CoChat
Sign Up
Cited by 1Nursing care and researchCancer survivorship and careFamily Caregiving in Mental Illness

Caregiver burden, quality of life, and psychosocial outcomes among informal caregivers of patients with glioma: A systematic review and meta-analysis

Open access
Wei, Haimeng, Zhang, Shuo, Tao, Shuai, Li, Jing, Liu, Xiaonan·2026·Asia-Pacific Journal of Oncology Nursing
DOI 10.1016/j.apjon.2026.100978PMC PMC13241747
Open this paper in CoChat — free account

Abstract

Objective: Informal caregivers of people with glioma frequently provide complex, long-term support in the context of neurological, cognitive and behavioural impairment, which may adversely affect caregiver burden, quality of life (QoL), and broader psychosocial wellbeing, including anxiety, depression, and distress. We synthesised evidence on caregiver burden and psychosocial outcomes among caregivers of patients with glioma, and compared outcomes with caregivers of other cancers where data permitted. Methods: We conducted a systematic review and meta-analysis in accordance with PRISMA 2020. PubMed, Embase, Scopus, PsycINFO and the Cochrane Library were searched from inception to the final search date. Eligible studies reported caregiver burden, QoL, anxiety, depression and/or distress among caregivers of patients with glioma. For single-group analyses, pooled prevalences of burden, anxiety, depression and distress were estimated using random-effects meta-analysis of proportions (Freeman-Tukey transformation). For comparative analyses, standardized mean differences (SMDs) were pooled using random-effects inverse-variance models (DerSimonian-Laird) comparing caregivers of patients with glioma with caregivers of other cancers. Results: Ten studies were included. Clinically significant caregiver burden was common (pooled prevalence = 60%). Pooled prevalences of depression and anxiety were 35% and 36%, respectively, while distress was high (68%). Comparative meta-analysis (3 studies; 710 participants) showed no statistically significant difference in caregiver QoL between glioma and other-cancer caregiver groups (SMD = -0.21). Heterogeneity was substantial across outcomes. Conclusions: Informal caregivers of patients with glioma experience substantial psychosocial morbidity, including high distress, frequent burden, and common anxiety and depressive symptoms. Routine caregiver assessment and integrated caregiver-focused supportive care should be embedded in neuro-oncology pathways.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review and meta-analysis found that informal caregivers of patients with glioma experience substantial psychosocial morbidity, especially high distress, burden, anxiety, and depressive symptoms. Comparative data did not show a statistically significant difference in caregiver quality of life between glioma and other-cancer caregiver groups.

Key findings

  • Pooled prevalence of clinically significant caregiver burden was 60% (95% CI 35%–83%) across 3 studies, with individual estimates from 33% to 75% and substantial heterogeneity (I² = 83.46%).
  • Pooled prevalences were 35% for depressive symptoms (95% CI 14%–60%; 6 studies), 36% for anxiety (95% CI 19%–55%; 4 studies), and 68% for psychological distress (95% CI 53%–82%; 3 studies).
  • Sensitivity analyses excluding high-risk-of-bias studies changed depression from 35% to 21%, distress from 68% to 61%, and anxiety from 36% to 40%.
  • Comparative meta-analysis of caregiver QoL (3 studies; 710 participants) showed no statistically significant difference between glioma caregivers and other-cancer caregivers (SMD = −0.21, 95% CI −1.15 to 0.72; P = 0.655), with considerable heterogeneity (I² = 96.0%).

Methods

  • Systematic review and meta-analysis conducted per PRISMA 2020; databases searched from inception to January 2026: PubMed, Embase, Scopus, PsycINFO, and Cochrane Library.
  • Ten studies were included, mostly of caregivers of high-grade glioma/glioblastoma patients; eligible outcomes were caregiver burden, QoL, anxiety, depression, and psychological distress.
  • Single-group prevalences were pooled using random-effects meta-analysis of proportions with Freeman–Tukey transformation; comparative QoL used random-effects inverse-variance SMDs (DerSimonian–Laird); risk of bias assessed with Newcastle–Ottawa Scale or adapted NOS.

