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Cited by 82Nursing care and researchCancer survivorship and careFamily Support in Illness

Quality of Life in Caregivers of Cancer Patients: A Literature Review

Open access
Guerra-Martín, María Dolores, Casado-Espinosa, María Del Rocío, Gavira-López, Yelena, Holgado-Castro, Cristina, López-Latorre, Inmaculada, Borrallo-Riego, Álvaro·2023·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph20021570PMC PMC9863368
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Abstract

(1) Background: Cancer constitutes one of the principal causes of morbi-mortality in the world and generates an important loss of patients’ self-sufficiency. People who are their caregivers usually become the main care providers, which impacts their quality of life; (2) Aim: Analyze the different problems (physical, emotional, social, and financial) faced by people who are caregivers of adults with cancer and describe the strategies required to improve their quality of life; (3) Method: A literature review was conducted on the following database: PubMed, Cinahl, PsycINFO, and Scopus. The following eligibility criteria were specified: (a) research studies of quantitative, qualitative, or mixed methods, (b) consistent with objective, and (c) published in the English language or Spanish during the last five years; (4) Results: 36 studies were selected from those found in the literature. Regarding the problems mentioned: eight studies described physical issues, 26 emotional effects, 10 social implications, and seven financial strains. Twenty-eight studies described strategies to improve the quality of life of caregivers; (5) Conclusions: Caregivers are usually women around the age of 50. Problems faced are mostly emotional in nature, followed by social, physical, and financial ones. In order to cope with this burden, there are some strategies that can be developed to help to build skills to manage both the disease and the impact derived from it, therefore improving their quality of life.

AI snapshot

Written from the paper’s full text.

TL;DR

This literature review synthesizes 36 studies on quality of life among caregivers of adults with cancer, finding that caregivers are predominantly women around age 50 and face mainly emotional, social, physical, and financial burdens. It describes strategies such as social support, coping-skills training, exercise, financial support, and health-professional training to improve caregiver quality of life.

Key findings

  • From 1812 initially identified studies, 36 met eligibility criteria; the total caregiver sample was 7663 people, with an average age of 54.42 years and 66.72% women.
  • Problems reported across studies were physical in 8 studies, emotional in 26, social in 10, and financial in 7 according to the abstract; the results text states 10 studies for financial problems but lists seven citations.
  • 28 studies described strategies to improve caregiver quality of life, including enhancing social support (10 studies), developing coping strategies (13 studies), breathing exercises and counseling (1 study), exercise (1 study), financial support (1 study), training health professionals (4 studies), and cultural awareness for professionals (1 study).
  • Caregivers were most commonly spouses or daughters/sons of patients and usually shared the same home; longer caregiving time was associated with greater emotional strain and worse quality of life.

Methods

  • A literature review was conducted in PubMed, Cinahl, PsycINFO, and Scopus during February–May 2022 using the search strategy: [(“Quality of Life” OR “Social Problem”) AND Neoplasm AND (Caregivers OR “Nursing Care”)].
  • Eligibility criteria included quantitative, qualitative, or mixed-method research studies; focus on issues of people caring for adults with cancer; participants aged 18 or older; and publication in English or Spanish during the past five years (2017–2022).
  • Studies were selected in four stages (search, duplicate removal, title/keyword/abstract screening, full-text critical reading), and data were extracted into a table covering author/year, objective, country/period, study type/instrument/sample, and main findings.

Limitations

  • The paper states that limiting the search to the last five years may have excluded available information, sample sizes varied across studies, the diversity of research designs limits interpretation, and no tool was used for study quality assessment.
  • Evident from the text: the review is narrative and does not report a meta-analysis or pooled effect estimates.
  • Evident from the text: the search was restricted to four databases and to English or Spanish publications, which may limit generalizability.

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

Integrity signals

Registry

Crossref · 10.3390/ijerph20021570

Cites

61 of 61 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

85 of 129 cited sources checked · 23 supported · 2 flagged · accuracy not yet measured

  • Findingcitation

    10 studies described financial problems of caregivers, resulting from costs associated with the disease, lack of financial support of other family members, or difficulty reconciling role as caregivers with work activity.

    “In the economic sphere, 10 studies [25,27,39,44,53,56,57] described the financial problems of people caregivers, resulting from the costs associated with the disease, the lack of financial support of other family members, or the difficulty of reconciling their role as caregivers with their work activity.”
    Quote in the paperNot a substantial claim5 of 7 sources checked
    • cites [25] Kristanti, 2019, The experience of family caregivers of patients with cancer in an Asian country: A grounded theory approach, Palliat. Med. source

      The Results (Contextual factors and Actions) describe treatment and care expenses and caregivers who adjusted careers or gave up jobs. The Discussion also links caregiving to reduced time at work. The paper says some caregivers asked relatives for contributions, but does not establish lack of financial support from family members as a cause of their financial problems; the count of 10 studies is an aggregate claim, not a finding of this individual study. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [27] Bilgin, 2018, Effect of nursing care given at home on the quality of life of patients with stomach cancer and their family caregivers’ nursing care, Eur. J. Cancer Care source

      The Discussion reports caregivers’ financial concerns and says economic problems remained unresolved after home nursing care; the Conclusion likewise says their financial concerns continued. The paper does not identify disease-related costs, lack of financial support from family, or difficulty combining caregiving with work as causes. The count of 10 studies belongs to the citing paper’s synthesis, not to this individual source. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [39] Yu, H., Zhang, H., Yang, J., Liu, C., Lu, C., Yang, H., Huang, W., Zhou, J., Fu, W., and Shi, L. (2018). Health utility scores of family caregivers for leukemia patients measured by EQ-5D-3L: A cross-sectional survey in China. BMC Cancer, 18. source

      The Background (page unavailable) says families of cancer patients face a heavy economic burden and risk catastrophic health spending, supporting the disease-cost aspect. The Results (page unavailable) associate caregivers’ low income and unemployment with lower health utility, but the paper does not describe a lack of financial support from other family members or difficulty reconciling caregiving with work. The citing paper’s count of 10 studies is not a finding attributed to this individual source. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [44] Cubukcu, 2018, Evaluation of quality of life in caregivers who are providing home care to cancer patients, Support. Care Cancer source
    • cites [53] Nayak, 2021, Effectiveness of Multicomponent Intervention on Quality of Life of Family Caregivers of Cancer Patients, Asian Pac. J. Cancer Prev. source
    • cites [56] Sadigh, 2022, Correlates of financial toxicity in adult cancer patients and their informal caregivers, Support. Care Cancer source
    • cites [57] Abbasi, 2020, Relationship between caring burden and quality of life in caregivers of cancer patients in Iran, Support. Care Cancer source
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.
  • Findingcitation

    26 studies alluded to emotional and psychological problems suffered by caregivers, highlighting anxiety, depression, feelings of grief and distress, and high levels of stress.

