The effectiveness of psychoeducational interventions on caregiver-oriented outcomes in caregivers of adult cancer patients: A systematic review and meta-analysis.

Abstract

Cancer caregiving can result in increased psychosocial distress and poor health-related quality of life (QOL). Psychoeducation has been shown to be effective in enhancing caregiving-oriented outcomes. A systematic assessment of the overall effect of psychoeducational intervention (PEI) and identification of individual intervention characteristics that may contribute to the effectiveness of PEI is needed. For this meta-analysis, relevant articles were identified through electronic databases using key search terms and their medical subject heading such as "family caregiver," "cancer," and "psychoeducational intervention." Twenty-eight controlled trials with 3876 participants were included. PEIs had beneficial effect on depression (Standardized Mean Difference [SMD] -0.26; 95% CI=-0.50 to -0.01, p<0.04), anxiety (SMD -0.41; 95% CI=-0.82 to 0.01, p<0.05), caregiver burden (SMD -0.84; 95% CI=-1.22 to -0.46, p<0.0001) and QOL (SMD 0.59, 95% CI 0.24-0.93; p<0.0009) at the immediate post-intervention period. At longer-term follow-up, the effectiveness of PEI was maintained on QOL (SMD 0.39, 95% CI=-0.00 to -0.77, p<0.05), and anxiety (SMD -0.57; 95% CI=-1.09 to -0.06, p<0.03). Moderation analysis showed that intervention characteristics such as studies conducted in high-income countries, group intervention and studies that focused on specific and mixed cancers explain some of the high variations observed among the included studies. PEI may benefit caregivers of cancer patients through the significant effects on caregiver burden, QOL, anxiety, and depression. The findings from the moderation analysis may be important for the design of future interventions.