Rapid Review of Family Caregiver Engagement in Hospice and End-of-Life Patient Care: Implications for Nursing Practice.
Natalie S McAndrew, Alison Camarda, Christine A Fortney and 3 others
PMID 40266187WHAT IT FOUND
Family caregivers in hospice and end-of-life care were central to comfort, decisions, and communication, and they felt more supported when nurses gave clear guidance.
Promising interventions were linked to lower anxiety and distress, but most evidence came from qualitative studies.
Key findings
01Family caregivers of adult and pediatric patients were central to comfort, decision-making, and communication, and they depended on nurses for support through end-of-life transitions.
02Interventions reported in the review, including caregiver support groups, legacy activities, and pain management education, were associated with lower anxiety or distress and greater caregiver confidence.
03Caregivers reported more distress and less trust when communication, involvement in decisions, or preparation for transitions was unclear or limited.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a rapid review limited to one database, CINAHL, English-language articles, and US-based studies, so relevant research from other databases, languages, or health systems may have been missed. The 22 included studies used very different designs and outcome measures, and many were qualitative, single-site, or secondary analyses, making direct comparison difficult. Several studies relied on family caregivers recalling events months or years after a death, which can introduce recall bias. Many studies included mainly White women living in urban areas, so findings may not represent diverse caregivers, rural families, or other caregiver-patient relationships. Intervention evidence was limited, with only one randomized trial identified, and the review did not include policy-specific research.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that any named intervention is proven to improve hospice outcomes. Most included studies were qualitative, single-site, or secondary analyses, and only one randomized trial was identified, so the review reports caregiver experiences and promising signals rather than established effectiveness.