The effectiveness of psychoeducational interventions on quality of life for family caregivers : a systematic review and meta-analysis
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Background: Caregivers (CGs) of older adults with chronic illnesses often face consequences of caregiving that negatively impact their quality of life (QoL). Objective: To examine the overall effect of psychoeducational interventions (PEIs) on QoL among CGs of older adults with chronic illnesses, including dementia, stroke, and cancer. Design: We conducted a systematic review and meta-analysis of published or unpublished randomized controlled trials testing the effects of PEIs on QoL among CGs of older adults with chronic illnesses. We located studies using electronic databases including PubMed, CINAHL, Scopus, and PsycINFO as well as alternative search strategies including hand searches. Data extraction and quality assessment: Two coders independently extracted data related to the study purpose, participant characteristics, intervention characteristics, and QoL outcomes, and compared their work for accuracy. The methodological quality of eligible studies was assessed by using the Jadad tool. Data synthesis: We conducted meta-analyses on summary scores of QoL and the following QoL domains: physical, psychological, social, and environment well-being. Standardized mean difference effect sizes (d) were calculated using final post-intervention data and then synthesized using a random effects model. Heterogeneity was assessed with Cochran's Q statistic and I2 statistic. Publication bias was evaluated by using the funnel plot and Egger's regression test. Results: We identified 27 eligible randomized controlled trials with a total of 3,154 CGs. PEIs had significant and positive effects on summary scores of QoL (d =0.508, 95% CI [0.253, 0.762], p [less than] 0.001) and social well-being (d =0.306, 95% CI [0.088, 0.525], p = 0.006). However, the effect sizes of PEIs showed no statistically significant improvement on physical well-being, psychological well-being, and environment well-being. Conclusion: PEIs for CGs of older adults with chronic illness significantly improved summary scores for QoL and social well-being, but not other QoL domains. It is recommended that future studies testing the effects of PEIs on QoL should be theory-driven, should assess CGs' knowledge, skills, and needs, and should consider interdisciplinary intervention. Future metaanalyses should consider examining the overall effect size of PEIs on various consequences of caregiving, such as depression and anxiety.