General practice based psychosocial interventions for supporting carers of people with dementia or stroke: a systematic review

Background Particularly with ageing populations, dementia and stroke and their resultant disability are worldwide concerns. Much of the support for people with these conditions comes from unpaid carers or caregivers. The carers’ role is often challenging and carers themselves may need support. General practice is often the first point of contact for people with these conditions and their carers, making it potentially an important source of support. This systematic review therefore synthesised the available evidence for the impact of supportive interventions for carers provided in general practice. Methods PRISMA guidelines were adopted and the following databases were searched: MEDLINE; EMBASE; the Cochrane Library; PsycINFO; CINAHL Plus; Applied Social Sciences Index and Abstracts and Healthcare Management Information Consortium. Results 2489 results were identified. Four studies, involving 447 carers, fitted the inclusion criteria. Three of these came from the United States of America. None investigated supportive interventions for carers of people with stroke. Primarily by the provision of information and educational materials, the interventions focussed on improving carer mental health, dementia knowledge, caregiving competence and reducing burden, difficulties and frustrations. Overall the evidence suggests that these interventions may improve carer well-being and emotional health but the impact on physical health and social variables was less clear. However, the diversity of the carer outcomes and the measures used means that the findings must be viewed with caution. Conclusions Unpaid carers pay an essential role in caring for people with stroke and dementia and the dearth of literature investigating the impact of supportive interventions for these carers of is surprising. The available evidence suggests that it may be possible to offer support for these carers in general practice but future research should consider focussing on the same outcome measures in order to allow comparisons across interventions

The measurement of empathy in a clinical and a non-clinical setting: does empathy increase with clinical experience?

Empathy is a process which encompasses a person's attempt to understand another person and then to demonstrate this understanding by means of appropriate non-verbal and verbal responses. It requires self-awareness and the characteristics of an effective helping relationship, both of which are important in physiotherapy. The purpose of this research is to measure empathy in a clinical setting and a non-clinical setting using the Barrett-Lennard Relationship Inventory and the Truax Accurate Empathy Scale. These measurements were used to investigate first the relationship between years of education and experience with empathetic levels in students and qualified physiotherapists in a non-clinical setting, and secondly to compare the empathetic levels of senior and junior physiotherapists in a clinical setting. The results in the first study indicated that qualified physiotherapists were more empathetic than students (using the TAES) showing that empathy increases with education and clinical experience. This however was confounded in the second study in which the junior physiotherapists were found to be more empathetic than the senior physiotherapists in their first sessions with new patients