Cancer care: impact of interventions on caregiver outcomes

The purpose of this review is to examine the research literature on interventions aimed at caregivers who, in the current health care environment, are assuming increasing responsibility for the complex care of significant others experiencing cancer. The general aim of the review is to synthesize the literature on interventions targeted to cancer caregivers and to summarize outcomes associated with the various intervention strategies described. Three broad categories of interventions were described in the literature: (1) educational, (2) counseling/psychotherapeutic, and (3) hospice and palliative home care. The review included studies that met the following criteria: data-based studies that described an intervention aimed at assisting caregivers to care for patients with cancer, studies published between 1975 and January 1999, and studies published in English. A total of 29 published papers was included. Although the original intent was to limit the review to studies that associated interventions with outcomes, a lack of well-delineated outcome variables was revealed as a major gap in the literature. Thus, some studies that did not include outcome variables were reviewed and the following conclusions made: (1) there is a dearth of data-based literature describing interventions aimed at caregivers; interventions that are described often lack well-defined effects due to a lack of or poor operationalization of outcomes; (2) of the small number of studies in this area, many used small samples and lacked randomization; and (3) studies often revealed selection bias to well-adjusted caregivers who were accepting of support, able to obtain respite care in order to participate, and often willing to avail themselves of a group-style intervention.