Limitations

  • The review was not prospectively registered in PROSPERO because registration could not be completed due to platform service limitations; only 10 studies met eligibility criteria, and some pooled analyses were based on only 3 studies.
  • Study quality was mixed, with 5 low, 2 moderate, and 3 high risk-of-bias studies; sensitivity analyses excluding high-risk studies changed some estimates, especially depressive symptoms.
  • Heterogeneity was significant across most outcomes, likely due to differences in study design, caregiver population, tumour grade, disease phase, care setting, outcome instruments, and non-uniform thresholds; the small number of studies limited subgroup analyses.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.apjon.2026.100978

Cites

33 of 33 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

23 of 37 cited sources checked · 5 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Caregiving in glioma differs from many other cancer types because disease often produces early neuro-oncological symptoms in patients that can disrupt personality, behaviour, communication, and functional independence.

    “Caregiving in glioma differs from many other cancer types because disease often produces early neuro-oncological symptoms in patients that can disrupt personality, behaviour, communication, and functional independence.5”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [5] Baddeley, 2025, Well-being and coping: key aspects of unmet need of people living with glioma, Neuro-Oncol Pract source

      The Introduction (page not specified) says glioma care needs differ from those of other cancers particularly because of neurocognitive impacts. Results, Themes 1 and 3 (pages not specified), describe effects on speech, executive functioning, mobility, independence, and caregivers. Our copy does not establish that these symptoms often arise early, and it does not clearly describe personality or behavioural disruption as such. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
  • Interpretationown data

    The inconsistent direction of study-level effects indicates that "other cancer" is not a uniform comparator category.

    “also indicates that “other cancer” is not a uniform comparator category.29”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [29] 2009, Abstracts from the 2009 joint meeting of the society for neuro-oncology (SNO) and the American association of neurological surgeons/congress of neurological surgeons (AANS/CNS) section on tumors, Neuro Oncol source

      The Results (p. 2) describe two virtual-reality surgical simulation scenarios, not comparisons among cancer groups. Searches for inconsistent study-level effects and an “other cancer” comparator found no passage addressing either point in our copy. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
  • Interpretationreasoning

    The inconsistent direction of study-level effects in this review is compatible with the interpretation that glioma caregivers may experience a distinctive form of burden.

    “The inconsistent direction of study-level effects in this review is compatible with that interpretation”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [29] 2009, Abstracts from the 2009 joint meeting of the society for neuro-oncology (SNO) and the American association of neurological surgeons/congress of neurological surgeons (AANS/CNS) section on tumors, Neuro Oncol source

      The Introduction and Results (p. 2) discuss a virtual-reality simulator for brain tumor surgery, not caregiver burden. Searches for glioma caregivers, caregiver burden, and inconsistent study-level effects found no passage addressing the claimed interpretation. (LLM, conf=0.77)

      Experimental — accuracy not yet measured
  • Premisecitation

    Across brain cancer more broadly, qualitative synthesis indicates that supportive care experiences are shaped by persistent informational, psychosocial, and practical unmet needs for both patients and informal caregivers, with gaps spanning communication, access to services, and navigation of palliative and rehabilitation resources.

    “Across brain cancer more broadly, qualitative synthesis indicates that supportive care experiences are shaped by persistent informational, psychosocial, and practical unmet needs for both patients and informal caregivers, with gaps spanning communication, access to services, and navigation of palliative and rehabilitation resources.15”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [15] Paterson, 2024, What are the experiences of supportive care in people affected by brain cancer and their informal caregivers: a qualitative systematic review, J Cancer Surviv source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
  • Premisecitation

    Neuro-oncology literature suggests that glioma caregivers may experience a particularly distinctive form of burden because patient cognitive, behavioural, and communication changes can disrupt relationships, shared decision-making, and daily family functioning in ways that are less prominent in many other cancers.

    “Conversely, neuro-oncology literature suggests that glioma caregivers may experience a particularly distinctive form of burden because patient cognitive, behavioural, and communication changes can disrupt relationships, shared decision-making, and daily family functioning in ways that are less prominent in many other cancers.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [29] 2009, Abstracts from the 2009 joint meeting of the society for neuro-oncology (SNO) and the American association of neurological surgeons/congress of neurological surgeons (AANS/CNS) section on tumors, Neuro Oncol source

      Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
  • Classified as probably not a substantial claim. 25
  • May combine two claims. 35

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Caregiver distress arises not only from practical care tasks, but also from prognostic uncertainty, the need for vigilance regarding neurological deterioration, and the psychological impact of witnessing progressive cognitive and functional loss in the patient.

