“Should WE Stand Together?”: A systematic review and meta‐analysis of the effectiveness of family‐based interventions for adults with chronic physical diseases

Abstract

Family support has been identified as an important factor for the psychological adjustment of patients with chronic physical conditions. This study aimed to systematically review and conduct a meta‐analysis of studies comparing the effectiveness of family‐based versus patient‐oriented interventions for chronic physical conditions. The search was performed between April 12 and April 29, 2021, on Web of Science (all databases included), Scopus, PsycINFO, and CENTRAL. Thirteen RCTs were included. The results favored family‐based interventions for various patient outcomes related to pain, distress, self‐efficacy, social and emotional function, coping, the welfare of the domestic environment, capacity to mobilize social support, and sexual relationships with medium to large effect sizes (Cohen's d range: 0.45–0.90). This type of intervention also decreased family members’ anxiety, depression, sleep problems, and distress, improving search and presence of meaning in life, social support, the support provided to the patient, and sexual relationships with medium to very large effect sizes (Cohen's d range: 0.58–2.76). The meta‐analytical findings suggested that the patients’ (k = 12, d = 0.34; 95% CI = 0.13–0.55, I2 = 74%, p < 0.01) and family members’ (k = 4, d = 0.68; 95% CI = 0.08–1.27, I2 = 88%, p < 0.01) psychosocial outcomes significantly improved with family‐based interventions compared with patient‐oriented interventions. The meta‐analysis of patients’ self‐efficacy showed a medium‐size effect (d = 0.64; k = 3; I2 = 19%). The results suggest a trend toward the beneficial effects of family‐based interventions, but more research is needed with higher quality RCTs to confirm this hypothesis.

Intervention effects of telenursing based on M-O-A model in empty-nest older adult individuals with chronic diseases: a randomized controlled trial

“…All of the indicators put forward an even greater need for the prevention and control of chronic diseases. Family support has been identified as an important beneficial effects for the older adults with chronic diseases ( 13 ). For empty-nest older adults individuals with chronic diseases, whether we can take measures to make up for the partial lack of family support is the concern of researchers.…”

Effectiveness of a videoconferencing group-based dyad acceptance and commitment therapy on the quality of life of chronic heart failure patients and their family caregivers: A study protocol for a randomized controlled trial

“…Non-pharmacological interventions that primarily target individuals, whether those with CHF or their FCs exclusively, have shown limited success in improving health outcomes [41][42][43][44]. Within the broader context of chronic illness, research has shown that interventions targeting both patients and FCs together, known as dyad interventions, are more effective for both patients and their FCs, compared to interventions focused solely on patients or FCs [45,46]. Positive effects on various health outcomes include physical symptoms, mental health, psychosocial functioning, dyadic relationship, and QOL for both patients and their FCs.…”

Designing family‐based interventions in kidney failure: The perspectives of the triad 'patients on haemodialysis/family caregivers/healthcare professionals

“…In other chronic health conditions, such as cancer, respiratory diseases and stroke, meta‐analyses have already shown that interventions involving people with chronic diseases and their family caregivers as a dyad (i.e., receiving the same intervention at the same time) are more effective in improving each person's psychosocial adjustment to illness and self‐efficacy to manage treatment demands, compared to interventions focused exclusively on the person with the disease or the informal caregiver (Martire et al, 2010; Shields et al, 2012; Sousa et al, 2021). Family‐oriented approaches provide families with health education and psychosocial support to facilitate coping and psychosocial adjustment to the demands of chronic illness, proposing concrete guidelines for crisis management, problem‐solving, and stress reduction, emphasizing the needs of the family system (Walsh, 2016).…”