"Should WE Stand Together?": A systematic review and meta-analysis of the effectiveness of family-based interventions for adults with chronic physical diseases.

Abstract

Family support has been identified as an important factor for the psychological adjustment of patients with chronic physical conditions. This study aimed to systematically review and conduct a meta-analysis of studies comparing the effectiveness of family-based versus patient-oriented interventions for chronic physical conditions. The search was performed between April 12 and April 29, 2021, on Web of Science (all databases included), Scopus, PsycINFO, and CENTRAL. Thirteen RCTs were included. The results favored family-based interventions for various patient outcomes related to pain, distress, self-efficacy, social and emotional function, coping, the welfare of the domestic environment, capacity to mobilize social support, and sexual relationships with medium to large effect sizes (Cohen's d range: 0.45-0.90). This type of intervention also decreased family members' anxiety, depression, sleep problems, and distress, improving search and presence of meaning in life, social support, the support provided to the patient, and sexual relationships with medium to very large effect sizes (Cohen's d range: 0.58-2.76). The meta-analytical findings suggested that the patients' (k=12, d=0.34; 95% CI=0.13-0.55, I2 =74%, p<0.01) and family members' (k=4, d=0.68; 95% CI=0.08-1.27, I2 =88%, p<0.01) psychosocial outcomes significantly improved with family-based interventions compared with patient-oriented interventions. The meta-analysis of patients' self-efficacy showed a medium-size effect (d=0.64; k=3; I2 =19%). The results suggest a trend toward the beneficial effects of family-based interventions, but more research is needed with higher quality RCTs to confirm this hypothesis.