    “At an emotional level, 26 studies [22,23,25,26,27,28,29,30,33,34,35,36,38,40,41,42,43,44,45,46,47,48,49,50,51,52] alluded to the emotional and psychological problems suffered by caregivers, highlighting anxiety, depression, feelings of grief and distress, and high levels of stress.”
    Quote in the paperSubstantial claim7 of 10 sources checked
    • cites [22] Benites, 2022, “You begin to give more value in life, in minutes, in seconds”: Spiritual and existential experiences of family caregivers of patients with advanced cancer receiving end-of-life care in Brazil, Support. Care Cancer source
    • cites [23] Paiva, 2019, What Is Missing for You to Be Happy? Comparison of the Pursuit of Happiness among Cancer Patients, Informal Caregivers, and Healthy Individuals, J. Pain Symptom Manag. source

      The Introduction says cancer caregiving can affect caregivers’ mental health and quality of life, and describes anxiety, depression, and distress as negative consequences studied in oncology. But this paper does not establish grief or high stress among its caregivers; its Results describe a study of happiness, not measurements of those symptoms. The count of 26 studies is the citing paper’s synthesis, not a finding attributed to this individual source. (LLM, conf=0.82)

      Experimental — accuracy not yet measured
    • cites [25] Kristanti, 2019, The experience of family caregivers of patients with cancer in an Asian country: A grounded theory approach, Palliat. Med. source
    • cites [26] Wittenberg, 2019, Variation in health literacy among family caregiver communication types, Psychooncology source
    • cites [27] Bilgin, 2018, Effect of nursing care given at home on the quality of life of patients with stomach cancer and their family caregivers’ nursing care, Eur. J. Cancer Care source
    • cites [28] Cho, 2018, Family Members of Cancer Patients in Korea Are at an Increased Risk of Medically Diagnosed Depression, J. Prev. Med. Public Health source
    • cites [29] McDonald, 2018, Caregiver quality of life in advanced cancer: Qualitative results from a trial of early palliative care, Palliat. Med. source
    • cites [30] Mollica, 2017, The role of medical/nursing skills training in caregiver confidence and burden: A CanCORS study, Cancer source

      The Results report moderate caregiver burden, and Methods > Measures includes an item about feeling stressed while balancing caregiving with other responsibilities. The paper therefore supports the broader point that caregivers experience strain, but our copy does not report anxiety, depression, grief, distress, or high levels of stress among its caregivers. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [33] Baudry, 2019, Profiles of caregivers most at risk of having unmet supportive care needs: Recommendations for healthcare professionals in oncology, Eur. J. Oncol. Nurs. Off. J. Eur. Oncol. Nurs. Soc. source
    • cites [34] Cuthbert, 2018, The Effects of Exercise on Physical and Psychological Outcomes in Cancer Caregivers: Results from the RECHARGE Randomized Controlled Trial, Ann. Behav. Med. source
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.
  • Findingcitation

    Eight studies described that care work implies a greater risk for caregivers of suffering physical morbidity with considerable wear, which increases as care burden continues over time.

    “In relation to physical problems, eight studies [25,34,37,40,41,42,43,44] described that care work implies a greater risk for caregivers of suffering physical morbidity with considerable wear, which in fact increases as the care burden continues over time.”
    Quote in the paperSubstantial claim5 of 8 sources checked
    • cites [25] Kristanti, 2019, The experience of family caregivers of patients with cancer in an Asian country: A grounded theory approach, Palliat. Med. source

      The Results (Consequences > Physical impact; page unavailable) report tiredness and neglect of physical health resulting from caregiving, particularly among elderly participants. This supports a physical toll, but the paper does not establish a greater risk of physical morbidity or that the toll increases as caregiving continues over time. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [34] Cuthbert, 2018, The Effects of Exercise on Physical and Psychological Outcomes in Cancer Caregivers: Results from the RECHARGE Randomized Controlled Trial, Ann. Behav. Med. source
    • cites [37] Steel, 2019, Psychosocial and behavioral pathways of metabolic syndrome in cancer caregivers, Psychooncology source

      The Introduction reports increased cardiovascular disease risk among caregivers, supporting the physical-morbidity concern. But the Results (Sociodemographic Characteristics of Patients and Caregivers; page unavailable) found no significant association between caregiving duration and metabolic syndrome, so this paper does not support the claim that physical morbidity increases as caregiving continues over time. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
    • cites [40] Lim, 2021, Cancer family caregivers’ quality of life and the meaning of leisure, Health Care Women Int. source
    • cites [41] Reblin, 2020, In-home conversations of couples with advanced cancer: Support has its costs, Psychooncology source

      The Background (page unavailable) says spouse caregivers of patients with advanced cancer are at risk of worse physical health outcomes associated with caregiving stress. It does not establish considerable physical morbidity or show that caregivers’ physical health worsens as the care burden continues over time. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [42] Kehoe, 2019, Quality of Life of Caregivers of Older Patients with Advanced Cancer, J. Am. Geriatr. Soc. source

      The Introduction (page not available) says caregiving stress can adversely affect physical health and that care burden increases as cancer progresses. The Discussion (page not available) reports an association between patient impairments and poorer caregiver physical health. The paper does not establish that caregiving causes physical morbidity or that caregivers’ physical deterioration increases over time. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [43] Shin, 2019, Influence of time lapse after cancer diagnosis on the association between unmet needs and quality of life in family caregivers of Korean cancer patients, Eur. J. Cancer Care source

      The Discussion (page unavailable) reports that cancer caregiving stress can exacerbate chronic conditions and affect caregivers’ physical health. It also describes increasing physical depletion over time, but only as one of two competing models; the study found no difference in caregivers’ quality of life by time since diagnosis. The claim presents worsening over time more definitively than this source supports. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [44] Cubukcu, 2018, Evaluation of quality of life in caregivers who are providing home care to cancer patients, Support. Care Cancer source
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.
  • Findingcitation

    10 studies emphasized the need of enhancing social support by reinforcing support networks and facilitating access to support groups and associations.

    “Among the strategies described, 10 studies [28,29,31,32,36,39,41,50,54,57] emphasized the need of enhancing social support by means of reinforcing the support networks and facilitating access to support groups and associations.”
    Quote in the paperNot a substantial claim6 of 10 sources checked
    • cites [28] Cho, 2018, Family Members of Cancer Patients in Korea Are at an Increased Risk of Medically Diagnosed Depression, J. Prev. Med. Public Health source

      The Introduction describes family caregivers as a source of social and emotional support for patients, and the Discussion calls for better diagnosis and management of depression among family members. Neither passage recommends reinforcing support networks or facilitating access to support groups and associations. Searches for those strategies found no supporting passage in our copy. (LLM, conf=0.75)

      Experimental — accuracy not yet measured
    • cites [29] McDonald, 2018, Caregiver quality of life in advanced cancer: Qualitative results from a trial of early palliative care, Palliat. Med. source
    • cites [31] Senneseth, 2017, Facing spousal cancer during child-rearing years: The short-term effects of the Cancer-PEPSONE programme-a single-center randomized controlled trial, Psychooncology source

