Review of subjective caregiver impact : experience and needs of informal caregivers of adults/older adults with cancer

Background: The number of older adults with cancer is steadily growing and treatment for cancer has largely shifted to the ambulatory care setting. Informal caregivers provide the main support for older people with cancer treated in this setting. Snyder (2005) developed a model depicting informal caregiver impact when supporting/caring for someone with cancer. The model identifies four domains impacted by undertaking the role of informal caregiver: emotional; spiritual; social/role; and physical. This model was used to frame this systematic review. The authors first sought to appraise and synthesise contemporary literature related to the experience of informal caregivers of people with cancer with particular emphasis on caregivers of older people with cancer. Second, the saliency of Snyder’s model in light of the current literature was determined. Materials and Methods: The electronic data bases Medline and Health Source: Nursing/Academic Edition were searched and 59 research articles reporting on quantitative, qualitative or mixed-method studies identified that fitted the inclusion and exclusion criteria. The research reports were appraised using standardised forms and their results systematically extracted for a narrative synthesis. Results: The findings are congruent with those of Snyder (2005), indicating that informal caregivers experience deep impacts within the emotional, social/role, physical and spiritual domains. Possible new impacts emerged from the literature reviewed: caregivers are reported, for example, to perceive an increased sense of altruism or to deny and suppress their own feelings. Other impacts reported were role overload and a sense of role captivity. Additionally, results of the current review suggest some overlap between impact domains described by Snyder’s model. The review highlighted also the paucity of evidence in relation to caregiver impact in the physical and spiritual domain, as well as pertaining to the assessment of caregiver needs in general and of caregivers of older cancer patients in particular. Conclusion: To be able to provide necessary support to informal caregivers of older cancer patients, nurses need to be knowledgeable about the experiences and needs of these caregivers. Further studies investigating specific impacts and needs of caregivers of older people with cancer are needed. Moreover, the results of the review warrant development and testing of the subjective caregiver impact model in future studies