title: How can informal caregivers in cancer and palliative care be supported? An updated systematic literature review of interventions and their effectiveness.
abstract: BACKGROUND
  Informal caregivers needs in cancer/advanced disease are largely unmet. The science of carer intervention evaluation is methodologically challenging, and the evidence historically weak.
  
  
  OBJECTIVE
  This systematic review updates an earlier effectiveness review to determine both the effectiveness of subsequently published intervention studies, and the current state of science.
  
  
  METHODS
  The evidence was identified and appraised using a comprehensive search strategy. Articles were searched from 2001 to 2010 using the following electronic databases: Medline, PsychINFO and CINAHL. Inclusion criteria were studies reporting intervention data for informal adult caregivers of a patient with a diagnosis of cancer or receiving palliative care. The design and evidence rigour were assessed using the Jadad Rating Scale, and the Quality Rating Scale.
  
  
  RESULTS
  33 studies met inclusion criteria. From the original review, an encouraging increase was identified in the number of evaluations (from 8 to 33), in carer-specific interventions (from 6 to 17) and in the robustness of the study design (an increase from 2 to 12 studies with before/after measures, comparison groups and prospective data).
  
  
  CONCLUSIONS
  The evidence suggests a rapid increase in the number of robust intervention studies. However, the range of models remains narrow in relation to caregivers' needs and preferences.
authors: King's College London, School of Medicine, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, London, UK. richard.harding@kcl.ac.uk
authors: Richard
authors: R
authors: Harding
authors: Sally
authors: S
authors: List
authors: Eleni
authors: E
authors: Epiphaniou
authors: Hannah
authors: H
authors: Jones
mesh_terms: D017028:Caregivers / Q000523:psychology*; D019317:Evidence-Based Medicine; D006301:Health Services Needs and Demand; D006699:Home Care Services / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D009369:Neoplasms / Q000451:nursing*; D010166:Palliative Care / Q000592:standards*; D012944:Social Support