      The indexed passage labelled “943 kB” (page unavailable) describes Cancer-PEPSONE as an intervention involving families and their social networks, and reports increased social support after one month. This supports reinforcing support networks, but the available passages do not describe facilitating access to support groups or associations. The count of 10 studies is the citing authors’ synthesis, not a finding attributed to this individual trial. (LLM, conf=0.83)

      Experimental — accuracy not yet measured
    • cites [32] Arredondo, 2022, Validation of the Latin American-Spanish version of the scale ‘Quality of Life in Life-Threatening Illness-Family Caregiver Version’ (QOLLTI-F), Health Soc. Care Community

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

    • cites [36] Kassir, Z.M., Li, J., Harrison, C., Johnson, J.T., and Nilsen, M.L. (2021). Disparity of perception of quality of life between head and neck cancer patients and caregivers. BMC Cancer, 21. source

      The Background discusses caregivers’ emotional support and losses to their social lives, while the Discussion and Conclusions propose caregiver screening, therapy referrals, and patient–caregiver communication. I found no passage recommending reinforcement of support networks or access to support groups or associations (searched those terms and social-support interventions). (LLM, conf=0.75)

      Experimental — accuracy not yet measured
    • cites [39] Yu, H., Zhang, H., Yang, J., Liu, C., Lu, C., Yang, H., Huang, W., Zhou, J., Fu, W., and Shi, L. (2018). Health utility scores of family caregivers for leukemia patients measured by EQ-5D-3L: A cross-sectional survey in China. BMC Cancer, 18. source

      The Discussion says social support is important for family caregivers of leukemia patients and notes that caregiver-support programs are lacking in China. It does not recommend reinforcing support networks or facilitating access to support groups and associations as specific strategies. The count of 10 studies is the citing authors’ synthesis, not a finding attributed to this individual paper. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [41] Reblin, 2020, In-home conversations of couples with advanced cancer: Support has its costs, Psychooncology source
    • cites [50] Hyde, 2018, Predictors of long-term distress in female partners of men diagnosed with prostate cancer, Psychooncology source
    • cites [54] Brom, 2019, Social consequences of advanced cancer in patients and their informal caregivers: A qualitative study, Support. Care Cancer source

      The Discussion’s Practical implications section recommends informing social relations about effective ways to help, which may strengthen support systems and reduce isolation. The Perceived social support section discusses mixed experiences of peer support, but the paper does not recommend facilitating access to support groups or associations. The figure of 10 studies describes the citing paper’s group of sources, not a finding attributed to this individual study. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [57] Abbasi, 2020, Relationship between caring burden and quality of life in caregivers of cancer patients in Iran, Support. Care Cancer source
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.
  • Findingcitation

    Caregivers of adults with cancer usually share the same home with the patient.

    “the role of caregiver is undertaken by spouses or daughters/sons of people with cancer and usually share the same home [22,23,25,26,27,28,30,32,33,34,35,36,37,38,39].”
    • Also stated in: § 5. Conclusions · boosted
      “The vast majority of caregivers of adults with cancer are women around 50 years old, being most commonly spouses or daughters of the patient with whom they usually live.”
    Quote in the paperNot a substantial claim3 of 3 sources checked
    • cites [22] Benites, 2022, “You begin to give more value in life, in minutes, in seconds”: Spiritual and existential experiences of family caregivers of patients with advanced cancer receiving end-of-life care in Brazil, Support. Care Cancer source

      The Results > Participants section (page unavailable) identifies caregivers’ relationships to patients and says they had provided care in the community, but does not say whether they shared a home. Searches for living together, household, and residence found no passage establishing that caregivers usually lived with patients. (LLM, conf=0.72)

      Experimental — accuracy not yet measured
    • cites [23] Paiva, 2019, What Is Missing for You to Be Happy? Comparison of the Pursuit of Happiness among Cancer Patients, Informal Caregivers, and Healthy Individuals, J. Pain Symptom Manag. source

      The Eligibility Criteria section includes caregivers accompanying cancer patients whether or not they are relatives, but does not say where they live. The Supplementary sociodemographic table reports caregivers’ marital status and region of residence, not whether they share a home with the patient. Searches for cohabitation and living with the patient found no supporting passage. (LLM, conf=0.74)

      Experimental — accuracy not yet measured
    • cites [25] Kristanti, 2019, The experience of family caregivers of patients with cancer in an Asian country: A grounded theory approach, Palliat. Med. source

      The Methods (Participants and recruitment, Tables 1–2; page unavailable) show that most participants were spouses or adult children and that living with the patient was one way to qualify for the study. Caregivers could instead qualify by providing at least three hours of care a day, and the paper does not report how many shared a home with the patient. It therefore does not support the claim that caregivers usually did so. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • Rests on an assumption: The review's sample of 7663 caregivers is representative of all caregivers of adults with cancer.
  • Classified as probably not a substantial claim. 21
  • May combine two claims. 17

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

    Findingcitation

    Ten studies did not describe average age.

    “However, it must be highlighted that 10 studies did not describe average age [22,23,24,25,26,27,28,29,30,31].”
    Quote in the paperNot a substantial claim8 of 10 sources checked
    • cites [22] Benites, 2022, “You begin to give more value in life, in minutes, in seconds”: Spiritual and existential experiences of family caregivers of patients with advanced cancer receiving end-of-life care in Brazil, Support. Care Cancer source
    • cites [23] Paiva, 2019, What Is Missing for You to Be Happy? Comparison of the Pursuit of Happiness among Cancer Patients, Informal Caregivers, and Healthy Individuals, J. Pain Symptom Manag. source
    • cites [24] Kilic, 2019, Family Caregivers’ Involvement in Caring with Cancer and their Quality of Life, Asian Pac. J. Cancer Prev. source
    • cites [25] Kristanti, 2019, The experience of family caregivers of patients with cancer in an Asian country: A grounded theory approach, Palliat. Med. source

      The Results section reports average ages for both groups: family caregivers had a mean age of 43 and patients a mean age of 55. This contradicts the inclusion of this study among those said not to describe average age. (LLM, conf=0.92)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
    • cites [26] Wittenberg, 2019, Variation in health literacy among family caregiver communication types, Psychooncology source
    • cites [27] Bilgin, 2018, Effect of nursing care given at home on the quality of life of patients with stomach cancer and their family caregivers’ nursing care, Eur. J. Cancer Care source

      The Results report mean ages in Table 1 for patients and Table 2 for family caregivers, contrary to the claim that this cited study did not describe average age. Page numbers are not available in the supplied passages. (LLM, conf=0.90)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
    • cites [28] Cho, 2018, Family Members of Cancer Patients in Korea Are at an Increased Risk of Medically Diagnosed Depression, J. Prev. Med. Public Health source
    • cites [29] McDonald, 2018, Caregiver quality of life in advanced cancer: Qualitative results from a trial of early palliative care, Palliat. Med. source
    • cites [30] Mollica, 2017, The role of medical/nursing skills training in caregiver confidence and burden: A CanCORS study, Cancer source
    • cites [31] Senneseth, 2017, Facing spousal cancer during child-rearing years: The short-term effects of the Cancer-PEPSONE programme-a single-center randomized controlled trial, Psychooncology source

      The indexed copy identifies the cited trial as Paper 2 in a doctoral thesis and says the article is not available there. The available study summary reports the sample size but does not say whether the trial reported participants’ average age. Searches for mean age and demographic characteristics did not resolve that point. (LLM, conf=0.73)

      Experimental — accuracy not yet measured
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.

