ประสิทธิผลของการบำบัดทางจิตสังคมโดยใช้อินเทอร์เน็ตเป็นฐานต่อความทุกข์ทางใจ ภาระการดูแล การแสดงออกทางอารมณ์ และความรู้เกี่ยวกับโรคจิต ในผู้ดูแลในครอบครัวของผู้ที่เป็นโรคจิตเภท: การทบทวนอย่างเป็นระบบ

Abstract

Family caregivers of individuals with schizophrenia are at increased risk of developing mental disorders. Internet-based interventions with caregivers of persons with schizophrenia could be an effectively feasible option for promoting well-being and quality of life among caregivers of persons with schizophrenia. The aim of this systematic review is to evaluate the effectiveness of internet-based psychosocial interventions. Randomized controlled trial or quasi-experimental research which investigated the family caregivers of individuals diagnosed with schizophrenia receiving internet-based psychosocial interventions published either in Thai or English language between 2010 and 2022 were considered for inclusion in this review. The JBI systematic review approach was used. The results revealed that four studies met the inclusion criteria and critical appraisal. However, the narrative synthesis was used because of the heterogeneity of the study. The narrative synthesis indicated that internet-based psychosocial interventions among family caregivers of persons with schizophrenia could be classified into three categories including problem-solving-based self-learning; passive psychoeducation; and active psychoeducation. Internet-based psychosocial interventions which was smartphone-based caregiver-facilitated problem-solving based self-learning with group sessions was effective in decreasing the caregiving burden, and passive psychoeducation videos without interactive elements were shown to significantly decrease expressed emotion. GRADE approach was used to evaluate the certainty of the evidence by outcomes of the studies. We found that caregivers’ psychological distress, caregiving burden, and knowledge about the psychosis of the family caregivers of persons with schizophrenia were moderate certainty due to methodological limitations and risk of bias. On the other hand, caregivers’ expressed emotion was of low certainty due to the risk of bias and inconsistency. In addition, the secondary outcome of the study included hospitalization of persons with schizophrenia was moderate certainty due to methodological limitations and risk of bias. This systematic review found that internet-based psychosocial interventions in family caregivers of persons with schizophrenia could primarily improve caregivers’ psychological distress, caregiving burden, and knowledge about the psychosis. However, to utilize this intervention, the context of family caregivers of persons with schizophrenia and health care settings needs to be carefully considerate. The robust RCT are required to carry out with the development of interventions and outcome parameter that are standardized for the population. The data will be adequate for combining with meta-analysis to further evaluate their effectiveness.