Association between dyadic interventions and outcomes in cancer patients: a meta-analysis

Abstract

Purpose: Patient–caregiver dyadic interventions are when “interventions are offered to cancer patients and their family caregivers together as the unit of care.” The purpose of the present study was to determine the association of dyadic intervention for cancer patients and their family caregivers with quality of life (QOL), and other outcomes for people with cancer. Methods: Literature searches were conducted using the electronic databases to identify all randomized clinical trials on cancer patient–caregiver dyads. Meta-analysis was used to analyze data. Results: Twenty-three RCTs provided data on 2317 patient–caregiver dyads. In the meta-analysis, at the 0- to 3-month follow-up, dyadic intervention was associated with statistically and clinically significant improvements in patient total QOL (standardized mean difference [SMD], 0.25; 95% confidence interval [CI], 0.01–0.50); the total spiritual aspect of QOL (SMD, 0.28; 95% CI, 0.06–0.50); the emotional (SMD, 0.16; 95% CI, 0.02–0.29), social (SMD, 0.21; 95% CI, 0.07–0.36), and mental (SMD, 0.26; 95% CI, 0.07–0.46) aspects of QOL; depression (SMD, − 0.35; 95% CI, − 0.65 to − 0.05); anxiety (SMD, − 0.42; 95% CI, − 0.70 to − 0.13); relatedness (SMD, 0.18; 95% CI, 0.04–0.32); and marital functioning (SMD, 1.01; 95% CI, 0.05–1.97). At the 3.1- to 6-month follow-up, dyadic intervention was associated with significant improvements in patient social aspect (SMD, 0.19; 95% CI, 0.03–0.35) and depression (SMD, − 0.29; 95% CI, − 0.56 to − 0.03). There was no association between dyadic interventions and the patient functional and physical aspects of QOL. Dyadic intervention was associated consistently with no improvements in hopelessness, pain, fatigue, and survival. Conclusions: In this review, dyadic interventions for caregivers and cancer patients were associated with improvements in multiple psychosocial aspects of patient outcomes.