Effectiveness of support interventions on the well being among informal caregivers of chronic kidney disease patients: A systematic review

Abstract

Background: Caregivers of both adult and children chronic kidney disease (CKD) patients experience one of the highest caregiver burden and poor quality of life (QoL) due to the challenging demands of caregiving. Till date, no reviews had assessed the benefits of support interventions (SI) on these caregivers. Objectives: To evaluate the effectiveness of SI on the caregiver burden and QoL among informal caregivers of CKD patients. Methods: Nine databases (CINAHL, Cochrane, EMBASE, ERIC, ProQuest, PsycINFO, PubMed, Scopus and Web of Science) were searched for published and unpublished English studies from 1 January 2008 to 1 December 2020. Only randomised-controlled trials (RCTs) & quasi-experimental studies (QES) were included. Two reviewers independently conducted data extraction and assessed the quality of studies using JBI critical appraisal tools and GRADE. Due to considerable heterogeneity observed between studies, findings were synthesised narratively, with tables and figures to aid data presentation. Results: A total of 2990 records were identified and 7 RCTs and 7 QES were included. Educational and psychological SI were the two main types of SI identified. Findings favoured SI in reducing caregiver burden and improving QoL. Though unable to ascertain which type of SI may be more effective, findings revealed that SI should be holistic and multi-component, comprising coping strategies, disease knowledge, and effective communication skills. Overall quality of evidence graded using GRADE was very low for both outcomes. Conclusion & Implications: Findings suggest that SI are effective in reducing caregiver burden and improving QoL among informal caregivers of CKD patients. Healthcare providers can utilise the findings to provide more tailored support for these caregivers. However, more well-designed and large scale RCTs are needed to inform the effectiveness of SI among these caregivers, especially those of children with CKD.