    “These findings align with broader neuro-oncology literature in which caregiver distress arises not only from practical care tasks, but also from prognostic uncertainty, the need for vigilance regarding neurological deterioration, and the psychological impact of witnessing progressive cognitive and functional loss in the patient.11”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [11] Long, 2016, Carers of patients with high-grade glioma report high levels of distress, unmet needs, and psychological morbidity during patient chemoradiotherapy, Neuro-Oncol Pract source

      Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Consistent caregiver burden might contribute to reduction in caregiver health-related quality of life, increased anxiety and depressive symptoms, sleep disruption, and reduced participation in employment and social activities.

    “Consistent caregiver burden might contribute to reduction in caregiver health-related quality of life (QoL), increased anxiety and depressive symptoms, sleep disruption, and reduced participation in employment and social activities.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [8] Sakurada, 2025, Mental health status and associated factors of caregivers of patients with malignant brain tumors, J Neuro Oncol source

      The Introduction says caregiving demands can affect caregivers’ quality of life and identifies caregiver burden as associated with depression and anxiety. The Discussion likewise links burden with depression and reports lower social functioning among caregivers. The paper does not establish that burden causes sleep disruption or reduced participation in employment and social activities; it mentions sleep quality as a factor related to depression, not as an outcome of burden. (LLM, conf=0.85)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Similar work in glioblastoma caregivers has highlighted that burden is not uniform across clinical settings and might vary according to treatment phase and patient clinical characteristics.

    “Similar work in glioblastoma caregivers has also highlighted that burden is not uniform across clinical settings and might vary according to treatment phase and patient clinical characteristics.10”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [10] Au, 2022, Caregiver burden by treatment and clinical characteristics of patients with glioblastoma, Support Care Cancer source

      The Results and Conclusion report that caregiver burden differs with patient clinical characteristics, including performance status and confusion. The Patient demographics section includes caregivers at different treatment stages, but the paper does not establish that burden varies by treatment phase; its Discussion notes that the one-time survey cannot reflect changes over the course of caregiving. No page numbers were available in our copy. (LLM, conf=0.86)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Prior caregiver research in cancer populations demonstrates prevalence estimates that vary widely depending on tools and thresholds, but consistently indicate clinically meaningful symptom levels.

    “Prior caregiver research in cancer populations demonstrates prevalence estimates that vary widely depending on tools and thresholds, but consistently indicate clinically meaningful symptom levels.30,31”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [30] Chen, 2021, The role of informal caregivers for patients with glioma: a systematic review and meta-synthesis of qualitative studies, Ann Transl Med source

      The Results (Findings of the review; page unavailable) describe anxiety, worry, fear, and distress among caregivers of people with glioma. But this qualitative review does not report caregiver symptom-prevalence estimates, compare measurement tools or thresholds, or establish that symptoms reached clinically meaningful levels. (LLM, conf=0.82)

      Experimental — accuracy not yet measured
    • cites [31] Pan, 2022, Systematic review and meta-analysis of prevalence of depression among caregivers of cancer patients, Front Psychiatr source

  • May combine two claims.

    Interpretationcitation

    The pooled burden prevalence in this review is broadly consistent with prior neuro-oncology literature, while the heterogeneity mirrors the diversity of caregiving contexts previously described.

    “The pooled burden prevalence in this review is broadly consistent with that literature, while the heterogeneity mirrors the diversity of caregiving contexts previously described.10,27”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [10] Au, 2022, Caregiver burden by treatment and clinical characteristics of patients with glioblastoma, Support Care Cancer source

      The Conclusion (page unavailable) says that glioblastoma caregiver–patient dyads are not all alike, and the Discussion describes differences in caregiver experience linked to patient characteristics. This supports the point about diverse caregiving contexts. The paper does not compare this review’s pooled burden prevalence with prior literature or assess the review’s statistical heterogeneity. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [27] Fortunato, 2020, Caregiver perceptions of end-of-life care in patients with high-grade glioma, Neuro-Oncol Pract source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Earlier reports in neuro-oncology often describe moderate-to-severe burden levels and identify patient functional dependence and neuropsychiatric symptoms as key correlates.

