Exploration of Medicine

Table 3. Intervention approaches targeting family burden in colorectal cancer survivorship.

Intervention category	Target	Delivery mode	Strongest evidence level	Representative outcomes	Key references
Couple-based dyadic coping	Dyad	Face-to-face and/or telephone/online; 4–8 sessions	SR and meta-analysis; RCTs	Small-to-moderate reductions in distress; improved dyadic coping and relationship functioning	[54, 55]
Mutual communication intervention	Dyad	Face-to-face skills training	RCT	Improved intra-couple communication and individual functioning	[56]
Psychoeducation and caregiver skills training	Caregiver	Group or individual; nurse-led; printed/digital	SR and meta-analysis	Improved caregiver preparedness; reduced emotional burden	[57]
Nurse-led survivorship care plans with family component	Patient and caregiver	Integrated across multidisciplinary team pathway	Integrative review	Better care coordination: reduced unmet needs when family explicitly addressed	[57, 58]
Face-to-face peer support	Patient and/or caregiver	Community-based, moderated groups	SR of qualitative studies; RCT meta-analysis	Small but significant improvements in anxiety, depression, and quality of life	[45, 59]
Online peer support	Patient and/or caregiver	Closed/open platforms; 24/7 access	Cross-sectional and qualitative studies	High perceived utility; quality variable; moderation and clinician input improve benefit	[45, 46]
Web-based dyadic symptom management	Dyad	Asynchronous modules; app-based	Feasibility/protocol studies; early RCTs	Feasibility and acceptability demonstrated; efficacy data emerging	[60]
Specialized palliative care with dyadic psychological component	Dyad (advanced disease)	Home-based, multidisciplinary	RCT (Nordic)	Feasible and acceptable; caregiver burden not reduced, informative negative trial	[61]
Caregiver-targeted fear of recurrence therapy	Caregiver	Individual; online or in-person; cognitive behavioral therapy	Pilot/feasibility RCT	Feasible and acceptable in caregivers with clinically significant fear of cancer recurrence	[27]
Disease-specific educational resources (e.g., LARSCAT)	Patient and family	Co-designed printed and digital materials	Multicenter implementation studies	Improved symptom literacy and help-seeking	[14]

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RCT: randomized controlled trial; SR: systematic review; LARSCAT: low anterior resection syndrome project of the Catalan Society of Surgery.

Declarations

Acknowledgments

During the preparation of this manuscript, the authors used Claude (Anthropic) to assist with language editing. All output was reviewed and edited by the authors, who take full responsibility for the content of the publication.

Author contributions

LWF and BTO: Conceptualization, Data curation, Investigation, Writing—original draft, Writing—review & editing. JR: Conceptualization, Writing—original draft, Supervision, Writing—review & editing. All authors read and approved the submitted version.

Conflicts of interest

The authors declare they have no conflicts of interest.

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