Meta-Analysis and Systematic Review: Mindfulness Intervention for Informal Cancer Caregivers

Sunday, 29 October 2017: 11:05 AM

Colleen Kurzawa, MFA, MSN
School of Nursing, Case Western Reserve University, Cleveland, OH, USA
Joyce J. Fitzpatrick, PhD, RN, FAAN
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA

Introduction: Family Caregivers are the foundation of long-term care nationwide and exceed Medicaid long-term spending in all states. Caregivers of cancer patients face multiple issues when caring for family members at the end of life. The quality of life for informal caregivers of cancer patients is influenced by the illness trajectory of the cancer patient. It has been suggested that informal caregivers have a lower quality of life and face increased stress and burden. Informal caregivers face intense strain due to the challenges of new and increased needs of the cancer patient and challenges of the caregiver role. When caregivers spend more time physically and emotionally providing care, there is less time for self-care needs and it may be challenging to work outside of the home.

Informal caregivers of cancer patients experience increased psychological distress, decreased quality of life, and increased risks of medical illness and death. Several studies have suggested that mindfulness interventions decrease psychological distress and increase quality of life in patients with chronic conditions, health care professionals, and caregivers of dementia patients. However, little is known regarding the effects of mindfulness interventions on informal cancer caregivers. The purpose of this meta-analysis and systematic review is to determine the effects of mindfulness interventions on psychological distress of caregivers’ for hospice cancer patients.

Methods: Electronic databases (PubMed, Embase, Cochrane, and CINAHL) were searched from inception to February 6, 2016 without language restrictions. Studies were included it they were randomized controlled trials, subjects were informal caregivers of cancer patients at the end of life, and included mindfulness interventions. For psychological distress, we used a random effects model to calculate the pooled standardized mean difference and 95% confidence interval (CI).

Results: Out of 1672 citations, four studies (N=320) met our inclusion criteria. We found inconsistent results for the use of mindfulness interventions versus standard care to decrease psychological distress in informal caregivers of cancer patients (standardized mean difference = 1.21 and 95% CI = -0.92, 3.34).

Conclusions: Mindfulness had mixed effects on caregivers’ psychological distress. Further studies will help elucidate what aspects of mindfulness interventions are most associated with the greatest effects.

Implications for Practice: Informal caregivers with less stress may have decreased psychological distress that promote caregiving behaviors and reduce the damaging effects of the caregiver role. The meta-analysis and systematic review identifies several critical gaps in the extant literature and underscores the need for clinical trials of mindfulness interventions to reduce the psychological burdens of informal caregivers.