Logotherapy-Based Interventions on Chinese Family Caregivers of Older Adults with Dementia through Online Groups: A Mixed-Methods Study

Background and Purpose

Dementia is one of the greatest health challenges for human and no cure is in sight currently. China’s population has an estimated 15.1 million older adults living with dementia. Their family caregivers suffer great physical burden and psychological distress in long-term caregiving. Logotherapy, as one means of empowerment, helps people to facilitate identity development through the recognition and clarification of values. It has been found to decrease anxiety, depression, and despair associated with irreversible physical loss and incurable disease. Therefore, this study aimed to examine the effects of logotherapy-based interventions on Chinese family caregivers of older adults with dementia to decrease caregiver burden.

Methods

This mixed-methods research used a pre–post quasi-experimental design with online semistructured interviews. A snowball sample of 13 family caregivers of people with dementia from a local area agency on aging in a suburban district in Shanghai, China, were enrolled from April 2022 to August 2022 under the following eligibility criteria: (1) care recipient with a dementia diagnosis and (2) access and capability to use smart devices. All participants received eight online logotherapy-based interventions facilitated by two licensed social workers with a focus on hope and meaning construction from September 2022 to October 2022. All participants completed the Zarit Burden Interview, a 22-item measure of caregiver burden, before and after the intervention. Paired t test using pretest and posttest scores was conducted to examine the effectiveness of logotherapy-based interventions. Within one month after the intervention ended, 30-min semistructured interviews were conducted by an MSW student to explore participants’ experiences with the intervention. Thematic analysis was used to explore the change in caregivers’ perceived caregiving burden.

Results

From the quantitative data, family caregivers of people with dementia reported moderate to severe caregiving burden at the baseline (M = 54.77, SD = 4.12). It significantly decreased after the logotherapy-based intervention (M = 52.33, SD = 4.09, p < 0.001). From the qualitative data, three themes about perceived change related to the intervention were identified: (1) decreased anxiety and depression, (2) a stronger sense of personal life meaning, and (3) enhanced hope. Most participants reported the group activities strengthened their sense of achievement out of providing care to their loved ones, which helped them to find meaningful values to cope with anxiety and depression. Overall, the logotherapy-based intervention was effective in decreasing the burden of Chinese family caregivers of older adults with dementia.

Implications

During the pandemic, the online format of interventions may largely improve the accessibility of psychosocial services for family caregivers of older people with dementia who live in rural areas in China. This study has demonstrated the effect of logotherapy-based intervention through online groups in decreasing caregiver burdens. Our findings generate valuable implications for clinical social workers to apply logotherapy in improving the well-being of family caregivers of people with dementia. Future study is encouraged to further examine the effectiveness of social work services through the online format.