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Cited by 145Nursing care and researchCancer survivorship and careFamily Caregiving in Mental Illness

Psychosocial interventions for informal caregivers of people living with cancer

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Treanor, Charlene J, Santin, Olinda, Prue, Gillian, Coleman, Helen, Cardwell, Chris R, O'Halloran, Peter, Donnelly, Michael·2019·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd009912.pub2PMC PMC6573123
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Abstract

BACKGROUND: Increasingly, cancer is recognised as a chronic condition with a growing population of informal caregivers providing care for cancer patients. Informal caregiving can negatively affect the health and well-being of caregivers. We need a synthesised account of best evidence to aid decision-making about effective ways to support caregivers for individuals 'living with cancer'. OBJECTIVES: To assess the effectiveness of psychosocial interventions designed to improve the quality of life (QoL), physical health and well-being of informal caregivers of people living with cancer compared with usual care. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, PsycINFO, ProQuest, Open SIGLE, Web of Science from inception up to January 2018, trial registries and citation lists of included studies. SELECTION CRITERIA: We included randomised and quasi-randomised controlled trials comparing psychosocial interventions delivered to adult informal caregivers of adults affected by cancer on a group or individual basis with usual care. Psychosocial interventions included non-pharmacological interventions that involved an interpersonal relationship between caregivers and healthcare professionals. We included interventions delivered also to caregiver-patient dyads. Interventions delivered to caregivers of individuals receiving palliative or inpatient care were excluded. Our primary outcome was caregiver QoL. Secondary outcomes included patient QoL, caregiver and patient depression, anxiety, psychological distress, physical health status and intervention satisfaction and adverse effects. DATA COLLECTION AND ANALYSIS: Pairs of review authors independently screened studies for eligibility, extracted data and conducted 'Risk of bias' assessments. We synthesised findings using meta-analysis, where possible, and reported remaining results in a narrative synthesis. MAIN RESULTS: Nineteen trials (n = 3, 725) were included in the review. All trials were reported in English and were undertaken in high-income countries. Trials targeted caregivers of patients affected by a number of cancers spanning newly diagnosed patients, patients awaiting treatment, patients who were being treated currently and individuals post-treatment. Most trials delivered interventions to caregiver-patient dyads (predominantly spousal dyads) and there was variation in intervention delivery to groups or individual participants. There was much heterogeneity across interventions though the majority were defined as psycho-educational. All trials were rated as being at 'high risk of bias'.Compared to usual care, psychosocial interventions may improve slightly caregiver QoL immediately post intervention (standardised mean difference (SMD) 0.29, 95% confidence interval (CI) 0.04 to 0.53; studies = 2, 265 participants) and may have little to no effect on caregiver QoL at 12 months (SMD 0.14, 95% CI - 0.11 to 0.40; studies = 2, 239 participants) post-intervention (both low-quality evidence).Psychosocial interventions probably have little to no effect on caregiver depression immediately to one-month post-intervention (SMD 0.01, 95% CI -0.14 to 0.15; studies = 9, 702 participants) (moderate-quality evidence). Psychosocial interventions may have little to no effect on caregiver anxiety immediately post-intervention (SMD -0.12, 95 % CI -0.33 to 0.10; studies = 5, 329 participants), depression three-to-six months (SMD 0.03, 95% CI -0.33 to 0.38; studies = 5. 379 participants) post-intervention and patient QoL six to 12 months (SMD -0.05, 95% CI -0.37 to 0.26; studies = 3, 294 participants) post-intervention (all low-quality evidence). There was uncertainty whether psychosocial interventions improve patient QoL immediately (SMD -0.03, 95 %CI -0.50 to 0.44; studies = 2, 292 participants) or caregiver anxiety three-to-six months (SMD-0.25, 95% CI -0.64 to 0.13; studies = 4, 272 participants) post-intervention (both very low-quality evidence). Two studies which could not be pooled in a meta-analysis for caregiver physical health status found little to no effect immediately post-intervention and a small intervention effect 12 months post-intervention. Caregiver or patient satisfaction or cost-effectiveness of interventions were not assessed in any studies. Interventions demonstrated good feasibility and acceptability.Psychosocial interventions probably have little to no effect on patient physical health status immediately post-intervention (SMD 0.17, 95 % CI -0.07 to 0.41; studies = 4, 461 participants) and patient depression three to six months post-intervention (SMD-0.11, 95% CI -0.33 to 0.12; studies = 6, 534 participants) (both moderate-quality evidence).Psychosocial interventions may have little to no effect on caregiver psychological distress immediately to one-month (SMD -0.08, 95% CI -0.42 to 0.26; studies = 3, 134 participants), and seven to 12 months (SMD 0.08, 95% CI -0.42 to 0.58; studies = 2, 62 participants) post-intervention; patient depression immediately (

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  • Research on caregivers of adult cancer patients, largely spouses, frequently shows equal and sometimes greater levels of distress in partners compared to the people living with cancer themselves, as well as high levels of anxiety and reduced quality of life.