    “When considering caregiver burden, earlier reports in neuro-oncology often describe moderate-to-severe burden levels and identify patient functional dependence and neuropsychiatric symptoms as key correlates.26,27”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [26] Saria, 2017, The hidden morbidity of cancer: burden in caregivers of patients with brain metastases, Nurs Clin North Am source

      In “Primary Demands of Caregiving” (page unavailable), the paper reports that functional status affected one caregiver-burden subscale in a study of primary brain tumors, while neuropsychiatric status affected every subscale. It does not establish the claimed moderate-to-severe burden levels in neuro-oncology; searches for that severity description found no supporting passage. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [27] Fortunato, 2020, Caregiver perceptions of end-of-life care in patients with high-grade glioma, Neuro-Oncol Pract source

  • May combine two claims.

    Premisecitation

    Empirical studies in patients with glioma suggest that caregiver burden is common and clinically meaningful.

    “Empirical studies in patients with glioma suggest that caregiver burden is common and clinically meaningful.6, 7, 8, 9, 10”
    Quote in the paperSubstantial claim3 of 5 sources checked
    • cites [6] Clifton, 2021, The impact of functional dependence and related surgical complications on postoperative mortality, J Med Syst source

      The Discussion addresses functional dependence, surgical complications, and postoperative mortality, not caregiver burden. Searches for glioma, caregivers, and clinically meaningful burden found no passage in our copy addressing the claim. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
    • cites [7] Coolbrandt, 2015, Family caregivers of patients with a high-grade glioma: a qualitative study of their lived experience and needs related to professional care, Cancer Nurs source
    • cites [8] Sakurada, 2025, Mental health status and associated factors of caregivers of patients with malignant brain tumors, J Neuro Oncol source
    • cites [9] Li, 2022, Caregiver burden and influencing factors among family caregivers of patients with glioma: a cross-sectional survey, J Clin Neurosci source
    • cites [10] Au, 2022, Caregiver burden by treatment and clinical characteristics of patients with glioblastoma, Support Care Cancer source

  • May combine two claims.

    Interpretationcitation

    Caregiver burden and QoL are core outcomes in glioma care, reflecting both the intensity of caregiving tasks and the broader psychosocial ecology in which caregiving occurs.

    “Collectively, these data suggest that caregiver burden and QoL are core outcomes in glioma care, reflecting both the intensity of caregiving tasks and the broader psychosocial ecology in which caregiving occurs.15”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [15] Paterson, 2024, What are the experiences of supportive care in people affected by brain cancer and their informal caregivers: a qualitative systematic review, J Cancer Surviv source

  • May combine two claims.

    Interpretationcitation

    When compared to previous literature on caregivers of other oncology patients, the prevalence of caregiver burden, anxiety, depression, and distress found in this review appears clinically significant and, in some ways, might be comparable to or higher than estimates reported in mixed cancer caregivers.

    “When compared to previous literature on caregivers of other oncology patients, the prevalence of caregiver burden, anxiety, depression, and distress found in this review appears clinically significant and, in some ways, might be comparable to or higher than estimates reported in mixed cancer caregivers.32, 33”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [32] Forst, 2022, Factors associated with psychological distress in caregivers of patients with malignant gliomas, Support Care Cancer source
    • cites [33] Molassiotis, 2022, Understanding and supporting informal cancer caregivers, Curr Treat Options Oncol source

      The paper’s “Impact of caregiving on informal cancer caregivers” section describes burden, anxiety, depressive symptoms, and psychological distress among cancer caregivers. It does not provide prevalence estimates for those outcomes, so it cannot substantiate the citing review’s comparison of rates with mixed-cancer caregiver estimates. No page number is available in our copy. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Caregivers of patients with advanced forms of cancer are known to have impaired quality of life and higher psychological morbidities.

