Interventions with Family Caregivers of Cancer Patients: Meta-Analysis of Randomized Trials
Open accessAbstract
Family caregivers of cancer patients receive little preparation, information, or support to perform their caregiving role. However, their psychosocial needs must be addressed so they can maintain their own health and provide the best possible care to the patient. The purpose of this article is to analyze the types of interventions offered to family caregivers of cancer patients, and to determine the effect of these interventions on various caregiver outcomes. Meta-analysis was used to analyze data obtained from 29 randomized clinical trials published from 1983 through March 2009. Three types of interventions were offered to caregivers: psychoeducational, skills training, and therapeutic counseling. Most interventions were delivered jointly to patients and caregivers, but they varied considerably with regard to dose and duration. The majority of caregivers were female (64%) and Caucasian (84%), and ranged in age from 18 to 92 years (mean age, 55 years). Meta-analysis indicated that although these interventions had small to medium effects, they significantly reduced caregiver burden, improved caregivers' ability to cope, increased their self-efficacy, and improved aspects of their quality of life. Various intervention characteristics were also examined as potential moderators. Clinicians need to deliver research-tested interventions to help caregivers and patients cope effectively and maintain their quality of life.
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Typically, generic caregiver interventions provide a range of information and coping skills training to help caregivers feel better equipped to manage the challenges of their role, which in turn might result in lowering depression and anxiety.
“Typically, generic caregiver interventions provide a range of information and coping skills training to help caregivers feel better equipped to manage the challenges of their role, which in turn might result in lowering depression and anxiety.37,69”
From Non-pharmacological Interventions for Caregivers with Depression and Caregivers of Care Recipients with Co-morbid Depression: Systematic Review and Meta-analysis (2021) · cites this paper as [69]
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 measuredThe effect sizes for both depression and anxiety in the present meta-analysis were in the small to moderate range in comparison to mostly small effect sizes in previous meta-analyses.
“However, the ESs for both depression and anxiety in the present meta-analysis were in the small to moderate range in comparison to mostly small ESs in previous meta-analyses.37,69”
From Non-pharmacological Interventions for Caregivers with Depression and Caregivers of Care Recipients with Co-morbid Depression: Systematic Review and Meta-analysis (2021) · cites this paper as [69]
In Results > Depression, Northouse et al. report small, nonsignificant effect sizes for caregiver depression. But the Discussion describes moderate effects on anxiety in prior meta-analyses, so this source does not support characterizing the previous findings for both depression and anxiety as mostly small. The citing authors’ description of their own meta-analysis is not a finding attributed to Northouse et al. (LLM, conf=0.83)
Experimental — accuracy not yet measuredInterventions dedicated to caregivers generally had small to medium effect sizes in reducing caregiver burden, alleviating psychological symptoms, and improving caregivers coping capabilities, self-efficacy and QoL.
“Results from two meta-analyses [20, 21] suggest that interventions dedicated to caregivers generally had small to medium effect sizes in reducing caregiver burden, alleviating psychological symptoms, and improving caregivers coping capabilities, self-efficacy and QoL.”
From It is time to address fear of cancer recurrence in family caregivers: protocol for the feasibility and acceptability of a randomized pilot study of the online version of the Family Caregiver–Fear Of Recurrence Therapy (FC-FORT) (2024) · cites this paper as [20]
The Results and Discussion report small-to-moderate benefits for caregiver burden, coping, self-efficacy, and distress or anxiety. But the Discussion explicitly says interventions did not improve caregivers’ overall quality of life, only specific components; the Results also found no significant reduction in depression. The claim overgeneralizes the quality-of-life and psychological-symptom findings. (LLM, conf=0.90)
Experimental — accuracy not yet measuredBased on a systematic review, an effect size of 0.3 is considered clinically meaningful for primary and secondary outcomes at 3 months post-intervention compared to WLCG.
“Based on a systematic review of caregiver interventions [20], an ES 0.3 for the intervention group will be considered a clinically meaningful finding for the primary and secondary outcomes at 3 months post-intervention compared to those in the waitlist control group (WLCG).”
