title: Informal caregiving of hospice patients.
abstract: BACKGROUND
  Informal caregivers play a critical role in the provision of care to hospice patients. The care they provide often impacts their physical and psychological well-being.
  
  
  OBJECTIVE
  This study synthesized 58 articles pertaining to informal hospice caregiving, focusing on caregivers' satisfaction with hospice services, the physical and psychological well-being of caregivers, the predictors of caregivers' well-being, the direct impact of hospice services on caregivers, and the effectiveness of targeted interventions for hospice caregivers.
  
  
  METHODS
  A systematic literature review of journal articles published between 1985 and 2012 was conducted.
  
  
  RESULTS
  The studies reviewed found hospice caregivers to experience clinically significant levels of anxiety, depression, and stress; however, results for caregiver burden and quality of life were mixed. Caregivers' perceptions regarding the meaningfulness of care as well as their levels of social support were associated with enhanced psychological outcomes.
  
  
  CONCLUSIONS
  Beyond satisfaction with hospice services, the direct impact of standard hospice care on caregivers remains uncertain. Caregiver intervention studies have demonstrated promising outcomes signifying a need for additional investigations into hospice-specific interventions that improve caregiver outcomes. Additional research and resources are needed to assist hospice caregivers, with the ultimate goal of minimizing their psychiatric and physical morbidity and enhancing their caregiving and subsequent bereavement processes.
authors.affiliation: 1 Department of Psychiatry, Dalhousie University , Capital District Health Authority, Halifax, Nova Scotia, Canada .
authors.forename: Colin G
authors.initials: CG
authors.lastname: Pottie
authors.forename: Karen A
authors.initials: KA
authors.lastname: Burch
authors.forename: Lori P Montross
authors.initials: LP
authors.lastname: Thomas
authors.forename: Scott A
authors.initials: SA
authors.lastname: Irwin
mesh_terms: D000223:Adaptation, Psychological; D017028:Caregivers / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005260:Female; D017051:Hospice Care; D006801:Humans; D008297:Male; D010549:Personal Satisfaction; D012944:Social Support; D013315:Stress, Psychological