    “Caregivers of patients with advanced forms of cancer are known to have impaired QoL and higher psychological morbidities.”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [32] Forst, 2022, Factors associated with psychological distress in caregivers of patients with malignant gliomas, Support Care Cancer source
    • cites [33] Molassiotis, 2022, Understanding and supporting informal cancer caregivers, Curr Treat Options Oncol source

      The ‘Impact of caregiving on informal cancer caregivers’ section says that caregiving can jeopardize quality of life and cause emotional distress; it also reports higher anxiety and depression after some caregivers are bereaved. These passages support the general point, but they do not establish both outcomes specifically for caregivers of patients with advanced cancer. Page numbers were not provided in our copy. (LLM, conf=0.84)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Interpretationcitation

    The overall pattern of findings aligns with the broader psycho-oncology literature demonstrating elevated caregiver burden and psychological morbidity among caregivers of cancer patients, while also reflecting features that are particularly salient in neuro-oncology.

    “The overall pattern of findings aligns with the broader psycho-oncology literature demonstrating elevated caregiver burden and psychological morbidity among caregivers of cancer patients, while also reflecting features that are particularly salient in neuro-oncology.11,30”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [11] Long, 2016, Carers of patients with high-grade glioma report high levels of distress, unmet needs, and psychological morbidity during patient chemoradiotherapy, Neuro-Oncol Pract source
    • cites [30] Chen, 2021, The role of informal caregivers for patients with glioma: a systematic review and meta-synthesis of qualitative studies, Ann Transl Med source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The impaired quality of life and higher psychological morbidities among caregivers of patients with advanced cancer are because symptom burden, treatment intensity, and end-of-life care needs for the patients are high.

    “This is because symptom burden, treatment intensity, and end-of-life care needs for the patients are high.32,33”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [32] Forst, 2022, Factors associated with psychological distress in caregivers of patients with malignant gliomas, Support Care Cancer source
    • cites [33] Molassiotis, 2022, Understanding and supporting informal cancer caregivers, Curr Treat Options Oncol source

      The sections on interpersonal factors and the impact of caregiving (page not provided) link patients’ care demands to caregiver burden and quality of life, and describe distress during chemotherapy and end-of-life transitions. They do not establish that high patient symptom burden, treatment intensity, and end-of-life care needs together explain impaired quality of life and greater psychological morbidity specifically among caregivers of patients with advanced cancer. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Prior studies in cancer caregiving consistently show that informal caregivers experience higher rates of anxiety, depressive symptoms, and reduced quality of life compared with population norms, with burden influenced by caregiving intensity, financial toxicity, and perceived lack of support.

    “Prior studies in cancer caregiving consistently show that informal caregivers experience higher rates of anxiety, depressive symptoms, and reduced QoL compared with population norms, with burden influenced by caregiving intensity, financial toxicity, and perceived lack of support.33”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [33] Molassiotis, 2022, Understanding and supporting informal cancer caregivers, Curr Treat Options Oncol source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • May combine two claims.

    Interpretationown data

    Informal caregivers of patients with glioma experience substantial psychosocial morbidity, including high distress, frequent burden, and common anxiety and depressive symptoms.

    “Informal caregivers of patients with glioma experience substantial psychosocial morbidity, including high distress, frequent burden, and common anxiety and depressive symptoms.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Overall risk of bias rating showed that five studies were rated low risk, two moderate, and three high risk of bias.

    “Overall risk of bias rating showed that five studies rated to have low risk, two moderate, and three high risk of bias.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Previous studies have shown that a significant number of family caregivers of patients with glioma report moderate to severe levels of burden, with respect to reduction in sleep duration and increased anxiety and depressive symptoms.

    “Previous studies have shown that a significant number of family caregivers of patients with glioma report moderate to severe levels of burden, with respect to reduction in sleep duration and increased anxiety and depressive symptoms.9”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] Li, 2022, Caregiver burden and influencing factors among family caregivers of patients with glioma: a cross-sectional survey, J Clin Neurosci source

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    A random-effects model was used for all meta-analyses.

    “Given expected clinical and methodological heterogeneity (differences in glioma grade, treatment phase, caregiver relationship, and outcome instruments), a random-effects model was used for all meta-analyses.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Risk of bias for observational studies was assessed independently by two reviewers using the Newcastle-Ottawa Scale (NOS) for cohort/case-control studies and an adapted NOS for cross-sectional studies.

