Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Jan;33(1):e6239.
doi: 10.1002/pon.6239. Epub 2023 Nov 20.

Existential distress among family caregivers of patients with advanced cancer: A systematic review and meta-analysis

Charlotte Walbaum  1   2 , Rebecca Philipp  1 , Karin Oechsle  2 , Anneke Ullrich  2 , Sigrun Vehling  1   2
Affiliations
Meta-Analysis

Existential distress among family caregivers of patients with advanced cancer: A systematic review and meta-analysis

Charlotte Walbaum et al. Psychooncology. 2024 Jan.

Abstract

Objective: Caregiving for a loved one is challenging and requires significant resources. Existential distress in family caregivers may include hopelessness, demoralization, fear of death, pre-loss grief, or a sense of not being emotionally prepared. The aim of this systematic review is to synthesize the quantitative literature on existential distress among family caregivers of patients with advanced cancer, focusing on its prevalence, association with mental disorders, as well as with sociodemographic, disease, and treatment-related factors.

Methods: We systematically searched electronic databases for quantitative studies of the above-described existential distress concepts in family caregivers of patients with advanced cancer. Two independent reviewers extracted data and evaluated study quality. Data were analyzed using random-effects meta-analysis.

Results: We retrieved 17.587 records, of which 31 studies fulfilled inclusion criteria. 63% of the studies (n = 20) provided sufficient data for meta-analysis for 5558 patients. We found an overall pooled prevalence of 30.6% for existential distress, 95% CI [24.2-37.0]. For existential distress subconcepts, prevalence rates were 57.0%, 95% CI [37.8-76.2], for death anxiety, 13.9%, 95% CI [10.8-17.0], for demoralization, 24.0%, 95% CI [18.0-30.0], for pre-loss grief, 18.4%, 95% CI [4.0-32.7], for hopelessness, 35.2%, 95% CI [28.2-42.2], for loneliness, and 35.6%, 95% CI [13.0-58.3], for emotional unpreparedness.

Conclusions: Approximately one third of the respondents were affected by high levels of existential distress. The review provides evidence for further development of support services that can reduce existential distress, focused on death anxiety, and improve the quality of life for family caregivers of patients with advanced cancer.

Keywords: cancer; family caregivers; meta-analysis; oncology; psychological distress.

PubMed Disclaimer

References

REFERENCES

    1. Applebaum AJ, Kryza-Lacombe M, Buthorn J, DeRosa A, Corner G, Diamond EL. Existential distress among caregivers of patients with brain tumors: a review of the literature. Neuro-oncology Pract. 2016;3(4):232-244. https://doi.org/10.1093/nop/npv060
    1. Yabroff KR, Davis WW, Lamont EB, et al. Patient time costs associated with cancer care. J Natl Cancer Inst. 2007;99(1):14-23. https://doi.org/10.1093/jnci/djk001
    1. Moor JSde, Dowling EC, Ekwueme DU, et al. Employment implications of informal cancer caregiving. J Cancer Surviv. 2017;11(1):48-57. https://doi.org/10.1007/s11764-016-0560-5
    1. Areia NP, Fonseca G, Major S, Relvas AP. Psychological morbidity in family caregivers of people living with terminal cancer: prevalence and predictors. Palliat Support Care. 2019;17(3):286-293. https://doi.org/10.1017/S1478951518000044
    1. Costa-Requena G, Cristófol R, Cañete J. Caregivers' morbidity in palliative care unit: predicting by gender, age, burden and self-esteem. Support Care Cancer. 2012;20(7):1465-1470. https://doi.org/10.1007/s00520-011-1233-6

LinkOut - more resources