Manijeh Firoozi - Health psychologist, University of Tehran, department of health psychology.

Purpose To understand family caregivers needs for better preparation and care, this state-of -the-science review examines the effect of caregiving on the health and well-being of caregivers, the efficacy of research-tested interventions on patient and caregiver outcomes, implications of the research on policy and practice, and recommendations for practice and future research.Methods We reviewed research that described the multiple effects of cancer on caregivers well-being. Five meta-analyses were analyzed to determine the effect of interventions with caregivers on patient and caregiver outcomes. In addition, we reviewed legislation such as the Affordable Care Act and the Family Leave Act along with current primary care practice to determine whether family caregivers needs have been addressed.Results Research findings indicate that caregiver stress can lead to psychological and sleep disturbances and changes in caregivers physical health, immune function, and financial well-being. Research-tested interventions delivered to caregivers of patients with cancer or other chronic illnesses can reduce many of these negative effects and improve caregivers coping skills, knowledge, and quality of life. Although these interventions also decrease patients symptoms, reduce mortality (non-dementia patients), and improve patients physical and mental health, they are seldom implemented in practice.Conclusion Recommendations for practice include development of standardized guidelines that address caregiver assessment, education, and resources; identification of caregiver champions in practice settings; provision of referrals to established support organizations for caregivers and collaboration among caregiving, professional, and cancer-related organizations to advocate policy and practice changes for family caregivers.

family caregiver, well-being, psychosocial intervention