Evidence map›Paper›PMID 29358414›Full record

SynthesisBMJ open2018

Quality of family relationships and outcomes of dementia: a systematic review.

Hannah B Edwards, Sharea Ijaz, Penny F Whiting, Verity Leach, Alison Richards, Sarah J Cullum, Richard Il Cheston, Jelena Savović

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Hannah B EdwardsBristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0002-1885-4771
Sharea IjazBristol Medical School, University of Bristol, Bristol, UK.
Penny F WhitingBristol Medical School, University of Bristol, Bristol, UK.
Verity LeachBristol Medical School, University of Bristol, Bristol, UK.
Alison RichardsBristol Medical School, University of Bristol, Bristol, UK.
Sarah J CullumPsychological Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Richard Il ChestonDepartment of Health and Social Sciences, University of the West of England, Bristol, UK.
Jelena SavovićBristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0002-2861-0578

Funding

Medical Research Council MR/K025643/1
6 · The paper itself

Abstract

objectivesTo evaluate the association between the quality of relationship between a person with dementia and their family carer and outcomes for the person with dementia.

designSystematic review. ELIGIBILITY CRITERIA: Cohort studies of people with clinically diagnosed dementia and their main carers. Exposures of interest were any elements of relationship quality, for example, attachment style, expressed emotion and coping style. Our primary outcome was institutionalisation, and secondary outcomes were hospitalisation, death, quality of life and behavioural and psychiatric symptoms of dementia ('challenging behaviour'). DATA SOURCES: MEDLINE, Embase, Web of Science, PsycInfo, the Cochrane Library and Opengrey were searched from inception to May 2017. STUDY APPRAISAL AND SYNTHESIS

methodsThe Newcastle-Ottawa Scale was used to assess risk of bias. A narrative synthesis of results was performed due to differences between studies.

resultsTwenty studies were included. None of the studies controlled for all prespecified confounding factors (age, gender, socioeconomic status and severity of dementia). Reporting of results was inadequate with many studies simply reporting whether associations were 'statistically significant' without providing effect size estimates or CIs. There was a suggestion of an association between relationship factors and global challenging behaviour. All studies evaluating global challenging behaviour provided statistical evidence of an association (most P values below 0.02). There was no consistent evidence for an association for any other outcome assessed.

conclusionsThere is currently no strong or consistent evidence on the effects of relationship factors on institutionalisation, hospitalisation, death or quality of life for people with dementia. There was a suggestion of an association between relationship factors and challenging behaviour, although the evidence for this was weak. To improve our ability to support those with dementia and their families, further robust studies are needed. PROSPERO REGISTRATION NUMBER: CRD42015020518.

Indexed as

Family RelationsQuality of LifeAdaptation, PsychologicalCaregiversDementiaHospitalizationHumansRisk Factorscarerschallenging behaviourdementiafamily relationshipsinstitutionalisation

Identifiers

PMID29358414
PMCPMC5780722

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.