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

    Premisecitation

    Quality of life comprises physical well-being, emotional, social, and material well-being dimensions.

    “Different authors have described both dimensions and indicators embodied by the quality of life, as follows: 1. Physical well-being dimension, being its indicators health, nutrition, leisure, mobility, and the capacity to develop daily life basic activities.”
    Quote in the paperNot a substantial claim1 of 4 sources checked
    • cites [16] Schalock, R.L., and Verdugo, M.A. (2003). Calidad de vida. Discapacidad e Inclusión, Alianza Editorial. [1st ed.].

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

    • cites [17] 2009, Distribución en España del cuidado formal e informal a las personas mayores de 65 y más years en situación de dependencia, Rev. Espyearla Salud Pública source

      The Introduction (page not provided) defines basic activities of daily living, including self-care and mobility, but does not describe them as quality-of-life indicators. A search for quality-of-life dimensions and for physical, emotional, social, and material well-being found no passage in our copy that sets out the attributed framework. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
    • cites [18] Sala, E. (2022, March 08). La Calidad de vida de las Cuidadoras Informales: Bases para un Sistema de Valoración. Available online: https://www.seg-social.es/wps/wcm/connect/wss/c3f111db-d9a6-4ee8-adfd-cbd7f9a8e99c/F74_07.pdf?MOD=AJPERES.

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

    • cites [19] Villatoro, K., and Sánchez, V. (2012). Calidad de vida y calidad de vida relacionada con la salud. Atención al Tratamiento de las Enfermedades Crónicas Desde el Centro de Salud, Universidad de Valencia.

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

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Study design and conductcitation

    Eligibility criteria for studies were presented with the greatest transparency and clarity in order to control selection bias.

    “Eligibility criteria for studies were presented with the greatest transparency and clarity in order to control selection bias [21].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [21] 2013, Standars on how to develop and report systematics reviews in Psychology and Health, Int. J. Clin. Health Psychol. source

      Step 3 recommends specifying inclusion criteria in the protocol and applying them systematically when selecting studies; the protocol table also calls for defining eligibility criteria. Step 4 notes that study-selection methods can introduce bias, but the paper does not specifically say that presenting eligibility criteria transparently and clearly controls selection bias. (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

    Non-professional caregivers are mostly women, aged 45 to 65, homemakers, and the daughter or spouse of the patient.

    “Diverse studies have profiled non-professional caregivers, concluding that they are mostly women, aged 45 to 65, homemakers, and the daughter or spouse of the patient [8,9].”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [8] Instituto de Mayores y Servicios Sociales (2022, February 27). Cuidados a las Personas Mayores en los Hogares Espyearles: El Entorno Familiar. Available online: http://envejecimiento.csic.es/documentos/documentos/imserso-cuidados-01.pdf.

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

    • cites [9] Navarro, 2016, Perfil de los cuidadores informales y ámbito de actuación del trabajo social, Trab. Soc. Hoy source

      Section 3.4 describes the typical informal caregiver as a woman aged 45–65 and the daughter of the dependent person; section 3.1 also identifies spouses as caregivers. The paper describes caregivers as generally unemployed, however, not as homemakers. Being unemployed does not establish that they are homemakers. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Family caregivers undergo an adaptation and acceptance process, facing numerous tasks with high level of stress, which result in physical, emotional, social, and financial draining, therefore affecting their quality of life.

    “Family caregivers undergo an adaptation and acceptance process with regard to the disease, facing numerous tasks with high level of stress, which result in physical, emotional, social, and financial draining, therefore affecting their quality of life [11,12].”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [11] 2017, Eficacia de las intervenciones no farmacológicas en la calidad de vida de las personas cuidadoras de pacientes con enfermedad de Alzheimer, Gac. Sanit. source

      The passage labeled Abstract (page not supplied) says that family caregivers face multiple tasks and that the workload can harm their physical, psychological and social health and quality of life; it also describes ongoing stress. It does not describe an adaptation-and-acceptance process or financial strain, so those parts of the attributed claim are unsupported. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
    • cites [12] Mesa, 2017, Cuidado de pacientes oncológicos: Una revisión sobre el impacto de la situación de estrés crónico y su relación con la personalidad del cuidador y otras variables moduladoras, Psicooncología source

  • May combine two claims.

    Findingcitation

    10 studies described how the patients' disease process has affected the social interaction of caregivers, who manifest great difficulty in reconciling their role as caregivers and the development of other daily activities, highlighting deterioration of working conditions.

    “With regard to social aspects, 10 studies [24,25,27,31,32,41,49,53,54,55] described how the patients’ disease process has affected the social interaction of caregivers, who manifest a great difficulty in reconciling their role as caregivers and the development of other daily activities, highlighting the deterioration of working conditions.”
    Quote in the paperSubstantial claim7 of 10 sources checked
    • cites [24] Kilic, 2019, Family Caregivers’ Involvement in Caring with Cancer and their Quality of Life, Asian Pac. J. Cancer Prev. source
    • cites [25] Kristanti, 2019, The experience of family caregivers of patients with cancer in an Asian country: A grounded theory approach, Palliat. 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
    • cites [27] Bilgin, 2018, Effect of nursing care given at home on the quality of life of patients with stomach cancer and their family caregivers’ nursing care, Eur. J. Cancer Care 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
    • cites [31] Senneseth, 2017, Facing spousal cancer during child-rearing years: The short-term effects of the Cancer-PEPSONE programme-a single-center randomized controlled trial, Psychooncology 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
    • cites [32] Arredondo, 2022, Validation of the Latin American-Spanish version of the scale ‘Quality of Life in Life-Threatening Illness-Family Caregiver Version’ (QOLLTI-F), Health Soc. Care Community

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

    • cites [41] Reblin, 2020, In-home conversations of couples with advanced cancer: Support has its costs, Psychooncology 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
    • cites [49] Hsu, 2019, Understanding Caregiver Quality of Life in Caregivers of Hospitalized Older Adults with Cancer, J. Am. Geriatr. Soc. source
    • cites [53] Nayak, 2021, Effectiveness of Multicomponent Intervention on Quality of Life of Family Caregivers of Cancer Patients, Asian Pac. J. Cancer Prev. source
    • cites [54] Brom, 2019, Social consequences of advanced cancer in patients and their informal caregivers: A qualitative study, Support. Care Cancer source
    • cites [55] Wood, 2019, The humanistic burden associated with caring for patients with advanced non-small cell lung cancer (NSCLC) in three European countries-a real-world survey of caregivers, Support. Care Cancer source
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.

  • May combine two claims.

