Efecto del apoyo social en la depresión de familiares cuidadoras de personas con Alzheimer: revisión sistemática con meta-análisis Social support effect on family caregivers of people with Alzheimer’s disease: A systematic review with meta-analysis

Efecto del apoyo social en la depresión de familiares cuidadoras de personas con Alzheimer: revisión sistemática con meta-análisis
Social support effect on family caregivers of people with Alzheimer’s disease: A systematic review with meta-analysis

Contenido principal del artículo

María Aranda López
Ana Isabel Martínez-López
Beatriz Montes-Berges

Resumen

El objetivo del estudio fue establecer la relación entre el apoyo social y la depresión en cuidadoras familiares de personas con Alzheimer, así como especificar los efectos y las formas en las que el apoyo social contribuye a un mejor estado psicosocial. Se realizó una revisión sistemática con metaanálisis estudiando el coeficiente de correlación combinado, tamaño muestral total e intervalo de confianza (95 %). Se analizó la heterogeneidad estadística con el grado de inconsistencia (I2) y el valor de p de Q. Se utilizó el valor de p de la prueba de Egger y la gráfica Funnel plot para el sesgo de publicación. Se estudió la robustez mediante el análisis de sensibilidad. La r combinada del Forest plot fue de -.332. En la heterogeneidad estadística, se halló una Q de 10.54, p = 0.4. Para el sesgo de publicación, el riesgo fue bajo tras revisar la simetría del Funnel plot y la prueba de Egger, p = 0.8; la sensibilidad del resultado fue de 4.5 %. En conclusión, se comprobó que el apoyo social, cuando cumple una serie de requisitos, reduce la depresión de las cuidadoras de enfermos con Alzheimer. Sin embargo, se requieren más investigaciones que identifiquen qué tipo de apoyo social se necesita en distintos tipos de cuidadoras y circunstancias.

Citas

Akarsu, N.E., Prince, M.J., Lawrence, V.C. y Das-Munshi, J. (2019). Depression in carers of people with dementia from a minority ethnic background: Systematic review and meta-analysis of randomised controlled trials of psychosocial interventions. International Journal of Geriatric Psychiatry, 34(6), 790–806. https://doi.org/10.1002/gps.5070

Arévalo-Flechas, L.C., Acton, G., Escamilla, M.I., Bonner, P.N. y Lewis, S.L. (2014). Latino Alzheimer’s caregivers: What is important to them? Journal of Managerial Psychology, 29(6), 661–684. doi: https://doi.org/10.1108/JMP-11-2012-0357

Au, A., Lau, K.M., Koo, S., Cheung, G., Pan, P.C. y Wong, M.K. (2009). The effects of informal social support on depressive symptoms and life satisfaction in dementia caregivers in Hong Kong. Hong Kong Journal of Psychiatry, 19(2), 57–64. Recuperado de https://bit.ly/3NlmPdz

Avargues-Navarro, M.L., Borda-Mas, M., Campos-Puente, A.M., Pérez-San-Gregorio, Mà., Martín-Rodríguez, A. y Sánchez-Martín, M. (2020). Caring for Family Members with Alzheimer’s and Burnout Syndrome: Impairment of the Health of Housewives. Frontiers in Psychology. 11(576), 1–14. doi: https://doi.org/10.3389/fpsyg.2020.00576

Ávila-toscano, J.H., García-Cuadrado, J.M. y Gaitán-ruiz, J. (2010). Habilidades para el cuidado e depresión en cuidadores de pacientes con demencia. Revista Colombiana de Psicología, 19(1), 71–84. Recuperado de https://www.redalyc.org/pdf/804/80415077007.pdf

Beck, A.T., Steer, R.A. y Brown, G.K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.

Berra, S., Elorza-Ricart, J.M., Estrada, M.D. y Sánchez, E. (2008). Instrumento para la lectura crítica y la evaluación de estudios epidemiológicos transversales. Gaceta Sanitaria, 22(5), 492–497. Recuperado en 13 de abril de 2022, de https://bit.ly/3wk8ys2

Berwig, M., Lessing, S. y Deck, R. (2019). Telephone-based aftercare groups for family carers of people with dementia: Study protocol of the Talking Time - REHAB project. BMC Health Services Research, 19(1), 1–10. doi: https://doi.org/10.1186/s12913-019-4003-7

Cabada Ramos, E. y Martínez Castillo, V.A. (2017). Prevalencia del síndrome de sobrecarga y sintomatología ansiosa depresiva en el cuidador del adulto mayor. Psicología y Salud, 27(1), 53-59. Recuperado de: https://bit.ly/3wmI8WD

Cerquera, A., Granados, F. y Buitrago, A. (2012). Sobrecarga en cuidadores de pacientes con demencia tipo Alzheimer. Psychologia, 6(1), 35–45. Recuperado de https://bit.ly/38szb52

Chang, B.L., Brecht, P. y Carter, P.A. (2011). Predictors of Social Support and Caregiver Outcomes. Women Healt, 33(1–2), 1–20. doi: https://doi.org/10.1300/J013v33n01_04

