The effect of targeted palliative care interventions on depression, quality of life and caregiver burden in informal caregivers of advanced cancer patients: A systematic review and meta-analysis of randomized controlled trials
Abstract
OBJECTIVE To investigate the efficacy of targeted palliative care interventions on depression, quality of life and caregiver burden in informal caregivers of advanced cancer patients, along with the consequences of various intervention types. DESIGN This study performed a comprehensive review and a meta-analysis of randomized controlled trials. METHOD An extensive search was carried out across eight databases, namely, PubMed, Embase, CLNAHL, PsyclNFO, Cochrane, VIP, CNKI, and WANFANG, spanning from the inception of the library to May 4, 2024. Two examiners independently screened the articles and extracted the data according to the eligibility criteria formulated in accordance with the PICOS principles. The meta-analysis was conducted utilizing the StataCorp (version 16.0), estimating the impacts of the interventions through the computation of the standardized mean difference (SMD) and the 95 % confidence interval (CI). Sensitivity analysis was carried out using a one-way-out method. Egger's test and the Duval and Tweedie trim-and-fill methods were used to explore the potential publication bias. The Cochrane risk-of-bias tool was used to evaluate the methodological quality of the included studies, and the overall quality of evidence was evaluated using the GRADE method. RESULTS This study pooled 16 RCTs (including 2046 informal caregivers) that were published from 2007 to 2023. The meta-analysis results indicated that the targeted palliative care interventions significantly improved depression (SMD = -0.74, 95 % CI: [-1.25, -0.23], P < 0.01) and quality of life (SMD = 0.63, 95 % CI: [0.08, 1.17], P = 0.03), though not in terms of caregiver burden (SMD = -0.33, 95 % CI: [-0.95, 0.29], P = 0.30) among informal caregivers of advanced cancer patients. Analysis of the subgroups revealed a correlation between short-term interventions, under three months, and the improvement of depression. Strategies focused solely on caregivers have proven effective in alleviating depression. Interventions utilizing offline methods have been shown to not only lower depression levels but also improve the quality of life for caregivers. CONCLUSIONS The targeted palliative care interventions effectively improved informal caregivers' depression and quality of life, yet they fail to markedly lessen the caregiver burden. To better support informal caregivers, interveners ought to adopt personalized strategies based on comprehensive consideration of the duration, format, and delivery methods of the interventions. Simultaneously, further exploration and effort from scholars are necessary to enhance the accessibility of palliative care services, and to effectively incorporate academic research findings into clinical practice. REGISTRATION CRD42023475620.
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Still being checked.
- Authors
- Yan, Q., Zhu, C., Li, L., Li, Y., Chen, Y., & Hu, X.
- Affiliations
- Sichuan University (CN)
- Corresponding author
- Hu, Xiaolin
- Venue
- International Journal of Nursing Studies
- Publisher
- Elsevier BV
- Published
- 2024-12
- Volume
- 160
- Pages
- 104895
- ISSN
- 0020-7489 (ISSN-L)
- OpenAlex
- W4402316397
- Semantic Scholar
- b7aaa3f2c5f6557e6fb4ef560f3637128d9e345f
- Cited by
- 30
- References
- 68
- Citations by year
- 2026: 19 · 2025: 11
- FWCI
- 3.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- International Journal of Nursing Studies (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Keywords
- palliative care interventions, informal caregivers, caregiver depression, quality of life, caregiver burden, advanced cancer, brief intervention, caregiver support programs, family caregivers of cancer patients, intervention efficacy comparison, publication bias, risk of bias, quality of evidence grading
- MeSH terms
- Caregiver Burden, Depression, Humans, Neoplasms, Palliative Care, Quality of Life, Randomized Controlled Trials as Topic, Caregivers
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