strain. Community Ment Health J 55(2):296–303. https://doi.org/10.1007/s10597-018-0345-6

    Article  Google Scholar 

  • Pearlin LI, Mullan JT, Semple SJ, Skaff MM (1990) Caregiving and the stress process: an overview of concepts and their measures. Gerontologist 30:583–594. https://doi.org/10.1093/geront/30.5.583

    Article  CAS  Google Scholar 

  • Pinquart M, Sörensen S (2003) Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychol Aging 18(2):250–267. https://doi.org/10.1037/0882-7974.18.2.250

    Article  Google Scholar 

  • Roth DL, Perkins M, Wadley VG, Temple EM, Haley WE (2009) Family caregiving and emotional strain: associations with quality of life in a large national sample of middle-aged and older adults. Qual Life Res 18:679–688. https://doi.org/10.1007/s11136-009-9482-2

    Article  Google Scholar 

  • Roth DL, Fredman L, Haley WE (2015) Informal caregiving and its impact on health: a reappraisal from population-based studies. Gerontologist 55(2):309–319. https://doi.org/10.1093/geront/gnu177

    Article  Google Scholar 

  • Sanz J, Vázquez C (1998) Fiabilidad, validez y datos normativos del inventario para la depresión de Beck [Reliability, validity and normative data of the Beck depression inventary]. Psicothema 10(2):303–318

    Google Scholar 

  • Schulz R, Sherwood P (2008) Physical and mental health effects of family caregiving. Am J Nurs 108(9):23–27. https://doi.org/10.1097/01.NAJ.0000336406.45248.4c

    Article  Google Scholar 

  • Sepe-Monti M, Vanacore N, Bartorelli L, Tognetti A, Giubilei F (2016) The Savvy Caregiver program: a probe multicenter randomized controlled pilot trial in caregivers of patients affected by Alzheimer’s disease. J Alzheimers Dis 54:1235–1246. https://doi.org/10.3233/JAD-160235

    Article  Google Scholar 

  • Sorensen S, Pinquart M, Duberstein P (2002) How effective are interventions with caregivers? An updated meta-analysis. Gerontologist 42(3):356–372. https://doi.org/10.1093/geront/42.3.356

    Article  Google Scholar 

  • Stephens MAP, Townsend AL, Martire LM, Druley JA (2001) Balancing parent care with other roles: interrole conflict of adult daughter caregivers. J Gerontol B-Psychol 56:24–34. https://doi.org/10.1093/geronb/56.1.P24

    Article  Google Scholar 

  • Toda M, Morimoto K, Nagasawa S, Kitamura K (2006) Change in salivary physiological stress markers by spa bathing. Biomed Res 27(1):11–14. https://doi.org/10.2220/biomedres.27.11

    Article  CAS  Google Scholar 

  • Williams VP, Bishop-Fitzpatrick L, Lane JD, Gwyther LP, Ballard EL, Venditelli AP, Hutchins TC, Williams RB (2010) Video-based coping skills (VCS) to reduce health risk and improve psychological and physical well-being in Alzheimer’s disease family caregivers. Psychosom Med 72:897–904. https://doi.org/10.1097/PSY.0b013e3181fc2d09

    Article  Google Scholar 

  • Zarit SH, Reever KE, Bach-Peterson J (1980) Relatives of the impaired elderly: Correlates of feelings of burden. Gerontologist 20:646–655. https://doi.org/10.1093/geront/20.6.649

    Article  Google Scholar 

Download references

Funding

This project was funded by the Spanish Ministry of Health, Social Services and Equality. REF. 101/2017/156/004/.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Cristina Noriega.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent to participate

Informed consent was obtained from all individual adult participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Noriega, C., Ortiz, M.D., Martínez, M.T. et al. Balneotherapy with a psychoeducation program for the promotion of a balanced care in family caregivers of older adults. Int J Biometeorol 65, 193–203 (2021). https://doi.org/10.1007/s00484-020-02018-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00484-020-02018-4

Keywords

Navigation