Effectiveness of psychoeducational interventions among caregivers of patients with cancer: A systematic review and meta-analysis.

BACKGROUND

Many of the needs of caregivers of patients with cancer are unmet, particularly their informational and psychological needs. Psychoeducational interventions that focus on providing caregivers with information, and on meeting their emotional and psychosocial needs, may therefore be effective.

OBJECTIVE

To evaluate the effectiveness of psychoeducational interventions on the outcomes of caregivers of patients with cancer and identify characteristics of effective psychoeducational interventions.

DESIGN

A systematic review and meta-analysis of randomised controlled trials.

DATA SOURCES

The databases of PubMed, Embase, the Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature Complete, the British Nursing Index, PsycINFO, Ovid Emcare, Scopus, Chinese Journal Net, and Wan Fang Data were searched in December 2020. Clinical trial registers, related websites and reference lists of included studies were also examined.

REVIEW METHODS

The Cochrane Risk of Bias Tool was used to appraise the quality of included studies. Meta-analysis was conducted, and narrative syntheses were performed where meta-analysis was inappropriate.

RESULTS

Fourteen articles describing 12 studies were included. The results of the meta-analysis showed that psychoeducational interventions have short-term (immediately post-intervention) positive effects on relieving anxiety [SMD: -0.50, 95%CI: (-0.97, -0.02), p = 0.04], depression [SMD: -0.54, 95%CI: (-0.76, -0.32), p < 0.00001] and caregiver burden [SMD: -0.57, 95%CI: (-0.87, -0.27), p = 0.0002] and improving their quality of life [SMD: 0.42, 95%CI: (0.23, 0.62), p < 0.0001) and self-efficacy [SMD: 0.31, 95%CI: (0.09, 0.53), p = 0.006] in the caregivers of patients with cancer. They also showed long-term (at least 3 months post-intervention) positive effects on improving physical health [SMD: 0.26, 95%CI: (0.05, 0.47), p = 0.02]. The types of psychoeducational interventions varied in the 12 studies. However, the main contents of effective psychoeducational interventions included tasks related to health care provisions for patients, caregiver self-care and stress management, and relationship and coping skills. In general, most studies had short follow-up periods and involved caregivers of older patients with cancer (>40 years old).

CONCLUSIONS

Psychoeducational interventions may have short-term desirable effects on caregivers' anxiety, depression, quality of life, burden and self-efficacy and long-term desirable effects on physical health. Individual psychoeducational intervention varied in contents, delivery mode, dosage and format. Research is needed to further specify the optimal combination of contents. Further high-quality RCTs are warranted, with longer follow-up periods, for caregivers of patients with cancer, especially caregivers of younger patients with cancer.