Skip to main content

Effectiveness of Support Programmes for (in)Formal Caregivers of Older Dependent People to Design Technologies

  • Conference paper
  • First Online:
Human Aspects of IT for the Aged Population (HCII 2023)


The growing number of older dependent population in Spain has incremented the demand for programmes and services aimed to provide support to (in)formal caregivers. Current legislation does not provide clear standardized practices for the results evaluation of such programmes which can constitute a guideline for public or private organizations, including NGOs. One strategy to successfully cope with this situation is the implementation of self-administrated questionnaires as an essential part of a cycle of continuous improvement of programmes and services. This paper is based on results from survey data collected from a sample of managers of programmes, suggests that entities using self-administrated questionnaires can, indeed, improve the effectiveness of their programmes significantly. The result of this study could contribute to the design and develop devices and software to improve care of older people and provide caregivers complementary assistance, especially, for older women.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions


  1. 1.


  2. 2.

    See more information and detailed description about the project here:

  3. 3.


  4. 4.


  5. 5.

  6. 6.

    For more information, see


  1. Agulló-Tomás, M.S.: Mujeres, cuidados y bienestar social: el apoyo informal a la infancia ya la vejez: Instituto de la Mujer (2002).

  2. Agulló-Tomás, M.S., Zorrilla-Muñoz, V., Gómez-García, M.V.: Género y evaluación de programas de apoyo para cuidadoras/es de mayores. Prisma Social: revista de investigación social (21), 391–415 (2018).

  3. Agulló-Tomás, M.S., Zorrilla-Muñoz, V., Gómez-García, M.V.: Aproximación socio-espacial al envejecimiento y a los programas para cuidadoras/es mayores. Int. J. Dev. Educ. Psychol. 1(1), 221–228 (2019)

    Google Scholar 

  4. Alwin, J., Öberg, B., Krevers, B.: Support/services among family caregivers of persons with dementia—perceived importance and services received. Int. J. Geriatr. Psychiatry 25(3), 240–248 (2010).

    Article  Google Scholar 

  5. Bañón, R., Caballero, V., Sánchez Medero, G.L: Evaluación de la acción y de las políticas públicas. Una visión desde la bibliografía. La Evaluación de la Acción y de las Políticas Públicas, compilado por Rafael Bañón i Martínez, Ediciones Díaz de Santos SA, Madrid, pp. 215–250 (2003)

    Google Scholar 

  6. Baraybar, F.A.: El Cuadro de Mando Integral «Balanced Scorecard»: ESIC Editorial (2011)

    Google Scholar 

  7. Bień, B., et al.: Disabled older people’s use of health and social care services and their unmet care needs in six European countries. Eur. J. Pub. Health 23(6), 1032–1038 (2013).

    Article  Google Scholar 

  8. Bustelo, M.: La evaluación y los planes de igualdad en el estado español. Cómo evaluar las políticas públicas desde la perspectiva de género, 127–152 (2003)

    Google Scholar 

  9. Campbell, S.M., Roland, M.O., Buetow, S.A.: Defining quality of care. Soc. Sci. Med. 51(11), 1611–1625 (2000).

    Article  Google Scholar 

  10. Catalan, J.M., Blanco, A., Bertomeu-Motos, A., Garcia-Perez, J.V., Almonacid, M., Puerto, R., Garcia-Aracil, N.: A modular mobile robotic platform to assist people with different degrees of disability. Appl. Sci. 11(15), 7130 (2021).

  11. Chiatti, C., Di Rosa, M., Melchiorre, M.G., Manzoli, L., Rimland, J., Lamura, G.: Migrant care workers as protective factor against caregiver burden: results from a longitudinal analysis of the EUROFAMCARE study in Italy. Ageing Ment. Health 17(5), 609–614 (2013).

    Article  Google Scholar 

  12. Chow, C.W., Ganulin, D., Haddad, K., Williamson, J.: The balanced scorecard: a potent tool for energizing and focusing healthcare organization management. J. Healthc. Manag. 43(3), 263–280 (1998).

