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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.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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measured
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“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“The needs of the partners have been overlooked and only a few interventions target the partners’ self-care as primary aim [4,5].”
The cited source says what the claim attributes to it.
In the citing paper
“A recent meta-analysis [4] and two recent systematic reviews [5,2] identified a variety of psychosocial interventions for partners.”
The cited source says what the claim attributes to it.
In the citing paper
“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].”
The cited source says what the claim attributes to it.
In the citing paper
“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]
The cited source says what the claim attributes to it.
In the citing paper
“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 the citing paper
“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 the citing paper
“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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- BIOSTAT, Inc., 2009, Comprehensive Meta-Analysis V.2 Software
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Cancer treatment and survivorship statistics, 2012
Siegel, R. L., Desantis, C. E., Virgo, K. S., Stein, K., Mariotto, A. B., Smith, T. G., Cooper, D. L., Gansler, T. S., Lerro, C. C., Fedewa, S. A., et al. (2012) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.21149 · Cited by 2,979
Caregiver Burden: A Clinical Review
Adelman, R. D., Tmanova, L. L., Delgado, D., Dion, S., & Lachs, M. S. (2014) · JAMA · doi:10.1001/jama.2014.304 · Cited by 2,002
Integration of oncology and palliative care: a Lancet Oncology Commission
Kaasa, S., Loge, J. H., Aapro, M., Albreht, T., Anderson, R., Bruera, E. D., Brunelli, C., Caraceni, A. T., Cervantes, A. M. R., Currow, D. C., et al. (2018) · The Lancet Oncology · doi:10.1016/s1470-2045(18)30415-7 · Cited by 879
Caregiving Burden, Stress, and Health Effects Among Family Caregivers of Adult Cancer Patients
Bevans, M., & Sternberg, E. M. (2012) · JAMA · doi:10.1001/jama.2012.29 · Cited by 620
Wolff, J. L., Spillman, B. C., Freedman, V. A., & Kasper, J. D. (2016) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2015.7664 · Cited by 585
Metadata
- 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 › Nursing › Research and Theory › Nursing care and research
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Clinical Psychology › 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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