Cheng, S.T., Chan, W.Ch. y Lam, L.C.W. (2019). Long-Term Outcomes of the Benefit-Finding Group Intervention for Alzheimer Family Caregivers: A Cluster-Randomized Double-Blind Controlled Trial. The American Journal of Geriatric Psychiatry, 27(9), 984–994. doi: https://doi.org/10.1016/j.jagp.2019.03.013

del Pino-Casado, R., Priego-Cubero, E., López-Martínez, C. y Orgeta, V. (2021) Subjective caregiver burden and anxiety in informal caregivers: A systematic review and meta-analysis. PLOS ONE, 16(3), e0247143. doi: https://doi.org/10.1371/journal.pone.0247143

Delicado Useros, M.V., Garia Fernández, M. A., López Moreno, B. y Martínez Sánchez, P. (2001). Cuidadoras informales: Una perspectiva de género. Revista Enfermería, 13, 12-16.

Durán-Gómez, N., Guerrero-Martín, J., Pérez-Civantos, D., López Jurado, C.F., Palomo-López, P. y Cáceres, M.C. (2020). Understanding Resilience Factors Among Caregivers of People with Alzheimer's Disease in Spain. Psychology research and behavior management, 13, 1011–1025. doi: https://doi.org/10.2147/PRBM.S274758

Fernández, I., Sentandreu-Mañó, T. y Tomas, J.M. (2019). Impact of frailty status on health and quality of life in Spanish older adults. Atención Primaria, 52(10), 731–737. doi: https://doi.org/ 10.1016/j.aprim.2019.11.006

Gallardo-Vargas, R., Hernández, D.B., Menor, E.C., Policlínico, P., González, N. y Viñales, F. (2012). El cuidado informal en enfermos de Alzheimer: evaluación a partir de un modelo teórico Alzheimer’s. Revista de Ciencias Médicas,16(1), 188–99. Recuperado de http://scielo.sld.cu/pdf/rpr/v16n1/rpr20112.pdf

Grupo Estatal de Demencias (2019). Plan Integral de Alhzeimer y otras Demencias (2019-2023). Madrid: Ministerio de Sanidad, Consumo y Bienestar Social. Recuperado de https://www.mscbs.gob.es/profesionales/saludPublica/docs/Plan_Integral_Alhzeimer_Octubre_2019.pdf

Haley, W.E., Levine, E.G., Brown, S.L. y Bartolucci, A.A. (1987). Stress, appraisal, coping, and social support as predictors of adaptational outcome among dementia caregivers. Psychology and Aging, 2(4), 323–30. doi: https://doi.org/10.1037//0882-7974.2.4.323

Haley, W.E., Roth. D.L., Coleton, M.I., Ford, G.R., West, C.A.C., et al. (1996). Appraisal, coping, and social support as mediators of well-being in black and white family caregivers of patients with Alzheimer’s disease. Journal of Consulting and Clinical Psychology, 64(1), 121–9. doi: https://doi.org/10.1037//0022-006x.64.1.121.

Hedges, L.V. y Vevea, J.L. (1998). Fixed- and Random-Effects Models in Meta-Analysis. Psychol Methods, 3(4), 486–504. doi: https://doi.org/10.1037/1082-989X.3.4.486

Hannappel, M., Calsyn, R.J. y Gary, A. (1993). Does Social Support Alleviate the Depression of Caregivers of Dementia Patients? Journal of Gerontological Social Work, 20(1–2), 97–114. doi: https://doi.org/10.1300/J083V20N01_04

Harandi, T.F., Taghinasab, M.M. y Nayeri, T.D. (2017). The correlation of social support with mental health: A meta-analysis. Electronic physician, 9(9), 5212–5222. doi: https://doi.org/10.19082/5212

Harwood, D.G., Barker-Warren, W.L. y Ranjan, D. (2000). Caregiver Self-Rated Health in Alzheimer’s Disease. Clinical Gerontologist, 24(6), 19–33. doi: https://doi.org/10.1300/J018v21n04_03

Heo, G.J. (2014). Religious Coping, Positive Aspects of Caregiving, and Social Support Among Alzheimer’s Disease Caregivers. Clinical Gerontology, 37(4), 368–85. doi: https://doi.org/10.1080/07317115.2014.907588

Huang, C.Y., Sousa, V.D., Perng, S.J., Hwang, M.Y., Tsai, C.C., Huang, M.H., et al. (2009). Stressors, social support, depressive symptoms and general health status of Taiwanese caregivers of persons with stroke or Alzheimer’s disease. Journal of Clinical Nursing, 18(4), 502–511. doi: https//doi.org/10.1111/j.1365-2702.2008.02443.x

Khusaifan, S.J. y Keshky, M.S. (2017). Social support as a mediator variable of the relationship between depression and life satisfaction in a sample of Saudi caregivers of patients with Alzheimer’s disease. International Psychogeriatrics, 29(2), 239–48. doi: https://doi.org/10.1017/S1041610216001824

