A systematic review of cancer caregiver interventions: Appraising the potential for implementation of evidence into practice

Abstract

Objective nformal caregivers provide substantial support for people living with cancer. Previous systematic reviews report on the efficacy of cancer caregiver interventions but not their potential to be implemented. The aim of this systematic review was to explore the potential for cancer caregiver interventions to be implemented into practice. Methods We searched three electronic databases to identify cancer caregiver interventions on 5 January 2018. We operationalised six implementation outcomes (acceptability, adoption, appropriateness, feasibility, fidelity, and costs) into a tool to guide data extraction. Results The search yielded 33 papers (27 papers from electronic databases and six papers from other sources) reporting on 26 studies that met review criteria. Fewer than half the studies (46%) contained evidence about the acceptability of interventions from caregivers' perspectives; only two studies (8%) included interventions developed with input from caregivers. Two studies (8%) addressed potential adoption of interventions, and no studies discussed intentions, agreement, or action to implement interventions into practice. All studies reported on intervention appropriateness by providing a rationale for the interventions. For feasibility, on average less than one‐third of caregivers who were eligible to be involved consented to participate. On fidelity, whether interventions were conducted as intended was reported in 62% of studies. Cost data were reported in terms of intervention delivery, requiring a median time commitment of staff of 180 minutes to be delivered. Conclusions Caregiver intervention studies lack components of study design and reporting that could bridge the gap between research and practice. There is enormous potential for improvements in cancer caregiver intervention study design to plan for future implementation.

Co-construction of the family-focused support conversation: a participatory learning and action research study to implement support for family members whose relatives are being discharged for end-of-life care at home or in a nursing home

“…The evidence review identified the importance of modelling interventions for family support on uncertainty [ 17 ], and therefore asking family members about their concerns [ 8 ]. Consistent with other reviews we found a lack of interventions adopting a family centred or family systems approach [ 2 ] and a lack of translation of research evidence into feasible clinical interventions [ 31 , 32 ]. Similarly, with respect to intervention reporting, we found inconsistent detail about the theoretical frameworks underpinning interventions [ 63 ] and insufficient evidence about the effectiveness of intervention mechanisms on outcomes [ 8 , 9 , 29 , 63 ].…”

“…Despite this, the interventional content is considered potentially transferable to other contexts, providing consideration is given to the specific needs of family caregivers [ 29 ], and their broader circumstances over time [ 30 ]. However, there is a paucity of research translating this evidence into realistic clinical applications [ 31 , 32 ].…”

Co-afflicted but invisible: A qualitative study of perceptions among informal caregivers in cancer care

“…The general lack of such support in the public health care sector has led to the development of private or charity-based support initiatives. Most of these are however, targeted at optimizing the delivery of patient care by informal caregivers rather than at supporting these caregivers (Rowland et al, 2017;Ugalde et al, 2019). The limited implementation of support initiatives and measures is likely related to a weak evidence basis, difficulties in targeting caregivers' specific and variable needs, and challenges in identifying a group for targeted intervention (Frambes et al, 2017;Kent et al, 2016).…”

Measuring next of kin satisfaction with hospital cancer care: Using a mixed‐method approach as basis for improving quality and safety

“…own consultation) and for the patient (e.g. interventions with special training that supports both next of kin and patient needs).This might have the potential of closing the gap on unsuccessful caregiver interventions in cancer care services (Ugalde et al, ).…”