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To identify and evaluate the magnitude of the association between caregiver psychosocial factors and depressive symptoms among people with dementia.
Systematic review and meta-analysis.
A systematic review with meta-analysis used a random-effects model to estimate the effect size.
Medline, PsycINFO, CINAHL, Scopus and Embase databases were searched for peer-reviewed studies from inception to 25 November 2023.
The review included 88 articles, with 61 selected for meta-analysis. Seven caregiver psychosocial factors were determined for the meta-analysis: caregiver quality of life, distress, positive aspects of caregiving, depression, burden, quality of the relationship and anxiety.
This study suggested that depressive symptoms in people with dementia were associated with caregiver quality of life, distress, burden, depression and positive aspects of caregiving.
Recognising the association between caregiver psychosocial factors and depressive symptoms in people with dementia has essential nursing implications. Adopting family-centred care models and integrating respite care and psychological support for caregivers can help improve patient outcomes and overall dementia care.
This study highlights the association between caregiver psychosocial factors and depressive symptoms in people with dementia. Caregiver distress, burden and depression were linked to increased depressive symptoms in people with dementia, while caregiver quality of life and positive aspects of caregiving were associated with depressive symptoms in people with dementia. These findings underscore the need for tailored interventions to enhance dyadic health.
This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
There was no patient or public contribution.
This review was registered in PROSPERO (2024 CRD42024511383).
Mortal distress encompasses emotional, cognitive, physical and behavioural responses to death and dying among healthcare staff who frequently encounter mortality in hospital settings. Healthcare workers often experience heightened levels of mortal distress due to their regular exposure to patient deaths, which can negatively impact both their personal and professional lives, leading to burnout and high turnover rates.
To identify and quantitatively synthesise correlates of mortal distress among hospital healthcare staff and examine moderating factors affecting these relationships.
Systematic review and meta-analysis following PRISMA 2020 guidelines
Two independent reviewers screened and extracted data from studies published between January 1990 and December 2024 across eight databases (five English: CINAHL, MEDLINE, ProQuest, PubMed, Scopus; three Chinese: Airiti, CNKI, Wanfang). Quality assessment was conducted using the Mixed Methods Appraisal Tool. Meta-analysis was performed using Comprehensive Meta-Analysis 3.0.
Analysis of 94 studies identified three factor domains: personal, job-related and situational. Four job-related factors demonstrated the strongest correlations with mortal distress: competence in coping with death in healthcare contexts, needs for death-related or hospice care training, quality of end-of-life communication, and working in departments with high patient mortality rates. Four significant moderators influenced correlation strength: publication language, geographic region, study quality, and measurement tools used for assessing mortal distress.
This synthesis provides evidence regarding the magnitude and strength of factors associated with mortal distress among healthcare staff. The identification of main and moderator effects emphasises the critical need for developing culturally sensitive, tailored interventions to help healthcare workers navigate mortality-related challenges.
The results can guide healthcare organisations in developing targeted interventions and training programs, inform medical and nursing education curricula by encouraging the inclusion of life and death education, and ultimately enhance staff well-being while improving the quality of patient and family care, especially in palliative care contexts.
This study did not include patient or public involvement in its design, conduct, or reporting.
PROSPERO number: CRD42021275460
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