    Article  Google Scholar 

  13. Collins, K.S., Hughes, D.L., Doty, M.M., Ives, B.L., Edwards, J.N., Tenney, K.: Diverse Communities, Common Concerns: Assessing Health Care Quality for Minority Americans. Commonwealth Fund, New York (2002)

    Google Scholar 

  14. Crespo López, M., López Martínez, J.: El apoyo a los cuidadores de familiares mayores dependientes en el hogar: desarrollo del programa “Cómo mantener su bienestar”: Imserso (2007)

    Google Scholar 

  15. Di Rosa, M., et al.: A typology of caregiving situations and service use in family carers of older people in six European countries: the EUROFAMCARE study. GeroPsych: J. Gerontopsychol. Geriatr. Psychiatry 24(1), 5 (2011).

  16. Epting, F.R., Suchman, D.I., Nickeson, C.J.: An evaluation of elicitation procedures for personal constructs. Br. J. Psychol. 62(4), 513–517 (1971).

    Article  Google Scholar 

  17. Espín Andrade, A.M.: Estrategia para la intervención psicoeducativa en cuidadores informales de adultos mayores con demencia. Cuidad de la Habana 2009 (2003)

    Google Scholar 

  18. EC. The Ageing Report. Economic and budgetary projection for the 27 EU Member States (2010–2060). Brussels (2012)

    Google Scholar 

  19. Gandoy Crego, M., et al.: Evaluación y resultados de la instauración de un programa de terapia de grupo dirigido a un colectivo de cuidadores familiares de enfermos de Alzheimer (1999)

    Google Scholar 

  20. Giacinto, G.: Caring for older europeans: comparative studies in 29 countries. Aldershot: Arena (1996)

    Google Scholar 

  21. Hodgson, C, Higginson, I., Jefferys, P.: Carers’ Checklist. An outcome measure for people with dementia and their carers. The Mental Health Foundation, London (1998)

    Google Scholar 

  22. Huenchuan, S., Roqué, M., Arias, C.: Envejecimiento y sistemas de cuidado:¿ oportunidad o crisis. Santiago de Chile: Naciones Unidas (2009)

    Google Scholar 

  23. Inamdar, N., Kaplan, R., Bower, M.: Applying the balanced scorecard in healthcare provider organizations. J. Healthc. Manage./Am. Coll. Healthc. Executives 47(3), 179–195 (2001). Discussion 195–176.

  24. IMSERSO: Redes y Programas Europeos de Investigación V PROGRAMA MARCO DE LA UE (1998–2002). Boletín sobre el envejecimiento, 19 & 19 (2005)

    Google Scholar 

  25. Jin, K., Simpkins, J.W., Ji, X., Leis, M., Stambler, I.: The critical need to promote research of ageing and ageing-related diseases to improve health and longevity of the elderly population. Ageing Dis. 6(1), 1 (2015).

  26. Keefe, J., Guberman, N., Fancey, P., Barylak, L., Nahmiash, D.: Caregivers’ aspirations, realities, and expectations: The care tool. J. Appl. Gerontol. 27(3), 286–308 (2008).

    Article  Google Scholar 

  27. Krevers, B., Öberg, B.: Support/services and family carers of persons with stroke impairment: perceived importance and services received. J. Rehabil. Med. 43(3), 204–209 (2011).

    Article  Google Scholar 

  28. Lam Díaz, R. M., Hernández Ramírez, P.: Los términos: eficiencia, eficacia y efectividad¿ son sinónimos en el área de la salud?. Revista Cubana de Hematología, Inmunología y Hemoterapia 24(2) (2008).

  29. Lamura, G., et al.: Group, EUROFAMCARE 2008 Family carers’ experiences using support services in Europe: empirical evidence from the EUROFAMCARE study. Gerontologist 48(6), 752–771 (2008).

    Article  Google Scholar 

  30. Lamura, G., et al.: Erfahrungen von pflegenden Angehörigen älterer Menschen in Europa bei der Inanspruchnahme von Unterstützungsleistungen. Z. Gerontol. Geriatr. 39(6), 429–442 (2006).

    Article  Google Scholar 

  31. Leadley, R.M., Armstrong, N., Reid, K.J., Allen, A., Misso, K.V., Kleijnen, J.: Healthy ageing in relation to chronic pain and quality of life in Europe. Pain Pract. 14(6), 547–558 (2014).

