Telephone-based Intervention Improves Quality of Life Among Family Caregivers of Persons with Dementia in Malaysia: The Mediating Role of Caregiver Burden

Background Family caregivers (FCs) of persons with dementia (PWD) are increasingly affected by mental and physical health which leads to poor quality of life (QoL). Telephone-based interventions offer flexible solution to support caregivers of PWD but the effectiveness needs further evaluation. This study aimed to assess the effectiveness of a telephone-based intervention in improving QoL among FCs of PWD and to examine the role of caregiver burden as a mediating factor. Methods A randomised controlled trial was conducted involving 121 FCs, divided into intervention (n = 60) and control (n = 61) groups. The intervention group received a 10-week intervention by the healthcare professionals via telephone. Quality of Life were measured using the validated Malay version of Control, Autonomy, Self-Realization and Pleasure (CASP-19) at baseline (T0) and endline (T1). The mean differences of FCs’ QoL between intervention and control groups, and within baseline (T0) and endline (T1) were analyse using mixed-ANOVA. Intention-to-treat (ITT) analysis was performed to determine the independent effect of the intervention on QoL, and mediation analysis was conducted using the multiple linear regressions. Results Participants in the intervention group showed a statistically significant improvement in QoL (β = 5.00, 95% CI 2.21–7.78, p = 0.001). Mediation analysis revealed that caregiver burden mediated the relationship between the telephone-based intervention and QoL. Additionally, reduction of caregiver burden was observed to mediate the relationship between telephone-based intervention and reduced anxiety symptoms. Conclusion Telephone-based intervention shows promising results in improving the QoL among FCs of PWD. Significant mediation effect suggests the importance of targeting FC’s caregiver burden for optimal intervention effectiveness. Trial registration: ISRCTN14565552 (retrospectively registered), registered on 23 September 2023 (https://www.isrctn.com/ISRCTN14565552)