Experiences of family caregivers caring for cancer patients at home: A qualitative systematic review comparing evidence from HICs and LMICs

The rising global cancer incidence and mortality rates increase burden for family caregivers of patients at home. Much research reflects Western-centric views, overlooking cultural, relational, and structural contexts worldwide. We compared experiences of family caregivers in high-income countries (HICs) and low- and middle-income countries (LMICs) through a qualitative systematic review using JBI methodology. We searched eight databases and screened articles for eligibility. We grouped article findings by HIC and LMIC and used the Transactional Model of Stress and Coping as a flexible heuristic to generate synthesized findings. Of 1067 records identified, 52 studies were included (41 HICs and 11 LMICs). Family caregivers faced high physical and psychosocial demands, inadequately addressed by healthcare and social services. The availability of resources like home-based services and financial protection differed between HICs and LMICs, but coping strategies were similar. Motivations for caring ranged from moral obligation to caregiving as an extension of relationships. Caregiving was characterized by emotional distress alongside meaning and satisfaction. Our findings show shared human responses to caregiving, despite differing healthcare access. The comparative insights underscore that caregivers, despite varying contexts are insufficiently acknowledged as vital care team members, compelling urgent health system integration into cancer care plans.