    Findingcitation

    13 studies indicated the need of developing coping strategies to improve management and control of both the situation and emotional strain, and to help increase training in caregivers, thus improving self-efficacy while reducing emotional impact.

    “Thirteen studies [23,24,27,30,32,35,37,38,45,46,47,49,54] indicated the need of developing coping strategies to improve the management and control of both the situation and the emotional strain, and also to help increase training in caregivers, thus improving their self-efficacy while reducing the emotional impact.”
    Quote in the paperSubstantial claim7 of 10 sources checked
    • cites [23] Paiva, 2019, What Is Missing for You to Be Happy? Comparison of the Pursuit of Happiness among Cancer Patients, Informal Caregivers, and Healthy Individuals, J. Pain Symptom Manag. source

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

      Experimental — accuracy not yet measured
    • cites [24] Kilic, 2019, Family Caregivers’ Involvement in Caring with Cancer and their Quality of Life, Asian Pac. J. Cancer Prev. 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
    • cites [27] Bilgin, 2018, Effect of nursing care given at home on the quality of life of patients with stomach cancer and their family caregivers’ nursing care, Eur. J. Cancer Care 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
    • cites [30] Mollica, 2017, The role of medical/nursing skills training in caregiver confidence and burden: A CanCORS study, Cancer source

      The Conclusions (page not provided) report that medical/nursing skills training was associated with reduced burden among cancer caregivers, partly mediated by confidence in providing physical care. The paper mentions coping and problem-solving training as prior work, but it does not establish that developing coping strategies improves control of the situation or reduces emotional strain. Its findings are associations, not proof that training causes those improvements. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
    • cites [32] Arredondo, 2022, Validation of the Latin American-Spanish version of the scale ‘Quality of Life in Life-Threatening Illness-Family Caregiver Version’ (QOLLTI-F), Health Soc. Care Community

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

    • cites [35] Halkett, 2020, From the carer’s mouth: A phenomenological exploration of carer experiences with head and neck cancer patients, Psychooncology source
    • cites [37] Steel, 2019, Psychosocial and behavioral pathways of metabolic syndrome in cancer caregivers, Psychooncology 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
    • cites [38] Washington, 2018, Delivering problem-solving therapy to family caregivers of people with cancer: A feasibility study in outpatient palliative care, Psychooncology source

      The Background describes problem-solving therapy as a way to improve coping and lessen distress, while Methods > Study Arms describes caregivers learning techniques to address caregiving stressors. The Results report reduced anxiety, but the paper does not report improved caregiver self-efficacy or establish a broader reduction in emotional impact; depression and quality-of-life differences were not statistically significant. Page numbers are unavailable in our copy. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [45] Jacobs, 2020, Multimodal psychosocial intervention for family caregivers of patients undergoing hematopoietic stem cell transplantation: A randomized clinical trial, Cancer source
    • cites [46] Pereira, 2020, Quality of life in caregivers of patients with multiple myeloma, Aging Ment. Health source
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.

  • May combine two claims.

    Findingcitation

    15 studies described caregivers as mostly spouses or daughters/sons of patients with cancer, usually sharing the same home.

    “As for family bonds, 15 studies described these caregivers as being mostly spouses or daughters/sons of the patients with cancer, usually sharing the same home [22,23,25,26,27,28,30,32,33,34,35,36,37,38,39].”
    Quote in the paperNot a substantial claim7 of 10 sources checked
    • cites [22] Benites, 2022, “You begin to give more value in life, in minutes, in seconds”: Spiritual and existential experiences of family caregivers of patients with advanced cancer receiving end-of-life care in Brazil, Support. Care Cancer source

      Table 1 in Results > Participants lists 7 partners/spouses and 7 sons among 16 caregivers, supporting the description of caregivers as mostly spouses or children. Neither that table nor the Participants passage says whether caregivers usually shared a home with patients; providing care in the community does not establish cohabitation. The count of 15 studies is the citing paper’s synthesis, not a finding attributed to this individual study. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [23] Paiva, 2019, What Is Missing for You to Be Happy? Comparison of the Pursuit of Happiness among Cancer Patients, Informal Caregivers, and Healthy Individuals, J. Pain Symptom Manag. source

      The Results report 126 informal caregivers of cancer patients, and the Eligibility Criteria allow caregivers whether or not they are relatives. The passages found on participant characteristics and recruitment do not report how many caregivers were spouses or children, or whether they shared a home with the patient. I searched for caregiver–patient relationships and cohabitation; this copy does not establish the family-bond pattern attributed to this study. (LLM, conf=0.72)

      Experimental — accuracy not yet measured
    • cites [25] Kristanti, 2019, The experience of family caregivers of patients with cancer in an Asian country: A grounded theory approach, Palliat. Med. source

      The Methods participant table reports that 20 of 24 caregivers were spouses, daughters, or sons, supporting this paper as one example among the cited studies. The inclusion criteria allowed caregivers who lived with the patient or provided at least three hours of care daily; they do not establish that caregivers usually shared a home. The count of 15 studies belongs to the citing paper's synthesis, not to this individual study. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [26] Wittenberg, 2019, Variation in health literacy among family caregiver communication types, Psychooncology source
    • cites [27] Bilgin, 2018, Effect of nursing care given at home on the quality of life of patients with stomach cancer and their family caregivers’ nursing care, Eur. J. Cancer Care source

      The Results (Table 2; page unavailable) show that nearly all caregivers in this study were spouses, children, or other close relatives of patients with stomach cancer. The paper does not establish that they usually shared the patient's home, and this single study cannot substantiate the citing sentence's count of 15 studies. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [28] Cho, 2018, Family Members of Cancer Patients in Korea Are at an Increased Risk of Medically Diagnosed Depression, J. Prev. Med. Public Health source

      The Methods section defines the studied family members as people sharing a household with a cancer patient, supporting the cohabitation part of the claim. It does not establish that these family members were mostly spouses or sons and daughters, or that all provided care; the Discussion says the study did not measure caregiver burden and cites another study when describing traditional caregivers’ family relationships in Korea. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
    • cites [30] Mollica, 2017, The role of medical/nursing skills training in caregiver confidence and burden: A CanCORS study, Cancer source

      The Results (Respondent and corresponding care recipient characteristics; page unavailable) report that 62.6% of caregivers were spouses of patients with lung or colorectal cancer. Our copy does not establish that daughters or sons were also a predominant group or that caregivers usually shared the patient's home. The count of 15 studies is the citing document's summary, not a finding attributed to this individual study. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [32] Arredondo, 2022, Validation of the Latin American-Spanish version of the scale ‘Quality of Life in Life-Threatening Illness-Family Caregiver Version’ (QOLLTI-F), Health Soc. Care Community

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

    • cites [33] Baudry, 2019, Profiles of caregivers most at risk of having unmet supportive care needs: Recommendations for healthcare professionals in oncology, Eur. J. Oncol. Nurs. Off. J. Eur. Oncol. Nurs. Soc. source

      The Participants section (page not supplied) reports that 280 of 364 caregivers (76.92%) were patients’ spouses, supporting the family-bond description for this study. Our copy does not establish that caregivers usually shared the patient’s home or that daughters and sons were a predominant group. This single study also does not substantiate the citing paper’s count of 15 studies. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [34] Cuthbert, 2018, The Effects of Exercise on Physical and Psychological Outcomes in Cancer Caregivers: Results from the RECHARGE Randomized Controlled Trial, Ann. Behav. Med. source
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.

