Group mindfulness-based cognitive therapy associated with reduced professional caregiver burden and improved quality of care in dementia: a multi-method study.

PURPOSE: To evaluate the association between an 8-week group Mindfulness-Based Cognitive Therapy (MBCT) program and changes in professional dementia caregiver burden, perceived stress, and patient neuropsychiatric symptoms. METHODS: This retrospective multi-method study included 94 professional dementia caregivers at a psychiatric hospital in China (intervention: n = 48; control: n = 46). The intervention group participated in an 8-week group MBCT program, while the control group received routine education. Caregiver burden (Neuropsychiatric Inventory Caregiver Distress Scale [NPI-D]), perceived stress (Perceived Stress Scale-10 [PSS-10]), and patient symptoms (Brief Psychiatric Rating Scale [BPRS], Behavioral Pathology in Alzheimer's Disease Rating Scale [BEHAVE-AD], Neuropsychiatric Inventory [NPI]) were assessed at baseline and five follow-up points over 20 weeks. Semi-structured interviews with 18 intervention participants explored perceived intervention mechanisms. Quantitative data were analyzed using repeated measures ANOVA; qualitative data were analyzed using reflexive thematic analysis. RESULTS: The intervention group demonstrated significantly greater reductions in caregiver burden (NPI-D: from 32.15 ± 8.53 to 19.90 ± 5.71) and perceived stress (PSS-10: from 23.83 ± 4.23 to 16.82 ± 3.94) compared to the control group from week 8 through week 20 (all p < 0.001). Significant group × time interactions were observed for BPRS (F = 2.682, p = 0.021), BEHAVE-AD (F = 2.747, p = 0.018), and NPI severity (F = 2.353, p = 0.040), with patient improvements emerging at week 12, independent of antipsychotic medication adjustments. Correlation analysis revealed positive associations between caregiver burden reduction and patient symptom improvement (r = 0.36-0.44, all p < 0.001). Qualitative findings identified five themes: development of mindful awareness, cognitive reappraisal of patient behaviors, cultivation of self-compassion, value of group support, and barriers and facilitators to sustained practice. CONCLUSION: The 8-week group MBCT program was associated with sustained reductions in caregiver burden and perceived stress, accompanied by improvements in patient neuropsychiatric symptoms among professional dementia caregivers. The group format provided additional perceived benefits through peer support and experience normalization. These findings support further investigation of group-based mindfulness interventions within professional dementia care settings using randomized controlled designs.