Quality of Life Research

, Volume 28, Issue 1, pp 13–33 | Cite as

Effects of caregiver-involved interventions on the quality of life of children and adolescents with chronic conditions and their caregivers: a systematic review and meta-analysis

  • Nan Sheng
  • Jiali Ma
  • Wenwen Ding
  • Ying ZhangEmail author



Childhood chronic conditions have a considerable effect on the quality of life (QoL) of pediatric patients and their caregivers. The purpose of this meta-analysis was to evaluate the effects of caregiver-involved interventions on the QoL of children and adolescents with chronic conditions and their caregivers.


The PubMed, EMBASE, Web of Science, Cumulative Index of Nursing and Allied Health Literature, Academic Search Complete, Education Resource Information Center, and PsycINFO databases were searched for published randomized controlled trials from inception to April 2016. Two reviewers (NS and JM) independently screened included studies and assessed study quality. The meta-analyses and meta-regressions using random-effects models were performed with the Comprehensive Meta-analysis software (version 3, Biostat, Englewood, NJ).


Fifty-four studies involving 10075 pediatric patients diagnosed with asthma, diabetes, cancer, hypersensitivity, cerebral palsy, arthritis, or sickle cell diseases and 10015 caregivers were included in our analysis. The interventions mainly involved education about disease, skill training, environment change, psychological intervention, physical exercise, experience sharing, monitoring, or social support. The results demonstrated that caregiver-involved interventions significantly improved the health-related QoL (HRQoL) of caregivers [standardized mean difference (SMD) = 0.26, 95% CI 0.14–0.38, p < 0.001], particularly those delivered through the face-to-face mode (SMD = 0.32, 95% CI 0.21–0.43, p < 0.001). However, no improvements in the QoL (SMD = 0.00, 95% CI − 0.22 to 0.22, p = 1.00) and HRQoL (SMD = 0.06, 95% CI − 0.02 to 0.14, p = 0.16) of children and both caregivers and children (SMD = 0.04, 95% CI − 0.08 to 0.17, p = 0.52) were observed.


This meta-analysis provides evidence on the positive effects of caregiver-involved interventions on the HRQoL of caregivers. Moreover, face-to-face mode is the delivery approach with a promising effect on the HRQoL of caregivers. Further research on conditions not found in this review is warranted.


Caregiver-involved intervention Child Chronic disease Meta-analysis Meta-regression Quality of life 



This study was supported by a grant from Shanghai Municipal Commission of Health and Family Planning (Grant No. 201540212) and Shanghai Municipal Education Commission-Gaoyuan Nursing Grant Support (Grant Nos. Hlgy1602gj and Hlgy17003yjs).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

11136_2018_1976_MOESM1_ESM.pdf (219 kb)
Supplementary material 1 (PDF 218 KB)
11136_2018_1976_MOESM2_ESM.pdf (135 kb)
Supplementary material 2 (PDF 134 KB)


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.School of NursingShanghai Jiao Tong UniversityShanghaiChina

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