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

    Findingcitation

    One study pointed out the need of providing financial support to caregivers in order to improve their well-being.

    “One study [39] pointed out the need of providing financial support to caregivers in order to improve their well-being.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [39] Yu, H., Zhang, H., Yang, J., Liu, C., Lu, C., Yang, H., Huang, W., Zhou, J., Fu, W., and Shi, L. (2018). Health utility scores of family caregivers for leukemia patients measured by EQ-5D-3L: A cross-sectional survey in China. BMC Cancer, 18. source

      The Discussion (page not available) reports lower health utility among caregivers with the lowest household income, which supports concern about their financial circumstances. It does not recommend providing financial support as a way to improve well-being; instead, it cautions that financial support alone may not solve caregivers’ low health utility. (LLM, conf=0.83)

      Experimental — accuracy not yet measured
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.

  • May combine two claims.

    Interpretationcitation

    Care provision by caregivers of adults with cancer causes financial problems, including lack of financial support, costs derived from the disease process, and difficulty developing work activity.

    “Several review studies [25,27,39,44,53,56,57] mentioned the financial problems of caregivers, highlighting among the possible causes, the lack of financial support, the costs derived from the disease process itself, or the difficulty of developing their work activity.”
    Quote in the paperNot a substantial claim3 of 3 sources checked
    • cites [25] Kristanti, 2019, The experience of family caregivers of patients with cancer in an Asian country: A grounded theory approach, Palliat. Med. source

      The Results (Contextual factors and Consequences; pages unavailable) report financial strain from cancer-care expenses, including costs not covered by insurance. The Discussion also describes reduced time at work, and the Results (Actions) report caregivers adjusting careers or leaving jobs. The paper does not explicitly identify a general lack of financial support as a cause, and it is a grounded-theory study rather than a review study. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [27] Bilgin, 2018, Effect of nursing care given at home on the quality of life of patients with stomach cancer and their family caregivers’ nursing care, Eur. J. Cancer Care source

      The Results report that some caregivers wanted financial aid, and the Discussion describes caregivers’ financial concerns and low-to-moderate economic status. The paper does not identify disease-related costs or difficulty working as causes of those concerns, and it is a home-nursing intervention study rather than a review. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [39] Yu, H., Zhang, H., Yang, J., Liu, C., Lu, C., Yang, H., Huang, W., Zhou, J., Fu, W., and Shi, L. (2018). Health utility scores of family caregivers for leukemia patients measured by EQ-5D-3L: A cross-sectional survey in China. BMC Cancer, 18. source

      The Background states that families of cancer patients in China bear a heavy economic burden and are vulnerable to catastrophic health spending. It does not identify lack of financial support or difficulty working as causes of caregivers’ financial problems. The cited paper is a cross-sectional survey, not a review study; page numbers were not available in our copy. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • Rests on an assumption: The included studies' findings are sufficiently credible to support the review's conclusions despite the absence of a formal quality assessment.
    • Rests on an assumption: The diversity of research designs and sample sizes across included studies does not prevent a meaningful synthesis of their findings.

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

    Findingcitation

    One study included completion of breathing exercises and counseling sessions to reduce emotional strain.

    “One study [53] included the completion of breathing exercises and counseling sessions to reduce emotional strain.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [53] Nayak, 2021, Effectiveness of Multicomponent Intervention on Quality of Life of Family Caregivers of Cancer Patients, Asian Pac. J. Cancer Prev. source
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.

  • May combine two claims.

    Findingcitation

    Four studies highlighted the need of training health professionals on existential and spiritual distress management, as well as the need to identify groups at risk and reassigning tasks among all family members.

    “Four studies [22,24,44,48] highlighted the need of training properly health professionals on existential and spiritual distress management, as well as the need to identify groups at risk and reassigning tasks among all family members.”
    Quote in the paperNot a substantial claim3 of 4 sources checked
    • cites [22] Benites, 2022, “You begin to give more value in life, in minutes, in seconds”: Spiritual and existential experiences of family caregivers of patients with advanced cancer receiving end-of-life care in Brazil, Support. Care Cancer source

      The Discussion (page unavailable) recommends training health care providers to manage patients’ and family members’ existential and spiritual distress. The available passages do not recommend identifying groups at risk or reassigning tasks among family members; searches for those recommendations found no supporting passage. The source therefore supports only the training portion of the sentence. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [24] Kilic, 2019, Family Caregivers’ Involvement in Caring with Cancer and their Quality of Life, Asian Pac. J. Cancer Prev. source

      The Discussion (page unavailable) identifies female caregivers as having lower quality-of-life scores and recommends interventions for the entire family, which partly supports identifying caregivers at risk and involving family members. It does not recommend reassigning tasks among family members or training health professionals specifically to manage existential and spiritual distress; its recommendation is to provide information and tools to patients and caregivers. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [44] Cubukcu, 2018, Evaluation of quality of life in caregivers who are providing home care to cancer patients, Support. Care Cancer source
    • cites [48] Abdullah, 2019, Health-Related Quality of Life (HRQOL) of Gastrointestinal Cancer Caregivers: The Impact of Caregiving, Asian Pac. J. Cancer Prev. source

      The Discussion (page not provided) says health care providers should identify caregivers at risk of poor quality of life and offer them more resources. It does not call for training professionals to manage existential or spiritual distress, or for reassigning tasks among all family members. The study records whether caregiving was shared, but that is not a recommendation to redistribute tasks. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.

  • May combine two claims.

    Interpretationcitation

    Care provision by caregivers of adults with cancer causes physical problems, and the risk of physical morbidity increases the longer care activity continues.

    “Different review studies have revealed that care provision on the part of caregivers causes physical problems, increasing the risk of suffering physical morbidity the longer the care activity continues [25,34,37,40,41,42,43,44].”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites [25] Kristanti, 2019, The experience of family caregivers of patients with cancer in an Asian country: A grounded theory approach, Palliat. Med. source

      The Results (Consequences, Physical impact; page unavailable) report tiredness and neglect of their own physical condition as effects of caregiving, particularly among elderly participants. The paper does not report that physical morbidity risk increases with the duration of care, and its qualitative findings do not establish that risk relationship. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [34] Cuthbert, 2018, The Effects of Exercise on Physical and Psychological Outcomes in Cancer Caregivers: Results from the RECHARGE Randomized Controlled Trial, Ann. Behav. Med. source
    • cites [37] Steel, 2019, Psychosocial and behavioral pathways of metabolic syndrome in cancer caregivers, Psychooncology source

      The Introduction reports an association between caregiving and cardiovascular disease risk, but does not establish that caregiving causes physical problems. The Results (Sociodemographic Characteristics of Patients and Caregivers) found no significant association between caregiving duration and metabolic syndrome, so the claimed increase in morbidity risk with longer caregiving is not supported. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
    • Rests on an assumption: The included studies' findings are sufficiently credible to support the review's conclusions despite the absence of a formal quality assessment.
    • Rests on an assumption: The diversity of research designs and sample sizes across included studies does not prevent a meaningful synthesis of their findings.

