{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:20:34Z","timestamp":1791199234074,"version":"4.1.0"},"reference-count":81,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T00:00:00Z","timestamp":1700438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005972","name":"Deutsche Krebshilfe","doi-asserted-by":"publisher","award":["70113404"],"award-info":[{"award-number":["70113404"]}],"id":[{"id":"10.13039\/501100005972","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Caregiving for a loved one is challenging and requires significant resources. Existential distress in family caregivers may include hopelessness, demoralization, fear of death, pre\u2010loss grief, or a sense of not being emotionally prepared. The aim of this systematic review is to synthesize the quantitative literature on existential distress among family caregivers of patients with advanced cancer, focusing on its prevalence, association with mental disorders, as well as with sociodemographic, disease, and treatment\u2010related factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We systematically searched electronic databases for quantitative studies of the above\u2010described existential distress concepts in family caregivers of patients with advanced cancer. Two independent reviewers extracted data and evaluated study quality. Data were analyzed using random\u2010effects meta\u2010analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We retrieved 17.587 records, of which 31 studies fulfilled inclusion criteria. 63% of the studies (<jats:italic>n<\/jats:italic>\u00a0=\u00a020) provided sufficient data for meta\u2010analysis for 5558 patients. We found an overall pooled prevalence of 30.6% for existential distress, 95% CI [24.2\u201337.0]. For existential distress subconcepts, prevalence rates were 57.0%, 95% CI [37.8\u201376.2], for death anxiety, 13.9%, 95% CI [10.8\u201317.0], for demoralization, 24.0%, 95% CI [18.0\u201330.0], for pre\u2010loss grief, 18.4%, 95% CI [4.0\u201332.7], for hopelessness, 35.2%, 95% CI [28.2\u201342.2], for loneliness, and 35.6%, 95% CI [13.0\u201358.3], for emotional unpreparedness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Approximately one third of the respondents were affected by high levels of existential distress. The review provides evidence for further development of support services that can reduce existential distress, focused on death anxiety, and improve the quality of life for family caregivers of patients with advanced cancer.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pon.6239","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T22:52:25Z","timestamp":1700607145000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Existential distress among family caregivers of patients with advanced cancer: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5746-4900","authenticated-orcid":false,"given":"Charlotte","family":"Walbaum","sequence":"first","affiliation":[{"name":"Department of Medical Psychology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"},{"name":"Department of Oncology, Hematology and 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