    “Risk of bias for observational studies was assessed independently by two reviewers using the Newcastle–Ottawa Scale (NOS) for cohort/case–control studies and an adapted NOS for cross-sectional studies.17”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle–Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa: Ottawa Hospital Research Institute. Available from: https://www.ohri.ca/en/who-we-are/core-facilities-and-platforms/ottawa-methods-centre/newcastle-ottawa-scale.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    If multiple time points were reported, baseline or the time point most comparable across studies was preferentially extracted.

    “If multiple time points were reported, baseline or the time point most comparable across studies (typically closest to diagnosis/treatment initiation) was preferentially extracted; alternative time points were explored in sensitivity analyses when data permitted.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Sensitivity analysis was performed to assess the robustness of the results by excluding studies at high risk of bias.

    “Sensitivity analysis was performed to assess the robustness of the results by excluding studies at high risk of bias.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    A prespecified hierarchy was applied when a study reported multiple eligible instruments for the same construct, prioritizing the most commonly used and validated scale in oncology caregiver research.

    “If a study reported multiple eligible instruments for the same construct (e.g., two depression scales), a prespecified hierarchy was applied prioritizing the most commonly used and validated scale in oncology caregiver research; otherwise, the instrument most frequently reported across included studies was selected to avoid double-counting.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Publication bias was assessed using a funnel plot with Egger's test for depression outcome.

    “Publication bias was assessed using a funnel plot with Egger's test for depression outcome as it had a reasonable number of studies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Pooled prevalence estimates indicate that clinically significant depressive and anxiety symptoms are frequent among glioma caregivers, reflecting a substantial mental health burden in this population.

    “For depression and anxiety, pooled prevalence estimates indicate that clinically significant symptoms are frequent among glioma caregivers, reflecting a substantial mental health burden in this population.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The different screening instruments and thresholds used across included studies measure the same underlying constructs sufficiently to be pooled.

  • May combine two claims.

    Study design and conductown data

    The funnel plot for depression was symmetrical, indicating no clear evidence of publication bias, confirmed by a non-significant Egger's test (P = 0.699).

    “Supplementary Fig. S4 shows the symmetrical funnel plot for depression indicating no clear evidence of publication bias and it was confirmed by a non-significant Egger's test (P = 0.699).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Glioma caregiving frequently involves an intense psychological strain profile that extends beyond routine caregiving demands and is likely shaped by neuro-oncological disease characteristics.

    “suggesting that glioma caregiving frequently involves an intense psychological strain profile that extends beyond routine caregiving demands and is likely shaped by neuro-oncological disease characteristics.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Across included studies, caregiver outcomes were consistently impaired, but magnitude varied substantially by study context, measurement approach, and clinical phase.

    “Across included studies, caregiver outcomes were consistently impaired, but magnitude varied substantially by study context, measurement approach, and clinical phase.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Disagreements in risk of bias assessment were resolved by consensus or third-party adjudication.

    “Disagreements were resolved by consensus or third-party adjudication.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The anxiety estimate remained broadly comparable and was not materially reduced after sensitivity analysis.

    “indicating that the anxiety estimate remained broadly comparable and was not materially reduced after sensitivity analysis.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Pooled estimates indicate that adverse caregiver experiences are common, with a sizeable proportion reporting clinically significant burden and emotional symptoms.

    “Overall, pooled estimates indicate that adverse caregiver experiences are common, with a sizeable proportion reporting clinically significant burden and emotional symptoms.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Two reviewers independently screened titles/abstracts and full texts for eligibility.

    “Two reviewers independently screened titles/abstracts for eligibility, followed by full-text screening of potentially eligible reports.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Premisecitation

    In a multicentre retrospective study focusing on the last months of life in glioblastoma, caregivers reported low QoL alongside symptoms suggestive of burnout and a strong need for targeted psychological support and caregiver training.

    “In a multicentre retrospective study focusing on the last months of life in glioblastoma, caregivers reported low QoL alongside symptoms suggestive of burnout and a strong need for targeted psychological support and caregiver training.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Many studies outside neuro-oncology report substantial quality-of-life impairment among caregivers of advanced cancers, particularly where symptom burden, treatment intensity, and end-of-life caregiving predominate, which could narrow observed differences between tumour types.