  • May combine two claims.

    Interpretationcitation

    Care provision by caregivers of adults with cancer causes social problems, including difficulty reconciling caregiving with other activities, deterioration of working conditions, and less social event engagement.

    “Regarding social problems, review studies [24,25,27,31,32,41,49,53,54,55] described how social interactions of caregivers were affected to the point of finding it very difficult to reconcile their role of caregivers with the rest of activities, where deterioration of working conditions and lesser social event engagement were highlighted.”
    Quote in the paperSubstantial claim3 of 3 sources checked
    • cites [24] Kilic, 2019, Family Caregivers’ Involvement in Caring with Cancer and their Quality of Life, Asian Pac. J. Cancer Prev. source
    • cites [25] Kristanti, 2019, The experience of family caregivers of patients with cancer in an Asian country: A grounded theory approach, Palliat. Med. source

      In Results > Actions (page unavailable), caregivers reported changing career plans, leaving jobs, working overtime, and giving up personal preferences to provide care. The Discussion (page unavailable) also notes reduced time at work or other productive tasks. These passages support disruption to work and other activities, but our copy does not establish reduced attendance at social events or the claim’s degree of difficulty reconciling roles. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [27] Bilgin, 2018, Effect of nursing care given at home on the quality of life of patients with stomach cancer and their family caregivers’ nursing care, Eur. J. Cancer Care source

      The Discussion (page unavailable) reports hardship in the caregiver role, impaired social interaction, and disruption in daily life among family caregivers of patients with stomach cancer. These findings support the claim about difficulty balancing caregiving with other activities, but the paper does not report deteriorating working conditions or reduced attendance at social events. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • Rests on an assumption: The included studies' findings are sufficiently credible to support the review's conclusions despite the absence of a formal quality assessment.
    • Rests on an assumption: The diversity of research designs and sample sizes across included studies does not prevent a meaningful synthesis of their findings.

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

    Findingcitation

    Two studies in the review described a larger number of male caregivers than female caregivers.

    “However, there were two studies that described a larger number of male caregivers with respect to women [28,31].”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [28] Cho, 2018, Family Members of Cancer Patients in Korea Are at an Increased Risk of Medically Diagnosed Depression, J. Prev. Med. Public Health source

      The Results report that, among family members of cancer patients, the proportion of males was approximately 15.2% higher than the proportion of females. However, the Methods define this group by shared household ID, not by whether members provided care, so the paper does not establish that male caregivers outnumbered female caregivers. This citation is one of the two studies named in the citing sentence; it need not itself establish the count of studies. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [31] Senneseth, 2017, Facing spousal cancer during child-rearing years: The short-term effects of the Cancer-PEPSONE programme-a single-center randomized controlled trial, Psychooncology source

      The available passage describing the study sample (section labeled “943 kB”; no page given) says it included 35 well parents caring for minor children, but gives no breakdown by sex. Searches for male and female caregivers, men and women, and participant sex distribution found no passage establishing whether men outnumbered women in this study. (LLM, conf=0.72)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingown data

    The total sample comprised 7663 caregivers with an average age of 54.42 years.

    “The total sample comprised 7663 people caregivers with an average age of 54.42 years.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.

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

    Findingown data

    Among selected studies, 28 followed a quantitative research method; 22 were descriptive, exploratory, or observational; 4 were randomized controlled trials; 1 was an experimental controlled trial; 1 was a case-control study; 7 were qualitative; and 1 was mixed method.

    “With regard to their typology, 28 studies followed a quantitative research method. Twenty-two of them were descriptive, exploratory, or based on observation; four were randomized controlled trials; one was an experimental controlled trial; and one was a case–control study. In the remaining studies, seven followed a qualitative research method and one, a mixed method.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.

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

    Findingown data

    66.72% of caregivers were women.

    “With regard to sex, 66.72% of caregivers were women.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.

  • May combine two claims.

    Findingreasoning

    The longer the care was needed over time, the greater the tension and emotional burden, resulting in worse quality of life.

    “Therefore, showing that, the longer the care was needed over time, the greater the tension and emotional burden, resulting in worse quality of life.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.

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

    Findingcitation

    One study described that health professionals require cultural awareness in order to properly meet the needs of caregivers.

    “One study [26] described that health professionals require cultural awareness in order to properly meet the needs of caregivers.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] Wittenberg, 2019, Variation in health literacy among family caregiver communication types, Psychooncology source
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.

  • May combine two claims.

    Findingown data

    Caregivers of adults with cancer are usually women around the age of 50.

    “Caregivers are usually women around the age of 50.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The 36 selected studies are representative of the available evidence on caregivers of adults with cancer.
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.
    • Rests on an assumption: The findings of the included studies can be aggregated despite differences in design, population, and setting.

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

    Findingcitation

    One study suggested exercising practice to improve perceived health levels on the part of caregivers.

    “One study [34] suggested exercising practice to improve the perceived health levels on the part of caregivers.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [34] Cuthbert, 2018, The Effects of Exercise on Physical and Psychological Outcomes in Cancer Caregivers: Results from the RECHARGE Randomized Controlled Trial, Ann. Behav. Med. source
    • Rests on an assumption: The methodological quality of the included studies is sufficient to support the review's conclusions.

  • May combine two claims.

    Findingown data

    The total sample of the review comprised 7663 caregivers, of whom 66.72% were women.

    “The total sample was made up of 7663 caregivers, 66.72% were women.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Being the caregiver of a care-dependent person implies an 86% risk of suffering anxiety and a 65% risk of suffering depression.

    “At the same time, being the caregiver of a care-dependent person implies 86% risk of suffering anxiety, and 65% of suffering depression [7].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7] 2012, Ansiedad y depresión en cuidadores de pacientes dependientes, Med. Fam.-SEMERGEN source

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

    Premisecitation

    Cancer causes devastation at physical, emotional, and social levels to people who suffer it and their families.

    “Cancer causes devastation at physical, emotional, and social levels to people who suffer it and their families [10].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] Cabrera, 2017, La psicología y la oncología: En una unidad imprescindible, Rev. Finlay

      Not checked in the free run.

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

    Premisecitation

    39% of caregivers have no education.

    “39% of caregivers have no education”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] 2012, Formación del cuidador informal: Relación con el tiempo de cuidado a personas dependientes mayores de 65 years, Aquichan

      Not checked in the free run.

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

    Premisecitation

    Cancer is one of the leading causes of death through disease and its cure remains unsolved despite advances in diagnosis and treatment.

