Effects of caregiver-involved interventions on the quality of life of children and adolescents with chronic conditions and their caregivers: a systematic review and meta-analysis

摘要

PurposeChildhood chronic conditions have a considerable effect on the quality of life (QoL) of pediatric patients and their caregivers. The purpose of this meta-analysis was to evaluate the effects of caregiver-involved interventions on the QoL of children and adolescents with chronic conditions and their caregivers.MethodsThe PubMed, EMBASE, Web of Science, Cumulative Index of Nursing and Allied Health Literature, Academic Search Complete, Education Resource Information Center, and PsycINFO databases were searched for published randomized controlled trials from inception to April 2016. Two reviewers (NS and JM) independently screened included studies and assessed study quality. The meta-analyses and meta-regressions using random-effects models were performed with the Comprehensive Meta-analysis software (version 3, Biostat, Englewood, NJ).ResultsFifty-four studies involving 10075 pediatric patients diagnosed with asthma, diabetes, cancer, hypersensitivity, cerebral palsy, arthritis, or sickle cell diseases and 10015 caregivers were included in our analysis. The interventions mainly involved education about disease, skill training, environment change, psychological intervention, physical exercise, experience sharing, monitoring, or social support. The results demonstrated that caregiver-involved interventions significantly improved the health-related QoL (HRQoL) of caregivers [standardized mean difference (SMD)=0.26, 95% CI 0.14-0.38, p0.001], particularly those delivered through the face-to-face mode (SMD=0.32, 95% CI 0.21-0.43, p0.001). However, no improvements in the QoL (SMD=0.00, 95% CI -0.22 to 0.22, p=1.00) and HRQoL (SMD=0.06, 95% CI -0.02 to 0.14, p=0.16) of children and both caregivers and children (SMD=0.04, 95% CI -0.08 to 0.17, p=0.52) were observed.ConclusionsThis meta-analysis provides evidence on the positive effects of caregiver-involved interventions on the HRQoL of caregivers. Moreover, face-to-face mode is the delivery approach with a promising effect on the HRQoL of caregivers. Further research on conditions not found in this review is warranted.