    “Many studies outside neuro-oncology report substantial QoL impairment among caregivers of advanced cancers, particularly where symptom burden, treatment intensity, and end-of-life caregiving predominate, which could narrow observed differences between tumour types.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [20] Minaya Flores, 2014, Assessing the quality of life among caregivers of patients with gliomas, Neuro-Oncol Pract source
    • cites [28] Boele, 2014, Symptom management and quality of life in glioma patients, CNS Oncol source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Discrepancies in screening were resolved through discussion; if unresolved, a third reviewer adjudicated.

    “Discrepancies were resolved through discussion; if unresolved, a third reviewer adjudicated.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Recent qualitative work in glioblastoma caregivers describes overwhelming burden, challenges coping with the caregiving role, and deficiencies in caregiver support, including limited education and confusion regarding hospice and palliative pathways.

    “Recent qualitative work in glioblastoma caregivers reinforces these themes, describing overwhelming burden, challenges coping with the caregiving role, and deficiencies in caregiver support, including limited education and confusion regarding hospice and palliative pathways.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The systematic review and meta-analysis was conducted and reported in accordance with the PRISMA 2020 statement.

    “This systematic review and meta-analysis was conducted and reported in accordance with the PRISMA 2020 statement.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Two reviewers independently extracted data using a piloted standardized extraction form.

    “Two reviewers independently extracted data using a piloted standardized extraction form.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Although the absolute severity of burden may overlap with that seen in other advanced cancer caregiving settings, the pattern and drivers of distress in glioma appear to be particularly complex.

    “Thus, although the absolute severity of burden may overlap with that seen in other advanced cancer caregiving settings, the pattern and drivers of distress in glioma appear to be particularly complex.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The review was conducted in accordance with the PRISMA 2020 guidelines.

    “Nevertheless, the review was conducted in accordance with the PRISMA 2020 guidelines”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Study quality may have contributed to variability in some pooled estimates, particularly depressive symptoms, although the overall conclusion that glioma caregivers experience substantial psychosocial morbidity remained unchanged.

    “These changes indicate that study quality may have contributed to variability in some pooled estimates, particularly depressive symptoms, although the overall conclusion that glioma caregivers experience substantial psychosocial morbidity remained unchanged.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationreasoning

    Although caregivers of patients with other advanced cancers also experience such burden, glioma caregiving may be unique and complex because of the combination of impact of neurological decline, cognitive and behavioural change, and rapid shifts in patient dependency.

    “Although caregivers of patients with other advanced cancers also experience such burden, glioma caregiving may be unique and complex because of the combination of impact of neurological decline, cognitive and behavioural change, and rapid shifts in patient dependency.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Heterogeneity might be due to differences in study design, caregiver population, tumour grade, disease phase, care setting, and variability in outcome measurement.

    “This might be due to differences in study design, caregiver population, tumour grade, disease phase, care setting, and variability in outcome measurement.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    This review was not prospectively registered in PROSPERO because registration could not be completed during the study period due to service limitations on the PROSPERO platform.

    “This review was not prospectively registered in PROSPERO because registration could not be completed during the study period due to service limitations on the PROSPERO platform.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    This review suggests that caregivers of patients with glioma experience substantial psychosocial burden, characterized by high levels of distress, followed by caregiver burden, anxiety, and depressive symptoms.

    “This review suggests that caregivers of patients with glioma experience substantial psychosocial burden, characterized by high levels of distress, followed by caregiver burden, anxiety, and depressive symptoms.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The different screening instruments and thresholds used across included studies measure the same underlying constructs sufficiently to be pooled.

  • May combine two claims.

    Interpretationreasoning

    A limited number of contributing studies reduces statistical power, precision, restricts the ability to explore heterogeneity, and limits the robustness and generalizability of pooled estimates.

    “a limited number of contributing studies reduces statistical power, precision, restricts the ability to explore heterogeneity, and limits the robustness and generalizability of pooled estimates.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductnone given

    Studies used different instruments to assess burden, quality of life, depression, anxiety, and distress, and thresholds for outcomes were not uniform across studies.

