Challenges of conducting of online educational programs for family caregivers of people with dementia living at home: An integrative review.
Yuting Wen, Yurong Xing, Yaping Ding and 2 others
PMID 36860711WHAT IT FOUND
Online programs for family caregivers of people with dementia often had repetitive or missing content, limited interaction, technology barriers, low computer literacy, high dropout, and little checking of whether the program was delivered as planned.
Key findings
01Content challenges included useless or repetitive information in three studies, limited access to dementia-related information in seven studies, and caregiver requests for stage-specific, difficult-behavior, end-of-life, and local-resource information.
02Delivery formats often provided little interaction with other caregivers or professionals, and some caregivers lacked time or preferred paper-based or in-person materials.
03Implementation problems included technical difficulties in nine studies, poor computer literacy, information storage limits, high dropout, and fidelity assessment in only three experimental studies.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included heterogeneous study designs, so it could not determine the best online program or which components caused effects. Many included studies had quality problems: randomization was unclear in 9 randomized controlled trials, missing data handling was limited, confounders were not controlled in some non-randomized trials, and qualitative or mixed-methods reporting was incomplete. Most studies evaluated the whole program rather than individual components, so interactive or culturally tailored elements cannot be proven to be responsible for improvements. The review was limited to English-language studies and included programs from mainly western countries, so findings may not transfer to all cultures or settings. Fidelity was rarely assessed, so it is unclear how well programs were delivered as planned.
Declared interests
Funding came from a Jiangsu Province nursing discipline construction project and a Nanjing Medical University philosophy and social science development project. The authors declared no competing interest.
The easy way to misread this
Do not read this review as proof that online education improves caregiver burden or dementia care. It describes challenges across mixed studies. Only 6 of 24 studies found burden improvements, and the review did not test which program components caused any effects.