A Systematic Review of Telehealth Tools and Interventions to Support Family Caregivers

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Introduction

The research problem of the study under analysis is to reveal opportunities that telehealth technology provides for support and better coping of caregivers. The research question is to investigate the effects that telehealth can have on caregivers. In fact, this study is a systematic review of evidence regarding the impact of telehealth applications on family caregivers. The authors claim that the role of caregivers is increasing in the process of care due to the growing number of aging people with chronic diseases who need continuous care (Chi & Demiris, 2014). They provide evidence of adverse effects that are observed among caregivers such as physical and psychological health problems, or social and financial challenges. More than a quarter of caregivers report an increase in health problems that result from their new caregiving responsibilities which, in turn, negatively affects the ability to provide high-quality care.

The authors suppose that technology can be useful to support caregivers. Thus, the hypothesis is that telehealth technology has the potential to make caregiving more effective, efficient, less stressful, and safer both for caregivers and for individuals under care. The authors developed this hypothesis because telehealth interventions are beneficial for patients but little attention is paid to caregivers who also need support to fulfill their duties properly. The researchers are revealing the diversity of telehealth technology types as well as tools and interventions that can be useful for caregivers.

Evaluation of the Research Methods

The study is a systematic review of the evidence of the impact telehealth applications have on caregivers. Therefore, the study itself is a review of the research literature. However, the researchers also use some additional literature to present the problem and its significance. For example, the researchers provide some statistics about the number of caregivers in the United States and the challenges faced by caregivers thus focusing on the problem significance. Nevertheless, there is no literature review as a separate part of the article.

The study is current and relevant to contemporary health issues. The researchers state that there is an increasing demand for formal and informal (family) caregivers due to an increase in the aging population and the growing rate of elderly patients with chronic diseases. Their role is crucial for patients who cannot provide efficient self-care and need assistance with daily activities as well as treatment procedures. According to National Alliance for Caregiving (as cited in Chi & Demiris, 2014), in 2009, there were about 66 million American citizens providing care for ill, disabled, or aged relatives (p. 39).

It is non-experimental research that applies a systematic review of the literature to investigate the problem of telehealth tools and interventions impact on family caregivers. The reviewed studies included a telehealth-based application or intervention used at any stage of implementation in the process of care. The research type corresponds to its purpose and allows supporting the hypothesis.

The sample for the study consisted of 65 papers published in 37 journals in different countries. The majority of these journals belonged to the field of medicine, nursing, medical informatics, gerontology, psychiatry, and pediatrics. Also, some journals in behavioral health and dementia care were included. The initial search in scholarly databases such as Embase, CINHAL, Cochrane, and PubMed resulted in 4205 articles that matched the key-words (Chi & Demiris, 2014). The criteria for selection included relevance to telehealth, availability of the full-text variant, English publication, involvement of family caregivers, and application of telehealth interventions. The selection was provided by both researchers to avoid possible bias.

Moreover, articles included in the sample were evaluated with the help of the Oxford Center for Evidence-Based Medicine framework for the score of the level of evidence (Chi & Demiris, 2014). The study designs in the selected papers were 19 randomized control trials (1b level of evidence) (29%), 33 non-randomized control trials (pilot, feasibility, comparison, quasi-experimental, and pre-and post-test design) (1c level of evidence) (51%), one secondary analysis (2b), 11 evaluation studies (2c), and one case study (3b). consequently, the level of evidence found in these papers was evaluated from high (1b) to medium (3b). The sample was appropriate for this research because it included studies that provided relevant evidence to investigate the problem and draw conclusions about the impact of telehealth tools and applications on caregivers.

The work seems practical. The researchers summarize technology utilization and interventions found in the studies. Thus, they define such telehealth technologies mentioned in the sample papers as video (videoconferencing or videophone) that was used in 40% of interventions; telephone-based (phone call or text message), which made 31% of technologies under analysis; web-based information, comprising 18% of the revealed applications of telehealth technology, and telemetry or remote monitoring (electronic data collection), that were applied in 11% of the studies. On the whole, video proved to be the most frequently-applied technology. These findings have practical value because they provide data about the usability of telehealth technology and the possible ways of its utilization. Also, Chi and Demiris (2014) identify six major categories of interventions delivered with the help of the above mentioned technologies.

Thus, interventions related to education, consultation, psychosocial or cognitive behavioral therapy, social support, data collection and monitoring, and clinical care delivery were applied in the papers under analysis. The most popular interventions are education, consultation, and behavioral therapy. The authors suggest that research results could be applied for a broader introduction of telehealth technology that has the potential to enhance the caregiving experience and empower shared decision-making involving family caregivers as well as patients. I believe that the study provides valuable evidence that telehealth technology can be successfully implemented in different settings including pediatrics, homes, or hospices. Moreover, the review under analysis proves that the availability of information and support by means of telehealth services is beneficial for all types of care. Finally, the study is a significant contribution to the problem of telehealth technology application because it summarizes experiences related to caregivers outcomes.

I believe the study achieved its purpose and used appropriate methods that allowed investigating the issue of using telehealth technology to improve caregivers outcomes. The study uses relevant literature selected in accordance with strict criteria. Therefore, I suppose the study cannot be improved. The writing in the paper is clear and straightforward. The article includes such logical components as a summary, introduction, methods, results, and discussion. The language used can be understood by all categories of readers and terms or abbreviations are explained. Moreover, the authors use figures to visualize study inclusions, journal fiends, and geography of journals where the selected articles were published.

Although this study is full and complete, there are some opportunities for further research on this subject. Thus, it is possible to conduct some comparative experimental studies involving different telehealth interventions and their impact on family caregivers. For example, research can be continued in comparing caregivers outcomes in pediatrics settings with the use of video and telephone-based interventions. Another opportunity for research is change projects based on education, consultation, behavioral therapy, social support, data collection and monitoring system, and clinical care delivery interventions. Also, the assessment of the effectiveness of their implementation will include experiments involving family caregivers in different settings.

Conclusion

On the whole, the study under analysis is a relevant investigation that contributes to research in healthcare. Its major value and the aspect that differentiates it from other studies in the field of telehealth technology investigation is that it is dedicated to caregivers outcomes while the majority of research projects involve patients. The study is based on a thorough literature review that provides data for analysis and conclusions. Also, the study is relevant to contemporary health issues because more people today need assistance that is provided by caregivers. This non-experimental research uses a suitable sample of papers that provide high-quality evidence for analysis. The practical character of this work makes it valuable not only for researchers and medical science as a whole but also applicable in clinical and home settings to inform caregivers on the opportunities provided by the use of telehealth technology. The clear and straightforward writing of the article makes it easy to read not only to a healthcare professional but to all individuals interested in the topic. Thus, it can be recommended for caregivers as a source of information about effective telehealth interventions and tools that have the potential for improvement of both patient and caregiver outcomes.

Reference

Chi, N., & Demiris, G. (2014). A systematic review of telehealth tools and interventions to support family caregivers. Journal of Telemedicine and Telecare, 21(1), 37-44. Web.

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