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What Are the Key Elements of Educational Interventions for Lay Carers of Patients With Advanced Disease? A Systematic Literature Search and Narrative Review of Structural Components, Processes and Modes of Delivery.

Accepted version
Peer-reviewed

Repository DOI


Type

Article

Change log

Authors

Penfold, Clarissa 
Walter, Fiona M 
Benson, John 

Abstract

CONTEXT: Educating carers about symptom management may help meet patient and carer needs in relation to distressing symptoms in advanced disease. Reviews of the effectiveness of carer interventions exist, but few have focused on educational interventions and none on the key elements that comprise them but which could inform evidence-based design. OBJECTIVES: To identify the key elements (structural components, processes, and delivery modes) of educational interventions for carers of patients with advanced disease. METHODS: We systematically searched seven databases, applied inclusion and exclusion criteria, conducted quality appraisal, extracted data, and performed a narrative analysis. RESULTS: We included 62 articles related to 49 interventions. Two main delivery modes were identified: personnel-delivered interventions and stand-alone resources. Personnel-delivered interventions targeted individuals or groups, the former conducted at single or multiple time points, and the latter delivered as series. Just more than half targeted carers rather than patient-carer dyads. Most were developed for cancer; few focused purely on symptom management. Stand-alone resources were rare. Methods to evaluate interventions ranged from postintervention evaluations to fully powered randomized controlled trials but of variable quality. CONCLUSION: Published evaluations of educational interventions for carers in advanced disease are limited, particularly for non-cancer conditions. Key elements for consideration in developing such interventions were identified; however, lack of reporting of reasons for nonparticipation or dropout from interventions limits understanding of the contribution of these elements to interventions' effectiveness. When developing personnel-delivered interventions for carers in advanced disease, consideration of the disease (and, therefore, caring) trajectory, intervention accessibility (timing, location, and transport), and respite provision may be helpful.

Description

Keywords

Informal carers, advanced disease, education, intervention, narrative review, symptom management, Caregivers, Humans, Palliative Care

Journal Title

J Pain Symptom Manage

Conference Name

Journal ISSN

0885-3924
1873-6513

Volume Title

Publisher

Elsevier BV
Sponsorship
Macmillan Cancer Support (unknown)
Macmillan Cancer Support for Post-Doctoral Fellowship funding for MF and the review consumables. CP’s work was part-funded by NIHR CLAHRC East of England. FMW’s work was undertaken during her NIHR Clinical Lectureship then NIHR Clinician Scientist award.