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Problem-solving counseling for caregivers of the cognitively impaired : effective for whom ? BACKGROUND Individualized problem-solving counseling for caregivers of cognitively impaired relatives is thought to help caregivers cope with the stress and burden of caregiving . Few studies have shown the effectiveness of counseling for these caregivers . OBJECTIVES To determine the effectiveness of individualized problem-solving counseling by nurses for caregivers and the expenditures of health care utilization . METHOD Caregivers ( n = 77 ) of the cognitively impaired living at home were randomized to receive nurse counseling or not . Psychosocial adjustment to their relative 's illness , psychological distress , burden , coping skills , and expenditures were measured after 6 months and 1 year . RESULTS Although on average , all caregivers receiving nurse counseling indicated no improvement in psychosocial adjustment to their relative 's illness , psychological distress , or caregiver burden , they found counseling very helpful and it was effective for a subgroup of caregivers . Those with poor logical analysis coping skills at baseline had decreased psychological distress ( F ( 1,53 ) = 9.7 , p = .003 ) and improved psychosocial adjustment ( F ( 1,53 ) = 4.7 , p = .035 ) after 1 year . Caregivers in control and counseling groups whose relatives entered a nursing home improved their psychosocial adjustment 23 % on average whereas those continuing to live in the community decreased by 8 % . Almost half as many relatives entered nursing homes in the counseling group ( n = 9 vs. n = 5 ) but these compared to control group relatives had greater annualized per person expenditures for health and social services ( Cdn $ 23,437 vs. Cdn $ 15,151 ) . CONCLUSIONS Caregivers found nurse counseling most helpful . Those indicating infrequent use of logical analysis coping skills showed benefits .
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Intervention_Educational
Problem-solving counseling
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Intervention_Educational
problem-solving counseling
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Intervention_Educational
individualized problem-solving counseling by nurses
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Intervention_Educational
nurse counseling or
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Intervention_Control
not
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Intervention_Educational
nurse counseling
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Intervention_Control
control
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Intervention_Educational
counseling
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Intervention_Educational
counseling
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Intervention_Control
control
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Intervention_Educational
nurse counseling
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Outcome_Mental
relative 's illness
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Outcome_Mental
psychological distress
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Outcome_Mental
burden
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Outcome_Mental
coping skills
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Outcome_Other
expenditures
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Outcome_Other
improvement
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Outcome_Mental
relative 's illness
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Outcome_Mental
psychological distress
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Outcome_Mental
caregiver burden
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Outcome_Mental
psychological distress
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Outcome_Mental
psychosocial adjustment
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Outcome_Mental
psychosocial adjustment
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Outcome_Other
health and social services
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Participant_Condition
77 )
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Participant_Condition
cognitively impaired