From It is time to address fear of cancer recurrence in family caregivers: protocol for the feasibility and acceptability of a randomized pilot study of the online version of the Family Caregiver–Fear Of Recurrence Therapy (FC-FORT) (2024) · cites this paper as [20]
The Research Method sections describe a meta-analysis of caregiver interventions, calculate effect sizes against control groups, and include follow-up through three months. Statistical Analyses classifies g = 0.20 as small and g = 0.50 as medium, but does not establish 0.3 as a clinically meaningful threshold or specify a waitlist control group. The 0.3 criterion is the citing authors’ decision, not a threshold stated by this review. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe small to moderate effect sizes between conditions at post-intervention and follow-up are in line with other (Web-based) caregiver interventions.
“The small to moderate effect sizes between the conditions at post-intervention and follow-up are in line with other (Web-based) caregiver interventions [10, 38].”
From Web-based self-help intervention for partners of cancer patients based on acceptance and commitment therapy and self-compassion training: a randomized controlled trial with automated versus personal feedback (2021) · cites this paper as [38]
The Discussion reports small-to-medium effects in this meta-analysis of cancer-caregiver interventions, comparable to effects in other caregiver meta-analyses. It does not support the Web-based qualifier: Directions for Future Research says the authors found no published Web-based studies in their target population. Page numbers were not available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Most existing psychosocial interventions for partners were aimed at couples instead of the partner alone, and their primary focus was often on the well-being of the patients.
“However, most of these interventions were aimed at couples instead of the partner alone, and as a consequence the primary focus was often on the well-being of the patients.”
From A web-based self-help intervention for partners of cancer patients based on Acceptance and Commitment Therapy: a protocol of a randomized controlled trial. (2015) · cites this paper as [4]
The Results (Format of Interventions; page unavailable) report that nearly two-thirds of interventions were delivered jointly to patients and family caregivers, and the Discussion says many primarily addressed patient care rather than caregiver self-care. The review concerns family caregivers generally, not partners specifically, and does not establish that joint delivery caused the patient-focused emphasis. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe internet offers opportunities to deliver easy accessible and cost-effective interventions.
“The internet can be of added value in this respect, because it offers opportunities to deliver easy accessible and (cost-)effective interventions [4].”
From A web-based self-help intervention for partners of cancer patients based on Acceptance and Commitment Therapy: a protocol of a randomized controlled trial. (2015) · cites this paper as [4]
In Discussion > Directions for Future Research (page unavailable), the paper identifies the Web as a possible way to deliver interventions to caregivers. It does not establish that Web interventions are easily accessible or cost-effective: it found no published Web studies in its target population, and none of the reviewed studies addressed costs. (LLM, conf=0.88)
Experimental — accuracy not yet measuredExisting values, patterns and roles may have been seriously threatened or challenged by cancer.
“This might especially be useful, as existing values, patterns and roles may have been seriously threatened or challenged by the cancer (e.g. Northouse et al. [4]; Applebaum and Breitbart [2]).”
From A web-based self-help intervention for partners of cancer patients based on Acceptance and Commitment Therapy: a protocol of a randomized controlled trial. (2015) · cites this paper as [4]
The Background says cancer can change family roles and responsibilities, disrupt communication, and harm family relationships. This supports the claim about roles and some patterns of interaction, but our copy does not address existing values being threatened. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe meta-analysis by Northouse et al. showed that psychoeducational, skill-building, and counseling interventions directed at caregivers of cancer patients reduce burden and improve coping, self-efficacy, and quality of life, with small to moderate effect sizes.
“El metaanálisis de Northouse et al. mostró que las intervenciones psicoeducativas, de desarrollo de habilidades y de asesoramiento dirigidas a los cuidadores de pacientes con cáncer reducen la sobrecarga y mejoran el afrontamiento, la autoeficacia y la calidad de vida, con efectos de magnitud pequeña a moderada (14).”
