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Psychosocial interventions for informal caregivers of people living with cancer
Open accessAbstract
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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“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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“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]
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“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
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“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]
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“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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Self-citationThe You CAN Campaign: Teamwork Training for Patients and Families in Ambulatory Oncology
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Sorted by citations
Kadambi, S., Loh, K. P., Dunne, R., Magnuson, A., Maggiore, R., Zittel, J., Flannery, M., Inglis, J., Gilmore, N., Mohamed, M., et al. (2020) · Nature Reviews Clinical Oncology · doi:10.1038/s41571-020-0421-z · Cited by 149
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Interventions to improve outcomes for caregivers of patients with advanced cancer: a meta-analysis
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“Our review adds to these results by providing a comprehensive meta-analysis including 29 trials (41-44,49,52,53,57,67-69,72,73,76,77,80-90,92,93,95,96) that were not included in recent publications (21-23).”
BackgroundResult
Metadata
- 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
- 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
- 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
- FWCI
- 3.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- 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 › Nursing › Research and Theory › 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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