title: Psychosocial care for family caregivers of patients with cancer.
abstract: OBJECTIVE
  To understand family caregivers' needs for better preparation and care, this state-of-the-science review examines the effect of caregiving on the health and well-being of caregivers, the efficacy of research-tested interventions on patient and caregiver outcomes, implications of the research on policy and practice, and recommendations for practice and future research.
  
  
  METHODS
  We reviewed research that described the multiple effects of cancer on caregivers' well-being. Five meta-analyses were analyzed to determine the effect of interventions with caregivers on patient and caregiver outcomes. In addition, we reviewed legislation such as the Affordable Care Act and the Family Leave Act along with current primary care practice to determine whether family caregivers' needs have been addressed.
  
  
  RESULTS
  Research findings indicate that caregiver stress can lead to psychological and sleep disturbances and changes in caregivers' physical health, immune function, and financial well-being. Research-tested interventions delivered to caregivers of patients with cancer or other chronic illnesses can reduce many of these negative effects and improve caregivers' coping skills, knowledge, and quality of life. Although these interventions also decrease patients' symptoms, reduce mortality (non-dementia patients), and improve patients' physical and mental health, they are seldom implemented in practice.
  
  
  CONCLUSIONS
  Recommendations for practice include development of standardized guidelines that address caregiver assessment, education, and resources; identification of "caregiver champions" in practice settings; provision of referrals to established support organizations for caregivers (eg, Cancer Support Community, Cancer Care); and collaboration among caregiving, professional, and cancer-related organizations to advocate policy and practice changes for family caregivers.
authors.affiliation: School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA. lnortho@umich.edu
authors.forename: Laurel
authors.initials: L
authors.lastname: Northouse
authors.forename: Anna-Leila
authors.initials: AL
authors.lastname: Williams
authors.forename: Barbara
authors.initials: B
authors.lastname: Given
authors.forename: Ruth
authors.initials: R
authors.lastname: McCorkle
mesh_terms: D017028:Caregivers / Q000191:economics / Q000331:legislation & jurisprudence / Q000523:psychology*; D003299:Cooperative Behavior; D055317:Evidence-Based Practice; D006801:Humans; D019964:Mood Disorders / Q000209:etiology; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D011320:Primary Health Care; D016032:Randomized Controlled Trials as Topic; D012893:Sleep Wake Disorders / Q000209:etiology