Mindfulness-Based Cognitive Therapy for Family Carers of Relatives Living with Dementia Adaptation and Feasibility studies for Online Delivery in Aotearoa New Zealand

Background: The worldwide prevalence of dementia is expected to triple in the next three decades. In New Zealand, the prevalence will double over that time with massive economic implications. Services for family carers who support relatives living with dementia need to be evidence based, culturally safe and accessible to make a difference. Mindfulness-Based Cognitive Therapy (MBCT) is a potential intervention for this population due to its robust evidence base in depressive disorder and cost-effective group delivery mode which can be potentially scalable to meet the public health need. Aims: 1. To systematically review the literature on MBCT-related stress reduction in the family carer population. 2. To adapt the MBCT protocol for delivery to family carers of relatives living with dementia including cultural adaptations for Māori and Pacific carers, and online delivery during the COVID-19 pandemic. 3. To examine the feasibility of the adapted MBCT protocol for stress reduction in the family carers population in New Zealand. Methods: 1. A systematic review was conducted following PRISMA guidelines. 2. An adaptation phase involved four stages: consultation, co-creation, reconciliation and pivot. 3. An intervention study was delivered involving pre-post quantitative measures and assessment of feasibility, 4. A qualitative focus group and in-depth qualitative interviews were analysed using a reflexive thematic analysis. Findings: 1. The systematic review showed that MBCT was a potentially effective intervention for this population but no consultation with carers as end-users had been undertaken in the design of the adapted protocols. 2. An adapted MBCT protocol was created incorporating Māori and Pacific values, as well as for online delivery. 3. The adapted online MBCT protocol resulted in significant improvements in all outcome measures (stress, anxiety, burden, wellbeing, self-compassion and trait mindfulness). It was feasible and acceptable to the population. The primary outcome measure, the Perceived Stress Score showed a significant reduction (T0 = 19.2, T1 = 13.9, p = 0.007). 4. Qualitative analysis suggested a journeying metaphor with three themes (“The perfect storm”, “The life raft of MBCT” and “Steadying the course”). Conclusions: The adapted online MBCT protocol was well-received and attended, with positive outcomes for carer stress, anxiety, burden and well-being.

Name thesis:degree_name

PhD

Level thesis:degree_level

Doctoral

Discipline thesis:degree_discipline

Medicine

Grantor dc:publisher

ResearchSpace@Auckland

Year dc:date.issued

2024

Author dc:creator

• Chacko, Emme

Advisors dc:contributor.advisor

• Cheung, Gary
• Sundram, Frederick
• Cullum, Sarah

• carer
• dementia
• mindfulness
• cognitive therapy
• mindfulness-based cognitive therapy

Statement dc:rights

• Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Licence dc:rights.uri

• https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm

Handle dc:identifier.uri

https://hdl.handle.net/2292/73800

OAI identifier oai:identifier

oai:researchspace.auckland.ac.nz:2292/73800