    “In terms of psychosocial distress, research on caregivers of adult cancer patients, largely spouses, frequently shows equal and sometimes greater levels of distress in partners compared to the PLWC themselves, as well as high levels of anxiety and reduced quality of life (Treanor et al. 2019).”

    From Psychosocial and Integrative Oncology: Interventions Across the Disease Trajectory. (2023) · cites this paper as Treanor et al. 2019

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  • The Cochrane review by Treanor et al. concluded that observed benefits tend not to be maintained at follow-up.

    “los beneficios observados tienden a no mantenerse en el seguimiento (15).”

    From Síndrome de burnout en cuidadores familiares de pacientes oncológicos: revisión sistemática (2026) · cites this paper as [15]

    The Effects of interventions section says a possible slight improvement in caregivers’ quality of life immediately after intervention may not be maintained six to 12 months later. The citing sentence extends that finding to observed benefits generally, whereas the review does not establish the same follow-up pattern across outcomes. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Acting as an informal caregiver may have detrimental effects on the physical, psychological, and social health of the caregiver and reduce their quality of life.

    “Research shows that acting as an informal caregiver may have detrimental effects on the physical, psychological, and social health of the caregiver and reduce their quality of life (Treanor et al. 2019).”

    From Psychosocial and Integrative Oncology: Interventions Across the Disease Trajectory. (2023) · cites this paper as Treanor et al. 2019

  • Most studies were interested in depression, which was also one of the most frequently measured outcomes in previous reviews about psychosocial intervention.

    “Most studies were interested in depression, which was also one of the most frequently measured outcomes in previous reviews about psychosocial intervention [4].”

    From Third-wave cognitive behavioral therapies for caregivers of cancer patients: a scoping review. (2023) · cites this paper as [4]

  • The Cochrane review by Treanor et al. concluded that evidence on the efficacy of psychosocial interventions in these caregivers is still limited and of low quality.

    “la revisión Cochrane de Treanor et al. concluyó que la evidencia sobre la eficacia de las intervenciones psicosociales en estos cuidadores es todavía limitada y de baja calidad”

    From Síndrome de burnout en cuidadores familiares de pacientes oncológicos: revisión sistemática (2026) · cites this paper as [15]

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2 of the 225 references couldn’t be matched to a known paper.

Research works printed but not linked: 4

  1. Applebaum 2016 {published data only} Applebaum A. The program for the study of cancer caregiving: A model of care for supporting the needs of caregivers. Psycho-Oncology 2016;25:7-8.
  2. Holmes 1987 {published data only} Holmes BC. Psychological evaluation and preparation of the patient and family. Cancer 1987;60:2021-4.
  3. Kalaitzi 2007 {published data only} Kalaitzi C, Papadopoulos VP, Michas K, Vlasis K, Skandalakis P, Fillippou D. Combined brief psychosexual Robinson 1998 {published data only} Robinson KD, Angeletti KA, Barg FK, Pasacreta JV, McCorkle R, Yasko JM. The development of Family Caregiver Cancer Education Programme. Journal of Cancer Education 1998;13:116-21.
  4. Schover 2015 {published data only} Schover L, Odensky E, Martinetti P. Developing an internet-based intervention for cancer-related male sexual problems. Psycho-Oncology 2015;24:2-3.

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Authors
Treanor, C. J., Santin, O., Prue, G., Coleman, H., Cardwell, C. R., O'Halloran, P., & Donnelly, M.
Affiliations
  • Queen's University Belfast (GB)
  • Queen's University Belfast; School of Nursing and Midwifery; 97 Lisburn Road Belfast UK BT9 7BL
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2019-06-17
Volume
2020
Issue
1
Pages
CD009912-CD009912
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd009912.pub2
PMC
PMC6573123
OpenAlex
W2992858012
Cited by
145
References
225
Citations by year
2026: 10 · 2025: 18 · 2024: 17 · 2023: 26 · 2022: 34 · 2021: 17 · 2020: 16 · 2019: 3 · 2018: 1 · 2017: 2 · 2014: 1
FWCI
3.37
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (Queen's University Belfast) (submittedVersion, other-oa)
Funders
Medical Research Council (MR/K023241/1)
Topics
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
Keywords
informal caregivers, cancer, psychosocial interventions, caregiver quality of life, caregiver well-being, caregiver depression, caregiver anxiety, psychological distress, patient-caregiver dyads, spousal caregivers, psychoeducational intervention, usual care comparison, intervention satisfaction, adverse effects, risk of bias, chronic illness caregiving
MeSH terms
Anxiety, Depression, Health Status, Humans, Neoplasms, Quality of Life, Randomized Controlled Trials as Topic, Caregivers

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