Dyadic interventions in older people with chronic diseases: An integrative review

The ageing population is growing worldwide, and a high incidence of chronic diseases is associated with this process.1 The American Health Survey showed that approximately 51.8% of adults suffer from at least one chronic disease.2 In China, three-quarters of elderly individuals suffer from one or more chronic diseases, and the burden of chronic diseases is on the rise.3 Chronic diseases not only affect individuals’ physical, mental, and activities of daily living (ADLs)4 but also their caregivers and their relationships with them.5 In managing chronic illness, caregivers may suffer from impaired health, burdens associated with providing support, and a decrease in satisfaction with the relationship with the afflicted individual.6 To improve the impact of chronic illness on patients and caregivers, dyadic interventions have been used.

Dyadic interventions for older people with chronic diseases are interventions in which older people with chronic diseases and their caregivers are involved together,7 and there are different degrees of interaction between dyads. Dyads are defined as two individuals (wife and husband or father and daughter) who maintain a socially significant relationship.8 The positive effects of dyadic interventions have been demonstrated in different chronic diseases. For example, family-engaged dignity therapy can increase hope, mental health, and family cohesion in people with malignant blood disorders and improve caregiver anxiety and depression.9 Family-centred empowerment programmes can improve the quality of life for people with stroke and caregiver burden.10 Psychoeducational interventions have a positive impact on the quality of life, emotional distress, and self-efficacy of cancer patients and their caregivers, and the financial cost is low.11

There are four main reasons for dyadic interventions in older people with chronic diseases. First, patients and caregivers influence each other due to chronic diseases. Thus, illness can directly or indirectly affect both patients and caregivers. Second, interventions for elderly individuals are difficult to adhere to due to age specificity, but caregiver involvement can improve the situation.12 Third, given the individual's social environment, the role of the family is crucial.13 Finally, dyadic interventions may achieve better intervention outcomes for older patients with chronic diseases.14

With the increasing number of elderly patients who have chronic diseases, we sought to understand the research progress of dyadic intervention in this population, laying the foundation for nursing practice and future research in older people with chronic diseases. In recent years, research related to dyadic interventions has become increasingly popular. The review findings will provide researchers with insights into the design and implementation of dyadic interventions and facilitate the development of dyadic research. Therefore, this study uses an integrative review research approach to explore the current state of research on dyadic interventions in older people with chronic diseases and to review how these interventions are developed and conducted.

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