European Journal of Cardiovascular Medicine

Dementia, a progressive cognitive syndrome, poses severe challenges for both patients and their caregivers, marked by a decline in memory, function, and cognitive capacity that disrupts daily life and autonomy. The global increase in dementia prevalence, particularly with an aging population, underscores a critical need for effective educational interventions that empower caregivers and enhance patient outcomes. Caregivers for dementia patients are often informal, comprising family members and relatives who shoulder significant physical, mental, social, and economic burdens.

Despite their vital role, caregivers frequently lack adequate training or resources to handle the multifaceted demands of dementia care. This knowledge gap reinforces stress and can lower care quality. Photobook-based educational interventions offer a promising approach for bridging this gap by combining visual and textual instruction in an accessible format tailored to routine caregiving tasks.

Objectives

• Develop a photobook to enhance dementia caregiving skills.
• Assess baseline knowledge of caregivers regarding dementia care.
• Demonstrate the photobook to caregivers.
• Evaluate the photobook’s effectiveness in improving caregiver knowledge.
• Examine correlations between knowledge improvement and demographic variables

A non-randomized quasi-experimental study design was utilized, comprising 60 caregivers—30 assigned to the experimental group (photobook intervention) and 30 to the control group (no intervention). The sampling method was purposive, focusing on caregivers actively involved in dementia care within Pataudi, Gurugram.

Knowledge assessments were conducted using a structured questionnaire both pre- and post-intervention. Main variables included the caregivers’ knowledge scores, age, gender, education, occupation, income, care frequency, and relationship to the patient. Data collection spanned two weeks, and statistical analysis involved descriptive measures, paired t-tests, and chi-square tests.

Ethical clearance was attained, and informed consent was collected from all participants

Socio-demographic Characteristics

Among the experimental group, the majority of caregivers were male (60%), while the control group predominantly included females (63%). Most caregivers were aged 31–40 or 41–50 in both groups, with high school education levels and roles as shopkeepers or farmers being most common.

• Experimental: Male 18, Female 12; Age 31–40: 15, 41–50: 9, 51+: 5
• Control: Male 11, Female 19; Age 31–40: 11, 41–50: 13, 51+: 6

Bar graphs showing knowledge scores (pre-test, post-test) and socio-demographic distributions of caregivers

Pre-test and Post-test Knowledge Scores

Prior to intervention, the majority in both groups had inadequate knowledge. Post-intervention, the experimental group showed a dramatic improvement:

• Experimental Pre-test: Inadequate 19, Moderate 11, Adequate 0
• Control Pre-test: Inadequate 14, Moderate 16, Adequate 0
• Experimental Post-test: Inadequate 6, Moderate 22, Adequate 2
• Control Post-test: Inadequate 15, Moderate 15, Adequate 0

Statistical analysis revealed a significant increase in mean knowledge score in the experimental group (pre-test mean 7.6, post-test mean 13.2, t=10.5, p<0.001). Changes in the control group were not significant. No significant association was observed between demographic variables and knowledge improvement.

Graphical Interpretation

As illustrated in the bar graphs above, post-test scores in the experimental group shifted markedly from the “inadequate” to “moderate” and “adequate” categories, underscoring the photobook's educational impact

Findings corroborate that photobook interventions can significantly improve caregivers’ knowledge concerning dementia care. These results align with Hernandez et al. (2020), who highlighted statistically significant knowledge gains through photobook-based education. The lack of significant demographic influence suggests such interventions are broadly applicable, regardless of caregivers’ backgrounds.

Caregivers in the experimental group demonstrated heightened competency in communication strategies, daily living management for dementia patients, and coping with behavioural challenges. This enhancement may lead to improved patient outcomes and lowered caregiver stress.

Furthermore, the absence of a significant knowledge gain in the control group implies that passive caregiving experience is insufficient for developing advanced dementia care skills.

Implications for Practice, Education, and Policy

The study suggests practical integration of visual aids and structured materials, like photobooks, in routine caregiver training programs. Nursing education curricula can be enriched by incorporating photobook-based modules, fostering empathetic, hands-on learning for both healthcare providers and family caregivers.

Policymakers should consider developing, validating, and distributing such resources as part of national dementia support initiatives, especially in contexts where formal training infrastructure is lacking. Investment in easily comprehensible, community-based knowledge tools can help mitigate caregiver burden, reduce stigma, and improve support networks.

Limitations

The study’s relatively small sample size and restriction to one urban Indian locality may limit generalizability. Short follow-up duration precluded analysis of long-term effects. Future research should incorporate larger, more diverse populations and longitudinal assessment to ascertain retention of skills and sustained benefit.

Recommendations

• Conduct similar studies in varied geographic, linguistic, and socio-economic settings.
• Explore the impact of different delivery formats (digital, video-integrated photobooks).
• Include longitudinal follow-up to track persistence of knowledge gains and behavioral change.
• Examine the effect on care recipients’ outcomes (well-being, symptoms, hospitalization rates).
• Encourage integration of photobooks into established health and community support agencies.

This study establishes the effectiveness of photobook-based education in enhancing caregiving skills among dementia caregivers in urban India. The photobook intervention facilitated significant knowledge improvements, with demonstrable impact on participants’ ability to address daily care challenges. Scaling up such interventions can be a cost-effective means of strengthening dementia care capacities in resource-limited settings.

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