Effectiveness of psychosocial interventions on the burden and quality of life of informal caregivers of hemodialysis patients: a systematic review

Abstract

Purpose To systematically review the effectiveness of psychosocial interventions developed for informal caregivers of hemodialysis patients. Methods Relevant studies were identified through five electronic databases: PubMed, Scopus, Web of Science, ProQuest, and the CENTRAL. Randomized controlled trials (RCTs) and quasi-experimental studies describing interventions for informal caregivers of adult in-center hemodialysis patients (≥18 years old) were included and independently appraised by two reviewers using the Joanna Briggs Institute Statistics Assessment and Review Instruments critical appraisal checklists. Results Eleven articles evaluating eight intervention programs were included in this review, covering a total of 729 informal caregivers. Most studies implemented educational or psycho-educational interventions (n = 6). Psycho-educational interventions designed to promote caregivers’ ability to care and to cope with the caregiving role had positive effects on burden and/or quality of life. Psychological interventions also had large effects on reducing the burden over time. Conclusions There are still few interventions available to caregivers of hemodialysis patients. Psychosocial interventions showed great potential in improving the caregiver burden and quality of life. Further research with rigorous designs is needed to achieve stronger evidence on the extent of the current findings. Trial registration number CRD42021247916. Implications for rehabilitation Patients with end-stage renal disease (ESRD) undergoing in-center hemodialysis often require emotional and/or practical support from family members or friends. Research has consistently shown that informal caregivers of hemodialysis patients may experience significant burden and a negative impact on their quality of life as a result of their caregiving role during the disease trajectory. This review evidenced that intervention programs involving education and psychological strategies had large positive effects on reducing caregiver burden and improving quality of life. The findings provide valuable evidence to recommend the inclusion of psychosocial programs to family caregivers as part of comprehensive renal care.