Coping and mental health in family caregivers: Systematic review with Meta-analysis

The care system is acquiring great relevance in developed countries due to the increase in life expectancy and the increase in the prevalence of chronic pathologies. This system can be formal or informal. The latter is made up of all those people who care for and support family members or close friends who, due to limitations in their functional capacity, cannot carry out one or more basic activities of daily life autonomously. Informal care is carried out by family caregivers, who are not professionals and do not receive remuneration in return. Given that the formal system cannot provide a sufficient response to the recent and growing “care needs” in our society, the figure of the family caregiver is acquiring great importance.

Family care is associated with positive aspects but also with a higher risk of experiencing negative consequences for physical, mental and social health, presenting worse psychological well-being and health than the general population. Mental health problems include anxiety and depression. Another frequent negative experience in family care is the multidimensional process of burden. However, the health of family caregivers can be improved. To do this, health policies must focus on interventions capable of promoting the health of this population. But it is necessary to better understand the different factors that influence the health status of family caregivers in order to develop appropriate intervention strategies.

The stress caused by family care can have a negative effect, producing anxiety or depression, among other psychological consequences. The relationship between stress and these consequences can be influenced by other variables. The way in which the family caregiver copes with a situation that generates stress can be a possible moderator or mediator between stressful events from family care and psychological morbidity.

Principal researchers:

  • Juan Carlos Muñoz Cruz. Universidad de Jaén.
  • Rafael Del Pino Casado. Universidad de Jaén.
  • Catalina López Martínez. Universidad de Jaén.

Collaborating researchers:

  • Vasiliki Orgeta. University College London


The general objective of this project is:

• Analyze the relationship between the different dimensions and coping strategies and the negative mental consequences that care produces in family carers of dependent people. 

 The specific objectives are:

• To study the relationship between coping and depressive symptoms, anxiety and subjective burden in family caregivers of dependent people over 18 years of age.

• Analyze the relationship between coping and depressive symptoms, anxiety and subjective burden in family caregivers of children and adolescents dependent on their stage of development.

• Examine the potential sources of heterogeneity of the results found in the different meta-analyses. 


Systematic review with Meta-analysis following the standards reported by Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). For the study of the different meta-analyses carried out, statistical heterogeneity, possible publication bias and the robustness of the results will also be analysed. Finally, several subgroup analyzes will be carried out to identify potential sources of heterogeneity.

We will evaluate the methodological quality of the studies included in the systematic review by controlling for selection, classification and confounding biases, as well as the length of follow-up and sample integrity for longitudinal studies.

Finally, we will study of the quality of the results of each meta-analysis through inconsistency, imprecision and risk of publication bias following the guidelines of the Grading of Recommendations Assessment, Development and Evaluation (GRADE).


Preparation of a protocol to carry out a systematic review with meta-analysis on the effects of the different coping strategies on the mental health of caregivers of family members or dependent relatives. Greater knowledge of the possible influence that different ways of coping with stress situations that appear during care have on mental health in this population can open up opportunities for more appropriate interventions by nurses.