Internet-delivered guided self-help acceptance and commitment therapy for family carers of people with dementia (iACT4CARERS): a feasibility study

Figures & data

Table 1. Characteristics of participants at screening.

Carer variable (range of the scale)	Mean (SD) or N (%) Screened (N = 79)^a	Mean (SD) or N (%) Invited to the intervention (N = 33)
Mean age (years)	63.59 (10.53)	62.00 (10.17)
Age group (years)
30–39	1 (1%)	0
40–49	6 (8%)	3 (9%)
50–59	21 (27%)	12 (36%)
60–69	25 (32%)	9 (27%)
70–79	22 (28%)	8 (24%)
80–89	4 (5%)	1 (3%)
Sex
Female	57 (72%)	29 (88%)
Male	22 (28%)	4 (12%)
Highest level of education
Primary school	0	0
Secondary school	24 (30%)	11 (33%)
Vocational diploma	26 (33%)	11 (33%)
Undergraduate degree	21 (27%)	9 (27%)
Post-graduate degree	8 (10%)	2 (6%)
Employment status
Part-time	16 (20%)	6 (18%)
Full-time	14 (18%)	6 (18%)
Unemployed	7 (9%)	4 (12%)
Retired	42 (53%)	17 (52%)
Length of being a carer (in months)	52.66 (40.58)	53.00 (19.48)
Relationship with the care recipient
Wife	24 (30%)	11 (33%)
Husband	15 (19%)	3 (9%)
Partner	3 (4%)	0
Daughter	29 (37%)	17 (52%)
Son	5 (6%)	1 (3%)
Other	3 (4%)	1 (3%)
Cohabitation status
Living with the care recipient	50 (63%)	20 (61%)
Not living with the care recipient	29 (37%)	13 (39%)
Hours of caring per week (h)
0–2	3 (4%)	1 (3%)
3–10	16 (20%)	7 (21%)
11–20	8 (10%)	3 (9%)
21–40	5 (6%)	2 (6%)
41–81	11 (14%)	6 (18%)
≥81	36 (46%)	14 (42%)
Current psychotropic medication
Yes	19 (24%)	9 (27%)
No	60 (76%)	24 (73%)
Previous psychotherapy
None	47 (57%)	14 (41%)
CBT	6 (7%)	3 (9%)
Counselling	23 (28%)	14 (41%)
Other	6 (7%)	3 (9%)
GAD7 (0–21)	6.54 (5.35)	6.36 (2.33)
None (0–4)	33 (42%)	6 (18%)
Mild (5–9)	31 (39%)	25 (76%)
Moderate (10–14)	5 (6%)	2 (6%)
Severe (15+)	10 (13%)	0
PHQ9 (0–27)	7.62 (5.88)	7.79 (3.43)
None (0–4)	27 (34%)	5 (15%)
Mild (5–9)	25 (32%)	15 (45%)
Moderate (10–14)	7 (22%)	13 (39%)
Severe (15+)	10 (13%)	0
CESD-R (0–60)	15.43 (12.72)	15.21 (7.26)
AAQ-II (7–49)	20.40 (9.79)	20.52 (7.60)
CFQ (7–49)	24.26 (9.90)	25.09 (7.58)
EACQ (15–75)	41.42 (8.95)	41.39 (8.95)
Patient variable (range of the scale)	Mean (SD) or N (%) Screened (N = 79)^a	Mean (SD) or N (%) Invited to the intervention (N = 33)
Dementia diagnosis
Alzheimer’s disease	31 (39%)	13 (39%)
Vascular dementia	9 (11%)	4 (12%)
Dementia with Lewy bodies	2 (3%)	2 (6%)
Frontotemporal dementia	2 (3%)	1 (3%)
Mixed dementia	23 (29%)	10 (30%)
Other	12 (15%)	3 (9%)
Mean age (years)	78.78 (8.99)	82.06 (8.61)
Sex
Female	44 (56%)	16 (48%)
Male	35 (44%)	17 (52%)
Frequency of memory and behaviour problems (RMBPC)
Total (0–96)	40.82 (16.91)	41.45 (14.39)
Memory-related problems (0–28)	20.90 (6.94)	21.27 (6.92)
Affective distress (0–36)	11.79 (8.13)	11.12 (7.54)
Disruptive behaviours (0–32)	8.13 (6.51)	9.06 (5.72)

AAQ-II, Acceptance and Action Questionnaire-II; CBT, Cognitive Behaviour Therapy; CESD-R, Center for Epidemiologic Studies Depression Scale-Revised; CFQ, Cognitive Fusion Questionnaire; GAD7, General Anxiety Disorder-7; EACQ, Experiential Avoidance in Caregiving Questionnaire; PHQ9, Patient Health Questionnaire-9; RMBPC, Revised Memory and Behavior Problem Checklist.

^aDue to missing data, 78 datasets were available for AAQ, CFQ and RMBPC and 77 datasets were available for EACQ.

Table 2. Means and standard deviations for clinical outcomes at follow-up and effect sizes.

	All sample (N = 24)		Completers sample (N = 18)
	Mean (SD)	ES	Mean (SD)	ES
GAD7 (0–21)	4.96 (3.56)	0.51	4.50 (3.84)	0.70
PHQ9 (0–27)	6.79 (3.15)	0.12	6.56 (3.28)	0.15
CESD-R (0–60)	14.08 (9.10)	−0.02	12.72 (8.68)	0.19
AAQ-II (7–49)	20.83 (7.82)	−0.12	19.72 (8.01)	0.07
CFQ (7–49)	23.42 (8.08)	0.19	22.00 (8.30)	0.32
EACQ (15–75)	38.04 (6.88)	0.62	37.06 (7.41)	0.63

AAQ-II, Acceptance and Action Questionnaire-II; CESD-R, Center for Epidemiologic Studies Depression Scale-Revised; CFQ, Cognitive Fusion Questionnaire; GAD7, General Anxiety Disorder-7; EACQ, Experiential Avoidance in Caregiving Questionnaire; PHQ9, Patient Health Questionnaire-9.

Figure 1. iACT4CARERS feasibility trial flow diagram.

Note. ¹⁾ Formal healthcare sample includes participants recruited via clinician referral from and primary (GP practice) and secondary (NHS mental health trusts) healthcare services; ²⁾ Community sample includes participants self-referred through public advertisement, Join Dementia Research and other ethically approved dementia studies.

Table 3. Reliable change in participants from baseline to follow-up including non-completers.

Symptom severity at baseline	Reliable deterioration N	No reliable change N	Reliable improvement N
Mild anxiety GAD7: 5–9 (N = 19)	0	12	7
Moderate anxiety GAD7: 10–14 (N = 1)	0	0	1
Mild depression PHQ9: 5–9 (N = 11)	2	8	1
Moderate depression PHQ9: 10–14 (N = 8)	0	4	4