From Síndrome de burnout en cuidadores familiares de pacientes oncológicos: revisión sistemática (2026) · cites this paper as [14]
The Abstract and Discussion report that psychoeducational, skills-training, and counseling interventions reduced caregiver burden and improved coping and self-efficacy, with small to moderate effects. The Discussion’s Clinical Application of Findings section says specific components of quality of life improved, but overall quality of life did not; the claim omits that distinction. (LLM, conf=0.89)
Experimental — accuracy not yet measuredThe needs of partners have been overlooked and only a few interventions target the partners' self-care as primary aim.
“The needs of the partners have been overlooked and only a few interventions target the partners’ self-care as primary aim [4,5].”
A recent meta-analysis and two recent systematic reviews identified a variety of psychosocial interventions for partners of cancer patients.
“A recent meta-analysis [4] and two recent systematic reviews [5,2] identified a variety of psychosocial interventions for partners.”
The presence of mental and physical health complaints has a negative impact on the partner's quality of life and on informal care for the patient.
“Therefore, the presence of mental and physical health complaints not only has a paramount impact on the partner’s quality of life, but it has also a negative impact on the informal care for the patient [4].”
Evidence-based caregiver interventions are well documented.
“Whilst evidence-based caregiver interventions are well documented [16]”
From Preparedness, resilience and unmet needs of informal caregivers of advanced cancer patients in a Regional Mission Hospital in Kenya: Qualitative Study (2023) · cites this paper as [16]
Nonpharmacologic interventions have been tested for distress, anxiety, and depression in patients with cancer and their caregivers.
“Nonpharmacologic interventions (NPIs) have been tested for distress, anxiety, and depression in patients with cancer and their caregivers. 9 , 19 , 20 , 21 , 22 , 23 , 24 , 25”
In one meta-analysis, 29 randomized controlled trials for informal caregivers were evaluated.
“In one meta‐analysis 27, 29 RCTs for ICs were evaluated.”
From Cognitive behavioral therapies for informal caregivers of patients with cancer and cancer survivors: a systematic review and meta-analysis (2017) · cites this paper as [27]
In that meta-analysis, the specific effect of the 7 studies categorized as employing cognitive behavioral therapies was not evaluated.
“Although studies were categorized according to intervention framework, that is, their self‐claimed main treatment orientation, the specific effect of the 7 studies categorized as employing CBTs was not evaluated.”
From Cognitive behavioral therapies for informal caregivers of patients with cancer and cancer survivors: a systematic review and meta-analysis (2017) · cites this paper as [27]
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- Authors
- Northouse, L. L., Katapodi, M. C., Song, L., Zhang, L., & Mood, D. W.
- Affiliations
- University of Michigan (US)
- University of North Carolina at Chapel Hill (US)
- Wayne State University (US)
- Venue
- CA: A Cancer Journal for Clinicians
- Publisher
- Wiley
- Published
- 2010-08-16
- Volume
- 60
- Issue
- 5
- Pages
- n/a-n/a
- ISSN
- 0007-9235 (ISSN-L)
- PMC
- PMC2946584
- OpenAlex
- W2131433218
- Cited by
- 857
- References
- 91
- Citations by year
- 2026: 26 · 2025: 47 · 2024: 48 · 2023: 47 · 2022: 77 · 2021: 75 · 2020: 67 · 2019: 79 · 2018: 68 · 2017: 52 · 2016: 51 · 2015: 60 · 2014: 56 · 2013: 38 · 2012: 46
- FWCI
- 9.45
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- CA A Cancer Journal for Clinicians (publishedVersion)
- PubMed (publishedVersion)
- edoc (University of Basel) (acceptedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- National Cancer Institute (CA090739, R01CA090739)
- Topics
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Sociology and Political Science › Family Support in Illness
- Keywords
- family caregivers, cancer patients, caregiver interventions, caregiver burden, coping, self-efficacy, quality of life, psychoeducational intervention, skills training, therapeutic counseling, patient-caregiver dyads, intervention moderators
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Neoplasms, Quality of Life, Randomized Controlled Trials as Topic, Caregivers
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