    “Studies used different instruments to assess burden, QoL, depression, anxiety, and distress, and thresholds for outcomes were not uniform across studies.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The review protocol was established prior to study screening and data extraction.

    “the review protocol was established prior to study screening and data extraction.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given

    Glioma caregiving might be challenging as caregivers must manage not only physical dependency and treatment-related demands, but also progressive cognitive impairment, behavioural disturbance, communication difficulty, personality changes, and loss of decision-making capacity of the patients.

    “However, glioma caregiving might be challenging as caregivers must manage not only physical dependency and treatment-related demands, but also progressive cognitive impairment, behavioural disturbance, communication difficulty, personality changes, and loss of decision-making capacity of the patients.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisereasoning

    Measurement variability is important in pooled analysis of prevalence, as it can influence both absolute estimates obtained within individual studies and comparability of results across studies.

    “Such measurement variability is important in pooled analysis of prevalence, as it can influence both absolute estimates obtained within individual studies and comparability of results across studies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Taken together, these findings suggest that glioma caregiving is not uniformly "worse" than caregiving in all other cancers, but it is likely to be uniquely complex and, in many settings, especially psychologically demanding.

    “Taken together, these findings suggest that glioma caregiving is not uniformly “worse” than caregiving in all other cancers, but it is likely to be uniquely complex and, in many settings, especially psychologically demanding.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The present synthesis is congruent with the general evidence base, but the notably high pooled distress and substantial burden estimates support the view that glioma caregiving can be uniquely challenging because of the additional neurocognitive, behavioural, and relational consequences of the disease.

    “The present synthesis is congruent with this general evidence base, but the notably high pooled distress and substantial burden estimates support the view that glioma caregiving can be uniquely challenging because of the additional neurocognitive, behavioural, and relational consequences of the disease.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Study quality was mixed, and domain-level assessment showed that some of the included studies had important methodological limitations with respect to sample selection, comparability, and outcome ascertainment.

    “Study quality was mixed, and domain-level assessment showed that some of the included studies had important methodological limitations with respect to sample selection, comparability, and outcome ascertainment.”
    Quote in the paperSubstantial claim
51 of 51

  • The paper relies on this without support.

    The magnitude of caregiver burden and QoL impairment in glioma caregiving, and the frequency of anxiety, depression, and distress, remain variably reported across studies using different instruments and sampling frames.

    “Despite growing attention, the magnitude of caregiver burden and QoL impairment in glioma caregiving, as well as the frequency of related psychosocial outcomes such as anxiety, depression, and distress, remain variably reported across studies using different instruments and sampling frames.”

  • The paper relies on this without support.

    The different screening instruments and thresholds used across included studies measure the same underlying constructs sufficiently to be pooled.

    “depression, anxiety, and distress were assessed using different screening instruments across included studies.”
    “Clinically significant outcomes were not defined using identical thresholds across the studies.”
    “Studies used different instruments to assess burden, QoL, depression, anxiety, and distress, and thresholds for outcomes were not uniform across studies.”
2 of 2

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentz = -0.45reported p = .655 · recomputed p = .653

    “z = −0.45, p = .655”

1 of 1

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Self-check results appear here once an independent check has confirmed them.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Wei, H., Zhang, S., Tao, S., Li, J., & Liu, X.
Affiliations
Capital Medical University (CN)
Corresponding author
Liu, Xiaonan
ORCID
Venue
Asia-Pacific Journal of Oncology Nursing
Publisher
Elsevier BV
Published
2026-12
Volume
13
Pages
100978
ISSN
2347-5625 (ISSN-L)
DOI
10.1016/j.apjon.2026.100978
PMC
PMC13241747
OpenAlex
W7161400235
Semantic Scholar
1cc5f7e2ce658e473289028853dda41c6892f089
Cited by
1
References
24
Citations by year
2026: 1
FWCI
3.51
Type
journal article
Language
en
Open access
Licence
Locations
  • Asia-Pacific Journal of Oncology Nursing (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (submittedVersion, cc-by-nc-nd)
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
caregiver burden, informal caregivers, glioma, quality of life, caregiver anxiety, caregiver depression, caregiver distress, psychosocial outcomes, neuro-oncology

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.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-14.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-14.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review