Introduction End-stage or advanced chronic illness has deleterious effects on the health and wellbeing of patients and their informal carers. Informal carers are often family members or friends who provide support and care to the patient. Informal carers experience many challenges associated with their caring role, which can impact their own wellbeing. Whilst there is growing evidence about the impact on carers; guidance on support for informal caregivers of patients with advanced, non-malignant, chronic conditions is lacking. There is little information available on effective psychosocial interventions for these carers.
Aims To explore effectiveness of psychosocial interventions for informal caregivers of people with advanced or end-stage chronic, non-malignant illness.
Methods Electronic databases: Medline, CINAHL, EMBASE, PsycINFO, were searched up to December 2021. Studies were assessed against inclusion criteria.
Results 4317 articles were screened, identifying 11 studies for inclusion. Data were extracted regarding study setting, design, methods, intervention components, and outcomes. The overall sample comprised 1317 caregivers. Mean age ranged 44–70 years. In all studies, a higher proportion of caregivers were female. Narrative synthesis revealed mixed results. Six studies highlighted significant improvements in psychosocial outcomes including caregiver burden, depression, anxiety and quality of life. Differences in outcomes were related to intervention type, design, duration and delivery.
Conclusions The findings suggest interventions for this cohort should be: evidence-based, psychosocial, developed within an appropriate psychological framework, delivered at home, involve patient-carer dyad, and capture appropriate psychosocial caregiver outcomes using reliable and valid psychosocial measures.
Impact This systematic review, to our knowledge, is the first to explore effectiveness of psychosocial interventions for caregivers of those with advanced, non-malignant, chronic conditions. It highlights the need for more robust, sufficiently powered, high quality trials of evidence-based interventions for this cohort of carers
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