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      Subjective caregiver burden and anxiety in informal caregivers: A systematic review and meta-analysis

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          Abstract

          There is increasing evidence that subjective caregiver burden is an important determinant of clinically significant anxiety in family carers. This meta-analysis aims to synthesise this evidence and investigate the relationship between subjective caregiver burden and anxiety symptoms in informal caregivers. We searched PubMed, CINAHL and PsycINFO up to January 2020. Combined estimates were obtained using a random-effects model. After screening of 4,312 articles, 74 studies (with 75 independent samples) were included. There was a large, positive association between subjective caregiver burden and anxiety symptoms (r = 0.51; 95% CI = 0.47, 0.54; I 2 = 0.0%). No differences were found in subgroup analyses by type of study design (cross-sectional vs. longitudinal), sampling, control of confounders or care-recipient characteristics. Subjective caregiver burden is an important risk factor for anxiety in informal caregivers. Targeting subjective caregiver burden could be beneficial in preventing clinically significant anxiety for the increasing number of family carers worldwide.

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          Most cited references114

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          Measuring inconsistency in meta-analyses.

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            Bias in meta-analysis detected by a simple, graphical test

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              Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis.

              We study recently developed nonparametric methods for estimating the number of missing studies that might exist in a meta-analysis and the effect that these studies might have had on its outcome. These are simple rank-based data augmentation techniques, which formalize the use of funnel plots. We show that they provide effective and relatively powerful tests for evaluating the existence of such publication bias. After adjusting for missing studies, we find that the point estimate of the overall effect size is approximately correct and coverage of the effect size confidence intervals is substantially improved, in many cases recovering the nominal confidence levels entirely. We illustrate the trim and fill method on existing meta-analyses of studies in clinical trials and psychometrics.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: Project administrationRole: SupervisionRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: Project administrationRole: SupervisionRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                1 March 2021
                2021
                : 16
                : 3
                : e0247143
                Affiliations
                [1 ] Faculty of Health Sciences, Department of Nursing, University of Jaén, Jaén, Andalusia, Spain
                [2 ] Division of Psychiatry, University College London, London, United Kingdom
                University of Bologna, ITALY
                Author notes

                Competing Interests: The first author was the chief investigator of two studies meeting inclusion criteria for this review. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no other known conflicts of interest.

                Author information
                https://orcid.org/0000-0003-2263-2415
                https://orcid.org/0000-0003-1303-7593
                Article
                PONE-D-20-29879
                10.1371/journal.pone.0247143
                7920375
                33647035
                e5f3949e-89a5-4369-a373-ac7108882966
                © 2021 del-Pino-Casado et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 29 September 2020
                : 2 February 2021
                Page count
                Figures: 3, Tables: 3, Pages: 20
                Funding
                The author(s) received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Health Care
                Caregivers
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Dementia
                Medicine and Health Sciences
                Neurology
                Dementia
                Biology and Life Sciences
                Psychology
                Emotions
                Anxiety
                Social Sciences
                Psychology
                Emotions
                Anxiety
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Statistical Methods
                Metaanalysis
                Physical Sciences
                Mathematics
                Statistics
                Statistical Methods
                Metaanalysis
                Science Policy
                Research Integrity
                Publication Ethics
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Neuropsychiatric Disorders
                Anxiety Disorders
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Neuroses
                Anxiety Disorders
                Medicine and Health Sciences
                Nephrology
                Renal Cancer
                Research and Analysis Methods
                Research Design
                Longitudinal Studies
                Custom metadata
                All relevant data are within the paper and its Supporting information files.

                Uncategorized
                Uncategorized

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