The Feasibility and Preliminary Effects of a Stress Process Model-Based Program in Dementia Caregiving (DeCare-SPM) for Family Caregivers: A Mixed-Methods Pilot Study

Jie Wu,1,* Xuelian Li,1,* Weichu Liu,2 Yingzhuo Ma,1 Qinghua Zhao,1 Mingzhao Xiao,1 Jun Wang1 1Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mingzhao Xiao, Department of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China, Email mingzhaoxiao@hospital.cqmu.edu.cn Jun Wang, Department of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China, Email 2H5877@hospital.cqmu.edu.cnBackground: Dementia caregiving causes significant stress, making psychosocial interventions crucial. However, its success depends on effective implementation. This study aimed to evaluate the feasibility, acceptability, and preliminary effects of DeCare-SPM, a theory-driven program designed to enhance positive aspects of caregiving and reduce burden.Methods: A single-group pre-post study without a control group, using an embedded mixed-methods design, was conducted from June to July 2023. The 1-month intervention included three face-to-face sessions and four weekly telephone-based consultations. The feasibility was evaluated through recruitment rate, adherence, and satisfaction. Focus group interviews with implementers and caregivers provided qualitative insights. Preliminary effects on positive aspects of caregiving (PAC), caregiver burden, sense of competence, social network, anxiety and depression, quality of life for caregivers, and neuropsychiatric symptoms and quality of life for individuals with dementia were measured at the end of the 1-month intervention period.Results: 32 caregivers were recruited; no dropouts. 81.3% (26/32) attended all sessions, and 87.5% (28/32) completed telephonic interventions. Overall satisfaction a showed a median score of 4 (P25–P75: 3.25– 5), with the highest ratings for the intervention team (median 4, P25–P75: 4– 4). Participation demonstrated a median score of 4 (P25–P75: 3.25– 4), with particularly high engagement in reading the provided materials (median 4.5, P25–P75: 4– 5). The most frequently applied strategy was seeking support from family and friends (median 4, P25–P75: 4– 4). (2) Qualitative findings revealed four themes: Perceived Benefit, Peer Support, Suggestions for Improvement, and Reasons for Low Application. Post-intervention improvements were seen in PAC (t=3.553, P=0.001, d=0.63), sense of competence (t=4.673, P< 0.001), social network (t=3.645, P=0.001), and EQ-5D index (t=2.785, P=0.009). Burden (t=− 3.083, P=0.004, d=0.55) and anxiety (t=− 3.544, P=0.001) decreased significantly.Conclusion: The DeCare-SPM was feasible and acceptable for family caregivers and showed preliminary effects on family caregivers.Keywords: Alzheimer’s disease, stress coping, family caregivers, psychosocial, feasibility