    “According to the WHO, cancer is one of the leading causes of death through disease and its cure is still unsolved despite the advances in diagnosis and treatment [2].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] World Health Organization (2022, March 03). Cancer. Available online: https://www.who.int/news-room/fact-sheets/detail/cancer. source

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

    Premisecitation

    Cancer is a leading cause of mortality and morbidity in the world.

    “Cancer is considered the disease of the 21st century, as it is a leading cause of mortality and morbidity in the world [1].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] National Cancer Institute (2022, March 03). What Is Cancer?, Available online: https://www.cancer.gov/about-cancer/understanding/what-is-cancer.

      Not checked in the free run.

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

    Premisecitation

    The average time devoted to provide care is 10.9 h per day.

    “the average time devoted to provide care is 10.9 h per day [5]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] 2012, Formación del cuidador informal: Relación con el tiempo de cuidado a personas dependientes mayores de 65 years, Aquichan

      Not checked in the free run.

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

    Premisecitation

    The concept of quality of life is greatly influenced by the social context experienced by the individual and the relationship this person establishes with everything that surrounds her or him.

    “The concept quality of life is greatly influenced by the social context experienced by the individual and the relationship this person establishes with everything that surrounds her or him [14].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14] Vinaccia, 2005, Calidad de vida, personalidad resistente y apoyo social percibido en pacientes con diagnóstico de cáncer pulmonar, Psicol. Salud source

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

    Study design and conductcitation

    Data were collected in a table following the recommendations of author Del Pino et al.

    “Data were collected in a table following the recommendations of author Del Pino et al. [20].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] Palomino, 2014, La revisión sistemática cuantitativa en enfermería, Rev. Iberoam. Enferm. Comunitaria

      Not checked in the free run.

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

    Study design and conductnone given

    The diversity of research designs employed limits interpretations.

    “On the other hand, the diversity of the research designs that were employed also limits interpretations.”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    No tool was used for study quality assessment.

    “Another limitation is that no tool was used for study quality assessment.”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    The number of subjects in the sample varied from one study to another.

    “Furthermore, the number of subjects in the sample vary from one study to another.”
    Quote in the paperNot a substantial claim
34 of 34

  • The paper relies on this without support.

    The 36 selected studies are representative of the available evidence on caregivers of adults with cancer.

    “Of the 1812 studies initially identified, 36 were selected as being consistent with the review objective and eligibility criteria (Figure 1).”

  • The paper relies on this without support.

    The methodological quality of the included studies is sufficient to support the review's conclusions.

    “Specific characteristics of these studies are detailed in Table 1.”

  • The paper relies on this without support.

    The findings of the included studies can be aggregated despite differences in design, population, and setting.

    “The total sample comprised 7663 people caregivers with an average age of 54.42 years.”

  • The paper relies on this without support.

    Cancer and its treatment cause sequelae and loss of self-sufficiency, requiring informal caregivers.

    “Cancer, as other chronic diseases, has numerous sequelae and an important limitation of self-sufficiency, thus requiring support from other people, usually from their immediate circle.”

  • The paper relies on this without support.

    The included studies' findings are sufficiently credible to support the review's conclusions despite the absence of a formal quality assessment.

    “Another limitation is that no tool was used for study quality assessment.”

  • The paper relies on this without support.

    The studies retrieved by the five-year search strategy are representative of the available evidence on caregivers of adults with cancer.

    “Shortening the search strategy to the last five years made it impossible to recover all the information available on this subject, though a rigorous process was followed in order to obtain the latest scientific findings.”

  • The paper relies on this without support.

    The diversity of research designs and sample sizes across included studies does not prevent a meaningful synthesis of their findings.

    “On the other hand, the diversity of the research designs that were employed also limits interpretations.”

  • The paper relies on this without support.

    The review's sample of 7663 caregivers is representative of all caregivers of adults with cancer.

    “The total sample was made up of 7663 caregivers, 66.72% were women.”
8 of 8

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Common feelings among caregivers include anxiety, distress, and depression, as well as changes in roles at home, school, or work.

    “Common feelings among caregivers include anxiety, distress, and depression9,10, as well as changes in roles at home, school, or work11.”

    From Anxiety, depression, and quality of life of caregivers of palliative care patients with cancer (2025) · cites this paper as [10]

    The Results (section 3.2.2; page unavailable) identify anxiety, distress, and depression among caregivers of adults with cancer. They also describe difficulty reconciling caregiving with daily activities and deteriorating working conditions, but do not address changes in school roles. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

Self-check

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

Each contradiction between two passages listed here was confirmed by an independent check.

  • Conflicting counts of studies reporting financial problems

    Minor

    The abstract reports seven studies describing financial strains, but the Results section says 10. The Results section cites seven studies for that claim, consistent with the abstract rather than its stated count of 10.

1 of 1

Cites

Flagged first, then by citations

2 of the 63 references couldn’t be matched to a known paper.

Research works printed but not linked: 6

  1. 2012, Formación del cuidador informal: Relación con el tiempo de cuidado a personas dependientes mayores de 65 years, Aquichan, 12, 241
  2. Lorenzo, 2019, Carga del cuidador en cuidadores informales primarios de pacientes con cáncer de cabeza y cuello, Rev. Habanera Cienc. Méd., 18, 126
  3. Mora, 2022, Bienestar y apoyo social en cuidadores informales de pacientes oncológicos, Eureka, 19, 54
  4. Rizo, 2016, Caracterización del cuidador primario de enfermero oncológico en estado avanzado, Rev. Cuba. Med. Gen. Integral, 32, 1
  5. Alvarado, 2009, Desgaste físico y Emocional del Cuidador Primario en Cáncer, Cancerología, 4, 39
  6. 2012, El papel del cuidado informal en la atención a la dependencia: ¿cuidamos a quiénes cuidan?, Actas Depend., 6, 99

Cited by

Sorted by citations

Related

Authors
Guerra-Martín, M. D., Casado-Espinosa, M. D. R., Gavira-López, Y., Holgado-Castro, C., López-Latorre, I., & Borrallo-Riego, Á.
Affiliations
  • Universidad de Sevilla (ES)
  • Andalusian Health Service (ES)
  • IDCQ Hospitales y Sanidad, S.L.U. (ES)
Corresponding author
Borrallo-Riego, Álvaro
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2023-01-15
Volume
20
Issue
2
Pages
1570
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph20021570
PMC
PMC9863368
OpenAlex
W4316464995
Semantic Scholar
06e0a22d391a8a4b252e35045c2fa7ead7a35019
Cited by
80
References
63
Citations by year
2026: 30 · 2025: 20 · 2024: 18 · 2023: 11 · 2022: 1
FWCI
28.95
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (submittedVersion, cc-by)
  • RePEc: Research Papers in Economics (submittedVersion)
  • Deposito de Investigacion Universidad de Sevilla (University of Seville) (submittedVersion, cc-by)
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
caregiver quality of life, cancer caregivers, caregiver burden, financial stress, physical burden, coping strategies, family caregivers
MeSH terms
Adult, Female, Humans, Neoplasms, Quality of Life, 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.

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.

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