    Article  Google Scholar 

  32. Lette, M., Ambugo, E.A., Hagen, T.P., Nijpels, G., Baan, C.A., y De Bruin, S. R.: Addressing safety risks in integrated care programs for older people living at home: a scoping review. BMC Geriatr. 20(1), 1–13 (2020)

    Article  Google Scholar 

  33. Lüdecke, D., Mnich, E., Kofahl, C.: The impact of sociodemographic factors on the utilisation of support services for family caregivers of elderly dependents–results from the German sample of the EUROFAMCARE study. GMS Psycho-Soc.-Med. 9 (2012)

    Google Scholar 

  34. Medina, M.E., et al.: Evaluación del impacto en cuidadores de usuarios del Servicio de Ayuda a Domicilio. Anales de Psicología 14, 105–126 (1998)

    Google Scholar 

  35. Executive, N.H.S.: Developing NHS Purchasing and GP Fundholding: Towards a Primary Care-led NHS. Department of Health, Heywood (1994)

    Google Scholar 

  36. Patton, M.Q.: Utilization-focused evaluation. In: Kellaghan, T., Stufflebeam, D.L. (eds.) International Handbook of Educational Evaluation, Kluwer International Handbooks of Education, vol. 9, pp. 223–242. Springer, Dordrecht (2003).

    Chapter  Google Scholar 

  37. Ayala, A., et al.: Influence of active and healthy ageing on quality of life changes: insights from the comparison of three european countries. Int. J. Environ. Res. Public Health 18(8), 4152 (2021).

  38. Rossi, P.H., Freeman, H.E., Hofmann, G.: Programm-Evaluation: Einführung in die Methoden angewandter Sozialforschung: Enke (1988).

    Google Scholar 

  39. Sixsmith, J., et al.: Healthy ageing and home: The perspectives of very old people in five European countries. Soc. Sci. Med. 106, 1–9 (2014).

    Article  Google Scholar 

  40. Stoltz, P., Uden, G., Willman, A.: Support for family carers who care for an elderly person at home–a systematic literature review. Scand. J. Caring Sci. 18(2), 111–119 (2004).

    Article  Google Scholar 

  41. Stein, C., Sadana, R.: The world health organization – the case for measuring wellbeing in Europe. In: Glatzer, W., Camfield, L., Møller, V., Rojas, M. (eds.) Global Handbook of Quality of Life, International Handbooks of Quality-of-Life, pp. 763–769. Springer, Dordrecht (2015).

    Chapter  Google Scholar 

  42. Steptoe, A., Deaton, A., Stone, A.A.: Subjective wellbeing, health, and ageing. Lancet 385(9968), 640–648 (2015)

    Article  Google Scholar 

  43. Stufflebeam, D.L.: The CIPP model for evaluation. In: Kellaghan, T., Stufflebeam, D.L. (eds.) International Handbook of Educational Evaluation, Kluwer International Handbooks of Education, vol. 9, pp. 31–62. Springer, Dordrecht (2003).

    Chapter  Google Scholar 

  44. Torres Egea, M., Ballesteros Pérez, E., Sánchez Castillo, P.D.: Programas e intervenciones de apoyo a los cuidadores informales en España. Gerokomos 19(1), 9–15 (2008).

    Article  Google Scholar 

  45. Triantafillou, J., et al.: Informal care in the long-term care system. Executive Summary (2011).

  46. Triantafillou, J., et al.: Informal care in the long-term care system European Overview Paper (2010)

    Google Scholar 

  47. Val-Calvo, M., Álvarez-Sánchez, J.R., Ferrández-Vicente, J.M. Fernández, E.: Optimization of real-time EEG artifact removal and emotion estimation for human-robot interaction applications. Front. Comput. Neurosci. 13, 80 (2019).

  48. Van Mierlo, L.D., Meiland, F.J., Van der Roest, H.G., Dröes, R.M.: Personalised caregiver support: effectiveness of psychosocial interventions in subgroups of caregivers of people with dementia. Int. J. Geriatr. Psychiatry 27(1), 1–14 (2012).

    Article  Google Scholar 

  49. Woolham, J., Challis, R.: Performance indicators in social care for older people. Ageing Soc. 28(3), 437 (2008).

    Article  Google Scholar 

  50. Zorrilla-Muñoz, V. et al.: Older women images and technologies to increase gender peace in crisis and COVID-19 times. In: Gao, Q., Zhou, J. (eds.) Human Aspects of IT for the Aged Population. Technology in Everyday Living. HCII 2022. LNCS, vol 13331. Springer, Cham (2022).

