Table 1.
Characteristics of included intervention studies for family caregivers of patients with advanced cancer
| Author/Country | Subject | N | Attrition Rate | Type of Intervention | Theoretical Basis | Setting of Intervention | Research Design | Overall Risk of Biasa |
|---|---|---|---|---|---|---|---|---|
| Psychosocial support | ||||||||
| Leow et al. /Singapore [36] | Family caregiver of a person with advanced (stage IV) cancer receiving home hospice care (having a prognosis of at least 3 months) | Con: n=42 Int: n=38 Mean age (years) 47.16±11.76 (range 22–72) Gender Male: n = 26 (32.5%) Female: n = 54 (67.5%) Race Chinese: n = 68 (85%) Malay: n = 8 (10%) Indian: n = 3 (3.8%) Caucasian: n = 1 (1.3%) |
Con: 0% Int: 0% | Int: Psychosocial Con: Routine care for their respective home hospice organization | Self-efficacy theory | Home hospice organizations and Outpatient clinic | RCT | Poor |
| McDonald et al. /Canada [25] | Primary caregivers of patients with stage IV cancer or stage III advanced cancer with poor prognosis (having a prognosis of 6–24 months) | Con: n=88 Int: n=94 Median age (years) Con: 57.0 (22–81) Int: 58.0 (25–83) Gender Male: 63 (34.6%) Female: 119 (65.4%) Race Not described |
Con: 15.9% Int: 18.1% | Int: Psychosocial Con: Standard oncology care | Not indicated | Outpatient Palliative clinic |
Cluster random ized trial | Poor |
| Educational support | ||||||||
| Badr et al. /US [31] | Advanced lung cancer patients and their caregivers (patients within 1 month of treatment initiation) | Con: 19 dyads Int: 20 dyads Mean age (years) 51.10±10.24 (range 35–70) Gender (caregivers) Male: 12 (31%) Female: 27 (69%) Race Not assessed |
Con: 5.2% Int: 0% | Int: Educational Con: Usual medical care | Selfdetermination theory (SDT) | Home | RCT | Poor |
| Dionne-Odom et al. /US [26] | Caregivers of patients with new diagnosis, recurrence, or progression of an advanced- stage cancer within 30–60 days (having a prognosis of 6–24 months) | Con (delayed palliative care group): n = 61 Int (early palliative care group): n = 61 Mean age (years) Con: 57.9±11.9 Int: 61.0±11.6 Gender Male: n = 26 (21.3%) Female: n = 96 (78.7%) Race White: n = 113 (92.6%) Other: n = 5 (4.1%) Missing: n =4 (3.3%) |
32% | Educational | Not indicated | Home | RCT (waitcontrol design) | Fair |
| DuBe nske et al. /US [33] | Primary caregivers of patients with non-small cell lung cancer at stage IIIA, IIIB, or TV (having a prognosis of at least 4 months) |
Con (Internet): n=117 Int (CHESSb): n=121 Mean age (years) 55.56 (range 18–84) Gender Male: 66 (28.2%) Female: 168 (71.8%) Race Not described |
Con: 43. 3% Int:45.8% | Int: Educational Con: Standard care plus a laptop computer with Internet access and a list of lung cancer and palliative care websites. | Not indicated | Home | RCT | Good |
| Holm et al. /Swed en [32] | Family caregivers to cancer patients in specialized palliative home care (having a prognosis longer than 5 weeks) | Con: n= 122 Int: n= 148 Mean age (years) Con: 60.0±14.3 Int: 63±13.4 Gender Male: 65 (33.5%) Female: 129 (66.5%) Race Not described |
Con: 27.9% Int: 39.9% | Int: Educational Con: Standard support from palliative settings | Theoretical framework of relatives’ involvement in palliative care | Home | RCT | Good |
| Psycho-educational support | ||||||||
| Hudson et al. /Australia [23,24] |
Primary family caregivers of patients with advanced cancer receiving home-based palliative care (within 2 weeks of referral) | Con: 148 Int 1 (one visit and three phone calls): 57 Int 2 (two visits and two phone calls): 93 Mean age (years) 59.0–13.9 (range 22–88) Gender Male: n = 85 (28.5%) Female: n = 207(69.5%) Unknown: n = 2 (0.7%) Race Not described |
Con: 48.6% Int 1: 45.6% Int 2: 43.0% | Int: Psychoeducational Con: Usual palliative care | Transaction al model of stress and coping | Home (home visits and phone calls) | RCT | Good |
| Hudson et al. /Australia [27] |
Caregivers of patients with advanced cancer receiving home-based palliative care (having a prognosis of several months) | N = 156 Mean age (years) 58.7±13.5 (range 20–84) Gender Male: n = 46 (30 %) Female: n = 109 (70%) Race Not described |
38% | Psychoeducational | Transaction al model of coping | Home- based palliative care service centers | Quasiexperimental study | Moderate |
| North ouse et al. /US [29] | Patients with advanced breast, colorectal , lung, or prostate cancer (stage III or IV, (having a prognosis of at least 6 months) and their primary family caregivers | Con: n= 163 Extensive Int: n= 162 Brief Int: n= 159 Mean age (years) 56.7±12.6 (range 18–88) Gender (caregivers) Male: 44.2% Female: 55.8% Race (dyads) Caucasian: 82.5% African- American: 13.5% Asian: 1.3% Multi-racial: 0.3% |
Con: 36.2% Extensi ve Int: 38.9% Brief Int: 37.7% |
Int: Psycho- educational Con: Usual care at the cancer center including medical treatment of cancer and symptom management | Stress-Coping Theory |
Home | RCT | Fair |
| Sun et al. /US [28] | Family caregivers of patients with non-small cell lung cancer (Stage IV, 57%) |
Con: n= 163 Int: n=203 (Stage IV: n = 209, 57% of total participants) Mean age (years) Con: 57.23±13.16 Int: 57.54±14.31 Gender(caregivers) Male: n = 139 (38%) Female: n = 227 (62%) Race (caregivers) American Indian n = 2 (0.5%) Asian: n = 41 (11.2%) Black or African American: n = 12 (3.3%) Native Hawaiian or other Pacific Islander: n = 11 (3.0%) White: n = 282 (77%) Other: n = 18 (4.9%) |
Con: 3.7% Int: 3.0% | Int: Psycho- educational Con: Usual care | Combined adult teaching principles, NCCN guidelines, IOM report, NCP guidelines, and the self-care concept |
Hospital | Quasi-experimentalstudy | Moderate |
| Walsh et al. /UK [34] | People who provided informal care to cancer patients newly referred to palliative care (median time to death: 12 weeks) | Con: n=134 Int: n=137 Mean age (years) 56.3±21.0 (range 16–92) Gender Male: n = 56 (21%) Female: n = 215 (79%) Race White: n = 232 (86%) Other: n = 39 (14%) |
Con: 59. 7% Int: 49.6% | Int: Psychoeducational Con: Usual palliative care | Not indicated | Outside of home or at the caregiver’s work place | RCT | Poor |
Abbreviations. Con (Control group); Int (Intervention group).
a
Cochrane RoB for RCT; ROBINS-I for quasi-experimental studies
b
The CHESS integrates services to facilitate coping by: (1) providing ready and organized access to information; (2) serving as a channel for communication and support with peers, experts, and users’ social networks; and (3) acting as an interactive coach by gathering information from the user, applying algorithms or decision rules, and providing feedback specifically relevant to the user.