Kiral, K., Yetim, Ü., Özge, A. y Aydin, A. (2017). The relationships between coping strategies, social support and depression: An investigation among Turkish care-givers of patients with dementia. Ageing & Society, 37(1), 167–87. doi: https://doi.org/10.1017/S0144686X1500104X

Krause, N. y Markides, K. (1990). Measuring social support among older adults. International Journal of Aging and Human Development, 31, 37-53. doi: https://doi.org/10.2190/CY26-XCKW-WY1V-VGK3

Lakey, B., Adams, K., Neely, L., Rhodes, G., Lutz, C.J. y Sielky, K. (2002). Perceived support and low emotional distress: The role of enacted support, dyad similarity, and provider personality. Personality and Social Psychology Bulletin, 28(11), 1546–55. doi: https://doi.org/10.1177/014616702237582

Larsen, D.L., Attkisson, C.C., Hargreaves, W.A. y Nguyen, T.D. (1979). Assessment of client/patient satisfaction: development of a general scale. Evaluation and Program Planning, 2(3), 197-207. doi: https://doi.org/10.1016/0149-7189(79)90094-6

López, J., Romero-Moreno, R., Marquez-González, M. y Losada, A. (2012). Spirituality and self-efficacy in dementia family caregiving: Trust in God and in yourself. International Psychogeriatrics, 24(12), 1943–1952. doi: https://doi.org/10.1017/S1041610212001287.

Luchsinger, J.A., Tipiani, D., Torres-Patiño, G., Silver, S., Eimicke, J.P., Ramirez, M., et al. (2015). Characteristics and mental health of hispanic dementia caregivers in New York City. American Journal of Alzheimer's Disease & Other Dementias, 30(6), 584–90. doi: https://doi.org/10.1177/1533317514568340

Mahoney, D.F., Tarlow, B.J. y Jones. R.N. (2003). Effects of an automated telephone support system on caregiver burden and anxiety: Findings from the REACH for TLC intervention study. Gerontologist, 43(4), 556–67. doi: https://doi.org/10.1093/geront/43.4.556

MaloneBeach, E.E. y Zarit, S.H. (1995). Dimensions of Social Support and Social Conflict as Predictors of Caregiver Depression. International Psychogeriatrics, 7(1), 25–38. doi: https://doi.org/10.1017/s1041610295001827

Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., et al. (2016). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Revista Española de

Nutrición Humana y Dietética, 20(2), 148–60. doi: https://doi.org/10.1186/2046-4053-4-1

Organización Mundial de la Salud (2020). Demencia. Recuperado de: https://www.who.int/es/news-room/fact-sheets/detail/dementia

Pagel, M. y Becker, J. (1987). Depressive Thinking and Depression: Relations With Personality and Social Resources. Journal of Personality and Social Psychology, 52(5), 1043–52. doi: https://doi.org/10.1037//0022-3514.52.5.1043

Pinyopornpanish, M., Pinyopornpanish, K., Soontornpun, A., Tanprawate, S., Nadsasarn, A., Wongpakaran, N. et al. (2021). Perceived stress and depressive symptoms not neuropsychiatric symptoms predict caregiver burden in Alzheimer’s disease: a cross-sectional study. BMC Geriatrics, 21(180), 1–10. doi: https://doi.org/10.1186/s12877-021-02136-7

Rapp, S.R., Shumaker, S., Schmidt, S., Naughton, M. y Anderson, R. (1998). Social resourcefulness: Its relationship to social support and wellbeing among caregivers of dementia victims. Aging of Mental Healt, 2(1), 40–8. doi: https://doi.org/10.1080/13607869856920

Roadolff, L. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Meassures, 1(3), 385-401. Recuperado de https://conservancy.umn.edu/bitstream/handle/11299/98561/v01n3p385.pdf

Roig, E., Abengózar, M.C. y Serra, E. (1998). La sobrecarga en los cuidadores principales de enfermos de Alzheimer. Anales de Psicología, 14(2), 215–27. Recuperado de: https://www.um.es/analesps/v14/v14_2/08-14-2.pdf

Rote, S.M., Angel, J.L., Kim, J. y Markides, K.S. (2021). Dual Trajectories of Dementia and Social Support in the Mexican-Origin Population, The Gerontologist, 61(3), 374–382. doi: https://doi.org/10.1093/geront/gnaa100

Schulz, R. y Williamson, G.M. (1991). A 2-year longitudinal study of depression among Alzheimer’s caregivers. Psycholy of Aging, 6(4), 569–78. doi: https://doi.org/10.1037//0882-7974.6.4.569

Sheehan, O.S., Haley, W.E., Howard, V.J., Huang, J., Rhodes, J.D. y Roth, D.L. (2021). Stress, Burden, and Well-Being in Dementia and Nondementia Caregivers: Insights from the Caregiving Transitions Study. The Gerontologist, 61(5), 670–679. doi: https://doi.org/10.1093/geront/gnaa108