Download references


The authors gratefully acknowledge the contributions of María Victoria Gómez and Alba Gil. We would like to thank our two anonymous referees and the editor of this publication for their comments and suggestions that substantially improved this contribution.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Vanessa Zorrilla-Muñoz .

Editor information

Editors and Affiliations

Ethics declarations

This research has also been supported by CM:LEDYEVA Project “Carers of the older people: the situation regarding the Dependency Act and evaluation of programs for caregivers” (funded by MINECO, “Ministry of Economy and Competitiveness”, Ref: CSO2009–10290, National R&D Plan, 2009–2013, Spain): The project was granted by Fundacion Pilares (2020) as “especial mention research”. The project was considered (2013) “Good Practice” by the Network at European level “WeDO Partnership” (For Wellbeing and Dignity of Older People) which regroups various organizations and countries linked to these issues. Also obtained (2012) the recognition of “good practice” by Fundacion Pilares.

This work is part of: ENCAGen-CM R&D Activities Program (Active Ageing, Quality of Life and Gender. Promoting a positive image of old age and aging against ageism) (Ref. H2019/HUM-5698) (Community of Madrid-FSE. PR: G. Fernandez-Mayoralas, C Rodriguez-Blázquez, MS Agulló-Tomás, MD Zamarrón, and MA Molina).

This contribution takes parts of the grant “Multimodal telerehabilitation assisted by robotic devices to maximize motor recovery” co-financed by FEDER funds, within the FEDER operational program of the Valencian Community (2014–2020) and the grant PROMETEO/2019/119 from the Generalitat Valenciana and the Bidons Egara Research Chair of the University Miguel Hernandez to Eduardo Fernandez. Moreover, this contribution has been supported by the Spanish Ministry of Science and Innovation, through the projects PID2019-108310RB-I00, TED2021-130431BI00 and PLEC2022-009424; and the AVI ( throught the project INNTA1/2022/2023 “Innovation Agent for the Bioengineering Institute for the Miguel Hernandez University of Elche”. The fieldwork for the qualitative analysis was financed by the ENVACES R&D + i project (MINECO-FEDER, ref. CSO2015–64115-R. PR: F. Rojo-Perez) and the ENCAGE-CM R&D Activities Program (Community of Madrid-FSE, ref. S2015/HUM-3367. LR: G. Fernandez-Mayoralas).



Appendix I. Comparison Item Categorized EUROFAMCARE SPQ, QRPCS and Defined Variables.

Groups of items proposed in EUROFAMCARE SPQ

Groups of items identified in QRPCS

Defined variables

Service providers to families, goals, monitoring needs / as caregivers / as family, program information

Program design: Objectives, establishment of program services, execution of the program Conditions regarding time, targets, indicators for analysis, methodology and State-guaranteed defined resources

Design variables: How has been designed the program to establish the needs of caregivers? “Internal_meetings”: Through internal meetings; “Implemented_program”: Implemented program has been applied by other entities; “Rules/opinions”: Rules/opinions of official bodies have been used; “Pre_assessment_study”: Pre-assessment study has been applied (survey, data, or other representers caregivers of groups); Goals_expressions: How have the goals been expressed in concrete and clear criteria and indicators?; “Program_schedule” Has the program a timing, schedule, planning?; “Goals_results_program:? Are still goals maintained to achieve some results ?; “Indicators_results_program”: Have been established indicators to achieve results?; “Activities_services_program”: Does the program develop activities or provide services?; “Methodology_program”: Does the program follow a clear methodology (in sequencing tasks, phases, etc.) ?; “Resources_program”: Has the program enough resources to achieve the objectives?; “Known_program”: Is the program sufficiently known?; “Updated_program”: Has been updated the program?

Items on background: the need to use the service organization by / as family caregivers

Participation design in the programs: Selected participants / -participation as caregivers / as in the design, development and evaluation of programs-, program coordination, coordination and management

Participation variables: “Participation_definition”: Is it clearly defined who will participate in the program and how?; Are caregivers involved in the program design? “Program_design_participation”: Are caregivers involved in the program design?; ““Program_design_development: Are caregivers involved in the program application and development?; “Program_design_evaluation”: Are caregivers involved in the program monitorization and evaluation?; “Interaction”: Have been coordination and participation stimulated between different actors?; “Objectives_achievement”: Do you think that the coordination and management have contributed to the achievement of objectives?; “Institutional_colaboration”: Do you think that institutional collaboration have contributed to the achievement of results?; “Benefits_overtime”: When the program has been finished: Do you consider that benefits achieved will last over time (in the medium and long term)?; “Program_viability”: Is the program viable at different levels?

Main benefits, satisfaction, development Programs in the future and improvement

Impact of programs on beneficiaries: Futures over time, continuity, benefits, recommendation and dissemination, future viability, resources, barriers, correcting problems, review, improvement and satisfaction with the programs

Impact variables: “Program_supported_external”: Is the program supported (funding, dissemination, for example) by other external entities?; “Program_known_society”: Do you think that the program is sufficiently known by society as a whole?; Do you think that caregivers have found barriers to access to programs? “Program_acc_bar_administrative”: Administrative barriers; “Program_acc_bar_economic”: Economic barriers ?; “Program_acc_bar_culture”: Culture barriers; “Program_acc_bar_geographycal”: Geographical barriers; “Program_acc_bar_temporary” Temporary barriers (i.e. They cannot leave the older person to anyone to attend the activity) ?; “Program_acc_bar_information”: Barriers due to the lack of information or knowledge of the program; “Program_framework_promotion”: Do you think that the current legal framework promotes the program to achieve its objectives?; Is the program appropriate-relevant (or appropriate to the context) from the point of view…? “Program_relevancy_institutional”: Political and institutional; “Program_relevancy_economic”: Economical; “Program_relevancy_social”: Social and cultural; “Program_changes”: Have been changes in the program context which may affect the program initially established?; “Careers_return_participation”: Do caregivers return to the entity requesting to participate in other programs?; “Careers_recommendation”: Are programs recommended by caregivers?; “Program_continuation”: Should the program continue in the future?; “Program_resources_continuation”: Are resources available to continue with the program activities?; “Detection_problems”: Are mechanisms foreseen for the detection and correction of program problems?; “Program_improve”: Do you think that the program could be improved?

Opportunities and demand for assistance / caregivers as / as, vision caregivers / as, resources and strategies for future development

Effectiveness of programs: Quality expectations and demands, achieved goals, influence of the program on / as caregivers / as, resource efficiency, utilization and resource efficiency, future achievement of objectives

Effectiveness variables: “Quality_certification”: Has the entity established a system to ensure quality in the provision of services?; “Program_coverage”: Is the program suitable to meet the expectations, demands and needs of caregivers?; “Achieved_objectives”: Have expected objectives been achieved?; Is the program influencing…? “Program_influence_employment”:… The employment situation (labour standards and/or, insertion, between others)?; “Program_influence_phys_health”:… Physical well-being and health?; “Program_influence_emotions”:… Emotional and psychological well-being?; “Program_influence_social”:… Social welfare and social relations?; “Program_impl_res_service”: Are the assigned resources enough for program implementation and service delivery?; “Program_impl_res_develop”: Are (economic, material and human) resources appropriate for program development which are used ?; Is there an optimal relationship with…? “Optimal_results_persons”:… Effort, human resources (personnel involved) ?; “ Optimal_results_time”:… Time spent ?; “Optimal_results_money”:… Invested money ?; “Efficiency_compared”: Are efficient use of resources allocated to the program compared with other possible alternative uses made? (i.e. service-program offering or giving money for it); “Assess_less_expensive”: Does the likelihood assess of achieving the same results in a less expensive more economically?

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this paper

Check for updates. Verify currency and authenticity via CrossMark

Cite this paper

Zorrilla-Muñoz, V., Veira-Ramos, A., Agulló-Tomás, M.S., Garcia-Aracil, N., Fernandez, E. (2023). Effectiveness of Support Programmes for (in)Formal Caregivers of Older Dependent People to Design Technologies. In: Gao, Q., Zhou, J. (eds) Human Aspects of IT for the Aged Population. HCII 2023. Lecture Notes in Computer Science, vol 14043. Springer, Cham.

Download citation

  • DOI:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-34916-4

  • Online ISBN: 978-3-031-34917-1

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics