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Whisenant M, Weathers SP, Li Y, Aldrich E, Ownby K, Thomas J, Ngo-Huang A, Bruera E, Milbury K. Simulation-based caregiving skills training for family members of high-grade glioma patients. Neurooncol Pract 2024; 11:432-440. [PMID: 39006525 PMCID: PMC11241359 DOI: 10.1093/nop/npae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024] Open
Abstract
Background Because family caregivers of patients with a high-grade glioma experience high levels of distress and feel unprepared to perform the complex caregiving tasks associated with the disease and its treatment, we pilot-tested a caregiving skills intervention that integrates hands-on caregiving with coping skill training. Methods In this single-arm trial, caregivers participated in a 4-session research nurse-led intervention involving simulation-based caregiving skills training at the hospital and psychoeducation delivered via videoconference. We collected measures of patients' and caregivers' psychological symptoms; caregivers' caregiving self-efficacy and role adjustment; and patients' cancer-related symptoms (MDASI) at baseline and again postintervention. We tracked feasibility data. Results We approached 29 dyads of which 10 dyads (34%) consented. All patients (mean age: 60 years, 89% male) and caregivers (mean age: 58 years, 80% female, 80% spouses) completed the baseline and 7 dyads completed the follow-up assessments (attrition was related to patient's hospice transfer). Seven caregivers completed all 4 sessions and rated the program as beneficial. Paired t-tests revealed a significant improvement in caregiving self-efficacy at 6 weeks postintervention (t = -3.06, P = .02). Although improvements in caregiver role adjustment and patient and caregiver symptoms were not observed, no decreases in symptom burden or role adjustment were found during the follow-up period. Conclusions This novel supportive care program appears to be safe, feasible, acceptable, and perceived as useful for caregivers of patients with high-grade glioma. Based on feasibility indicators and a signal of intervention efficacy, a randomized controlled trial is warranted.
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Affiliation(s)
- Meagan Whisenant
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Shiao-Pei Weathers
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yisheng Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ellen Aldrich
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kristin Ownby
- Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Jessica Thomas
- Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - An Ngo-Huang
- Department of Palliative, Rehabilitation, & Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation, & Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kathrin Milbury
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Cruz-Oliver DM, Milner GE, Mensh K, Bugayong M, Blinka MD, Durkin N, Abshire Saylor M, Budhathoki C, Oliver DP. Promising Impact of Telenovela Intervention for Caregivers of Hospice Patients: A Pilot Study. Am J Hosp Palliat Care 2024:10499091241228835. [PMID: 38321708 DOI: 10.1177/10499091241228835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Hospice family caregivers (HFCGs) support the needs of their loved ones but are at risk of developing distress and anxiety. NOVELA is a four-chapter telenovela-style educational video to support topics related to hospice caregiving. Telehealth visits are scheduled in 4 weekly sessions consisting of a chapter and subsequent discussion with an interventionist. This feasibility pilot study tested NOVELA's effect to change HFCGs' outcomes, session and outcome measure completion (defined a priori as >70%). METHODS This is a single-group pretest-posttest study of HFCGs of care recipients with PPS score >20% from 3 hospices in the U.S. Mid-Atlantic region. At baseline and at final posttest, participants completed a web-based survey assessing 3 outcomes: anxiety, self-efficacy, and satisfaction with intervention. Descriptive, t-test, and chi-square statistics were computed. RESULTS Participants in our study (N = 59) were mainly collage educated, White, female, adult children of home-bound people with a non-cancer diagnosis. Outcomes changed in the expected direction (P > .05) with higher self-efficacy (Cohen's d = -.08 [95% CI -.4 to .2) and lower anxiety (Cohen's d = .2 [95% CI -.1 to .5]) scores from final to baseline, 86% of HFCGs were satisfied or very satisfied with NOVELA, session (33/59) and outcome measure (43/59) completion averaged 68%. CONCLUSION Encouraging trends in NOVELA's estimation of effect suggests that NOVELA may buffer stressful aspects of hospice caregiving. However, further refinement of NOVELA is needed. Supporting HFCGs through supportive educational interventions may reduce distress and anxiety with broad implications for quality improvement.
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Affiliation(s)
- Dulce M Cruz-Oliver
- Section of Palliative Medicine, Division of General Internal Medicine Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA
| | | | - Kelsea Mensh
- Med-Surg Oncology 5A, Sibley Memorial Hospital, Washington, DC, USA
| | - Marielle Bugayong
- Division of General Internal Medicine Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Marcela D Blinka
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center on Aging and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nowella Durkin
- Division of General Internal Medicine Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | | | - Debra Parker Oliver
- Division of Palliative Medicine, Goldfarb School of Nursing, Barnes Jewish Hospital, Washington University, St. Louis, MO, USA
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3
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Alshakhs S, Park T, McDarby M, Reid MC, Czaja S, Adelman R, Sweet E, Jedlicka CM, Delgado D, Phongtankuel V. Interventions for Family Caregivers of Patients Receiving Palliative/Hospice Care at Home: A Scoping Review. J Palliat Med 2024; 27:112-127. [PMID: 37582194 PMCID: PMC10790551 DOI: 10.1089/jpm.2023.0160] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/17/2023] Open
Abstract
There is a need for understanding the breadth of interventions for caregivers of individuals receiving hospice care at home, given the important role caregivers play in caring and the negative outcomes (e.g., depression) associated with their caregiving. Previous reviews were limited in scope to certain types of interventions or patient populations. The objective of this scoping review was to broadly examine the interventions targeting caregivers who provide care to terminally ill patients in home, with the purpose of (1) describing the characteristics of these interventions, (2) discussing key outcomes, limitations, and knowledge gaps, (3) highlighting intervention strengths, and (4) proposing future research directions. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Intervention studies that met the inclusion criteria and that were published up until October 2022 were obtained from the following databases: Ovid MEDLINE, Ovid EMBASE, CINAHL (EBSCO), and The Cochrane Library (Wiley). We analyzed 76 studies describing 55 unique interventions that took place in 14 countries. Interventions were largely delivered by nurses (n = 18, 24%), followed by an interdisciplinary team (n = 16, 21%), a health care provider (n = 10, 13%), research staff (n = 10, 13%), social worker (n = 5, 7%), and others (n = 11, 15%). Six interventions (8%) were self-administered. The most measured outcome was caregiver quality of life (n = 20, 26%), followed by anxiety (n = 18, 24%) and burden (n = 15, 20%). Missing data on patient and caregiver characteristics (i.e., age, gender) were common, and less than half of studies (n = 32, 42%) reported race/ethnicity data. Our review highlighted the current state of interventions for caregivers of patients receiving hospice care at home. Many of the interventions were in the early phases of development, raising the need for future studies to look at efficacy, effectiveness, and the ability to implement interventions in real-world settings.
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Affiliation(s)
| | | | - Meghan McDarby
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - M. Cary Reid
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Sara Czaja
- Center on Aging and Behavioral Research, Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
| | | | | | - Caroline M. Jedlicka
- Weill Cornell Medical College, New York, New York, USA
- Robert J. Kibbee Library, Kingsborough Community College, CUNY (City University of New York), New York, New York, USA
| | - Diana Delgado
- Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, New York, USA
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Carr AL, Bilenduke E, Adolf E, Kessler ER, Arch JJ, Ranby KW, Kilbourn K. A pilot randomized study of a telephone-based cognitive-behavioral stress-management intervention to reduce distress in phase 1 oncology trial caregivers. Palliat Support Care 2023; 21:820-828. [PMID: 36994841 PMCID: PMC10544682 DOI: 10.1017/s1478951523000196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
OBJECTIVES Caregivers of adult phase 1 oncology trial patients experience high levels of distress and face barriers to in-person supportive care. The Phase 1 Caregiver LifeLine (P1CaLL) pilot study assessed the feasibility, acceptability, and general impact of an individual telephone-based cognitive behavioral stress-management (CBSM) intervention for caregivers of phase I oncology trial patients. METHODS The pilot study involved 4 weekly adapted CBSM sessions followed by participant randomization to 4 weekly cognitive behavioral therapy sessions or metta-meditation sessions. A mixed-methods design used quantitative data from 23 caregivers and qualitative data from 5 caregivers to examine the feasibility and acceptability outcomes. Feasibility was determined using recruitment, retention, and assessment completion rates. Acceptability was assessed with self-reported satisfaction with program content and participation barriers. Baseline to post-intervention changes in caregiver distress and other psychosocial outcomes were assessed for the 8-session intervention. RESULTS The enrollment rate was 45.3%, which demonstrated limited feasibility based on an a priori criterion enrollment rate of 50%. Participants completed an average of 4.9 sessions, with 9/25 (36%) completing all sessions and an 84% assessment completion rate. Intervention acceptability was high, and participants found the sessions helpful in managing stress related to the phase 1 oncology trial patient experience. Participants showed reductions in worry and isolation and stress. SIGNIFICANCE OF RESULTS The P1CaLL study demonstrated adequate acceptability and limited feasibility and provided data on the general impact of the intervention on caregiver distress and other psychosocial outcomes. Caregivers of phase 1 oncology trial patients would benefit from supportive care services; a telephone-based intervention may have more utilization and thus make a larger impact.
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Affiliation(s)
- Alaina L. Carr
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
- Lombardi Comprehensive Cancer Center, Cancer Prevention and Control, Washington, DC, USA
| | - Emily Bilenduke
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Esmeralda Adolf
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Elizabeth R. Kessler
- Division of Medical Oncology, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - Joanna J. Arch
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Krista W. Ranby
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Kristin Kilbourn
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
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5
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Thrower C, Barrie C, Baxter S, Bloom M, Borja MC, Butters A, Dudgeon D, Haque A, Lee S, Mahmood I, Mirhosseini M, Mirza RM, Murzin K, Ankita A, Skantharajah N, Vadeboncoeur C, Wan A, Klinger CA. Interventions for Grieving and Bereaved Informal Caregivers: A Scoping Review of the Canadian Literature. J Palliat Care 2023; 38:215-224. [PMID: 35726197 PMCID: PMC10026166 DOI: 10.1177/08258597221101826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The palliative approach to care is playing a larger role in the healthcare of older adults in Canada. Within (hospice) palliative care, informal caregivers play a crucial role as part of the interdisciplinary care team. Ensuring high quality palliative care includes providing effective grief and bereavement supports for them. Objective: This study aimed to identify current interventions addressing the grief and bereavement experiences of informal caregivers of geriatric patients in the Canadian (hospice) palliative/end-of-life care realm. Methods: A scoping review was undertaken using Arksey and O'Malley's framework. Seven electronic health and social science databases were searched. In addition, several stakeholder organizations' websites were reviewed to identify grey literature sources. Interventions that took place in Canada, were in English, and explored grief and bereavement supports for informal caregivers in an adult/geriatric (hospice) palliative care setting were included. After full text review, data were extracted and charted. Major themes were established following thematic content analysis. Results: Within a total of 18 sources, three themes were identified: (1) Classification of intervention, (2) Format of intervention, and (3) Intervention target. Method of delivery and type of intervention for grief and bereavement supports were aligned with the international literature. There is a need for large-scale evaluations of interventions and informal caregivers should be engaged in this process. Practitioners should be encouraged to direct bereavement interventions toward grieving caregivers, and to collaborate with them to improve access to these interventions. Policy makers should provide additional funding for grief interventions for informal caregivers. Conclusions: It is important to better understand the needs of informal caregivers experiencing grief and bereavement. Interdisciplinary collaborations will be necessary to develop, evaluate, and scale future interventions.
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Affiliation(s)
- Carly Thrower
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Carol Barrie
- Canadian Frailty Network (CFN), Kingston, Ontario, Canada
- Quality End-of-Life Care Coalition of Canada (QELCCC), Ottawa, Ontario, Canada
| | - Sharon Baxter
- Quality End-of-Life Care Coalition of Canada (QELCCC), Ottawa, Ontario, Canada
- Canadian Hospice Palliative Care Association (CHPCA), Ottawa, Ontario, Canada
| | - Meryl Bloom
- Global Health Office, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Maria Carolina Borja
- Health Studies Program, Faculty of Arts and Science, University of Toronto, Toronto, Ontario, Canada
| | - Anica Butters
- Health Studies Program, Faculty of Arts and Science, University of Toronto, Toronto, Ontario, Canada
| | - Deborah Dudgeon
- Quality End-of-Life Care Coalition of Canada (QELCCC), Ottawa, Ontario, Canada
- Canadian Partnership Against Cancer (CPAC), Toronto, Ontario, Canada
- School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Ayeshah Haque
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Suzanna Lee
- Health Studies Program, Faculty of Arts and Science, University of Toronto, Toronto, Ontario, Canada
| | - Iqra Mahmood
- Health Studies Program, Faculty of Arts and Science, University of Toronto, Toronto, Ontario, Canada
| | - Mehrnoush Mirhosseini
- Quality End-of-Life Care Coalition of Canada (QELCCC), Ottawa, Ontario, Canada
- College of Family Physicians of Canada (CFPC), Mississauga, Ontario, Canada
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Raza M Mirza
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Life Course and Aging, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- National Initiative for the Care of the Elderly (NICE), Toronto, Ontario, Canada
| | - Kate Murzin
- Quality End-of-Life Care Coalition of Canada (QELCCC), Ottawa, Ontario, Canada
- Realize, Toronto, Ontario Canada
| | - Ankita Ankita
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Neerjah Skantharajah
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Christina Vadeboncoeur
- Quality End-of-Life Care Coalition of Canada (QELCCC), Ottawa, Ontario, Canada
- Canadian Network of Palliative Care for Children (CNPCC), Ottawa, Ontario, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Andrew Wan
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Christopher A Klinger
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Quality End-of-Life Care Coalition of Canada (QELCCC), Ottawa, Ontario, Canada
- Life Course and Aging, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- National Initiative for the Care of the Elderly (NICE), Toronto, Ontario, Canada
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Pallium Canada, Ottawa, Ontario, Canada
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Weaver MS, Shostrom VK, Neumann ML, Robinson JE, Hinds PS. Homestead together: Pediatric palliative care telehealth support for rural children with cancer during home-based end-of-life care. Pediatr Blood Cancer 2021; 68:e28921. [PMID: 33522720 DOI: 10.1002/pbc.28921] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/14/2020] [Accepted: 01/08/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Children with terminal cancer and their families describe a preference for home-based end-of-life care. Inadequate support outside of the hospital is a limiting factor in home location feasibility, particularly in rural regions lacking pediatric-trained hospice providers. METHODS The purpose of this longitudinal palliative telehealth support pilot study was to explore physical and emotional symptom burden and family impact assessments for children with terminal cancer receiving home based-hospice care. Each child received standard of care home-based hospice care from an adult-trained rural hospice team with the inclusion of telehealth pediatric palliative care visits at a scheduled minimum of every 14 days. RESULTS Eleven children (mean age 11.9 years) received pediatric palliative telehealth visits a minimum of every 14 days, with an average of 4.8 additional telehealth visits initiated by the family. Average time from enrollment to death was 21.6 days (range 4-95). Children self-reported higher physical symptom prevalence than parents or hospice nurses perceived the child was experiencing at time of hospice enrollment with underrecognition of the child's emotional burden. At the time of hospice enrollment, family impact was reported by family caregivers as 46.4/100 (SD 18.7), with noted trend of improved family function while receiving home hospice care with telehealth support. All children remained at home for end-of-life care. CONCLUSION Pediatric palliative care telehealth combined with adult-trained rural hospice providers may be utilized to support pediatric oncology patients and their family caregivers as part of longitudinal home-based hospice care.
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Affiliation(s)
- Meaghann S Weaver
- Department of Pediatrics, Division of Pediatric Palliative Care, Children's Hospital and Medical Center, Omaha, Nebraska
| | - Valerie K Shostrom
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska
| | - Marie L Neumann
- Department of Pediatrics, Division of Pediatric Palliative Care, Children's Hospital and Medical Center, Omaha, Nebraska
| | - Jacob E Robinson
- Department of Pediatrics, Division of Pediatric Palliative Care, Children's Hospital and Medical Center, Omaha, Nebraska
| | - Pamela S Hinds
- Department of Nursing Science, Professional Practice and Quality, Children's National Health System, Washington, District of Columbia.,Department of Pediatrics, George Washington University, Washington, District of Columbia
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7
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Mosher CE, Winger JG, Hanna N, Jalal SI, Einhorn LH, Birdas TJ, Ceppa DP, Kesler KA, Schmitt J, Kashy DA, Champion VL. Randomized Pilot Trial of a Telephone Symptom Management Intervention for Symptomatic Lung Cancer Patients and Their Family Caregivers. J Pain Symptom Manage 2016; 52:469-482. [PMID: 27401514 PMCID: PMC5075493 DOI: 10.1016/j.jpainsymman.2016.04.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 03/18/2016] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
Abstract
CONTEXT Lung cancer is one of the most common cancers affecting both men and women and is associated with high symptom burden and psychological distress. Lung cancer patients' family caregivers also show high rates of distress. However, few interventions have been tested to alleviate significant problems of this population. OBJECTIVES This study examined the preliminary efficacy of telephone-based symptom management (TSM) for symptomatic lung cancer patients and their family caregivers. METHODS Symptomatic lung cancer patients and caregivers (n = 106 dyads) were randomly assigned to four sessions of TSM consisting of cognitive-behavioral and emotion-focused therapy or an education/support condition. Patients completed measures of physical and psychological symptoms, self-efficacy for managing symptoms, and perceived social constraints from the caregiver; caregivers completed measures of psychological symptoms, self-efficacy for helping the patient manage symptoms and managing their own emotions, perceived social constraints from the patient, and caregiving burden. RESULTS No significant group differences were found for all patient outcomes and caregiver self-efficacy for helping the patient manage symptoms and caregiving burden at two- and six-weeks post-intervention. Small effects in favor of TSM were found regarding caregiver self-efficacy for managing their own emotions and perceived social constraints from the patient. Study outcomes did not significantly change over time in either group. CONCLUSION Findings suggest that our brief telephone-based psychosocial intervention is not efficacious for symptomatic lung cancer patients and their family caregivers. Next steps include examining specific intervention components in relation to study outcomes, mechanisms of change, and differing intervention doses and modalities.
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Affiliation(s)
- Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA.
| | - Joseph G Winger
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Nasser Hanna
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Shadia I Jalal
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, USA
| | - Lawrence H Einhorn
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Thomas J Birdas
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - DuyKhanh P Ceppa
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kenneth A Kesler
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jordan Schmitt
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, USA
| | - Deborah A Kashy
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
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Evaluation of a video, telephone follow-ups, and an online forum as components of a psychoeducational intervention for caregivers of persons with advanced cancer. Palliat Support Care 2016; 14:474-8. [PMID: 27071801 DOI: 10.1017/s1478951516000225] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Our aim was to evaluate caregivers' perceptions of a video, telephone follow-up, and online forum as components of a psychoeducational intervention. METHOD Qualitative semistructured face-to-face interviews were conducted with 12 participants two weeks post-intervention. The study was conducted from September of 2012 to May of 2015. Family caregivers were recruited from four home hospice organizations (HCA Hospice Care, Metta Hospice, Singapore Cancer Centre, and Agape Methodist Hospice) and the National Cancer Centre outpatient clinic in Singapore. A purposive sample was employed, and participants were recruited until data saturation. Qualitative interviews were transcribed verbatim. Transcripts were coded and analyzed using content analysis. Two of the research team members were involved in the data analysis. RESULTS Two-thirds of participants were females (n = 8). Their ages ranged from 22 to 67 (mean = 50.50, SD = 11.53). About two-thirds were married (n = 7). Most participants were caring for a parent (n = 10), one for a spouse, and one for her mother-in-law. Caregivers favored the use of video for delivery of educational information. They liked the visual and audio aspects of the video. The ability to identify with the caregiver and scenarios in the video helped in the learning process. They appreciated telephone follow-ups from healthcare professionals for informational and emotional support. The online forum as a platform for sharing of information and provision of support was not received well by the caregivers in this study. The reasons for this included their being busy, not being computer savvy, rarely surfing the internet, and not feeling comfortable sharing with strangers on an online platform. SIGNIFICANCE OF RESULTS This study provided insight into caregivers' perceptions of various components of a psychoeducational intervention. It also gave us a better understanding of how future psychoeducational interventions and support for caregivers of persons with advanced cancer could be provided.
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9
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Michels CTJ, Boulton M, Adams A, Wee B, Peters M. Psychometric properties of carer-reported outcome measures in palliative care: A systematic review. Palliat Med 2016; 30:23-44. [PMID: 26407683 PMCID: PMC4708617 DOI: 10.1177/0269216315601930] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Informal carers face many challenges in caring for patients with palliative care needs. Selecting suitable valid and reliable outcome measures to determine the impact of caring and carers' outcomes is a common problem. AIM To identify outcome measures used for informal carers looking after patients with palliative care needs, and to evaluate the measures' psychometric properties. DESIGN A systematic review was conducted. The studies identified were evaluated by independent reviewers (C.T.J.M., M.B., M.P.). Data regarding study characteristics and psychometric properties of the measures were extracted and evaluated. Good psychometric properties indicate a high-quality measure. DATA SOURCES The search was conducted, unrestricted to publication year, in the following electronic databases: Applied Social Sciences Index and Abstracts, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, EMBASE, PubMed, PsycINFO, Social Sciences Citation Index and Sociological Abstracts. RESULTS Our systematic search revealed 4505 potential relevant studies, of which 112 studies met the inclusion criteria using 38 carer measures for informal carers of patients with palliative care needs. Psychometric properties were reported in only 46% (n = 52) of the studies, in relation to 24 measures. Where psychometric data were reported, the focus was mainly on internal consistency (n = 45, 87%), construct validity (n = 27, 52%) and/or reliability (n = 14, 27%). Of these, 24 measures, only four (17%) had been formally validated in informal carers in palliative care. CONCLUSION A broad range of outcome measures have been used for informal carers of patients with palliative care needs. Little formal psychometric testing has been undertaken. Furthermore, development and refinement of measures in this field is required.
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Affiliation(s)
- Charlotte T J Michels
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Mary Boulton
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Astrid Adams
- Sir Michael Sobell House, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Bee Wee
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK Sir Michael Sobell House, Oxford University Hospitals NHS Trust, Oxford, UK Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Michele Peters
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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10
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Zheng Y, Head BA, Schapmire TJ. A Systematic Review of Telehealth in Palliative Care: Caregiver Outcomes. Telemed J E Health 2015; 22:288-94. [PMID: 26360181 DOI: 10.1089/tmj.2015.0090] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Telehealth interventions have proven efficacy in healthcare, but little is known about the results of such interventions in palliative care. We conducted a systematic review to evaluate caregiver outcomes related to palliative telehealth interventions. MATERIALS AND METHODS We searched multiple databases for articles published between January 2003 and January 2015 related to telehealth in palliative care. Two hundred twenty-one articles were considered; nine of these met study inclusion criteria. Data on study design, population, interventions, methods, outcomes, conclusions, and methodological quality were extracted and evaluated by three investigators. RESULTS Of the nine studies, five measured caregiver quality of life, three measured caregiver anxiety, and two measured caregiver burden. All the studies measuring caregiver quality of life showed no significant difference after telehealth interventions. The caregiver anxiety score decreased after the intervention in two studies, and one study reported significantly reduced caregiver burden. Although feasibility of or caregiver satisfaction with the telehealth intervention was not the focus of this review, most studies reported such findings. Of the nine studies, the majority were rated as having moderate quality using the Cochrane Collaboration's tool for assessing risk of bias. CONCLUSIONS This systematic review suggests there is evidence of overall satisfaction in caregivers who undergo a telehealth intervention, but outcomes reported were often not substantial. Methodological flaws and small sample sizes negatively affected study quality. More rigorous research to test and evaluate such palliative interventions is needed.
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Affiliation(s)
- Yongqiang Zheng
- 1 Kent School of Social Work, University of Louisville , Louisville, Kentucky
| | - Barbara A Head
- 2 School of Medicine, University of Louisville , Louisville, Kentucky
| | - Tara J Schapmire
- 2 School of Medicine, University of Louisville , Louisville, Kentucky
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Pottie CG, Burch KA, Thomas LPM, Irwin SA. Informal caregiving of hospice patients. J Palliat Med 2015; 17:845-56. [PMID: 24992371 DOI: 10.1089/jpm.2013.0196] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Informal caregivers play a critical role in the provision of care to hospice patients. The care they provide often impacts their physical and psychological well-being. OBJECTIVE This study synthesized 58 articles pertaining to informal hospice caregiving, focusing on caregivers' satisfaction with hospice services, the physical and psychological well-being of caregivers, the predictors of caregivers' well-being, the direct impact of hospice services on caregivers, and the effectiveness of targeted interventions for hospice caregivers. METHOD A systematic literature review of journal articles published between 1985 and 2012 was conducted. RESULTS The studies reviewed found hospice caregivers to experience clinically significant levels of anxiety, depression, and stress; however, results for caregiver burden and quality of life were mixed. Caregivers' perceptions regarding the meaningfulness of care as well as their levels of social support were associated with enhanced psychological outcomes. CONCLUSIONS Beyond satisfaction with hospice services, the direct impact of standard hospice care on caregivers remains uncertain. Caregiver intervention studies have demonstrated promising outcomes signifying a need for additional investigations into hospice-specific interventions that improve caregiver outcomes. Additional research and resources are needed to assist hospice caregivers, with the ultimate goal of minimizing their psychiatric and physical morbidity and enhancing their caregiving and subsequent bereavement processes.
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Affiliation(s)
- Colin G Pottie
- 1 Department of Psychiatry, Dalhousie University , Capital District Health Authority, Halifax, Nova Scotia, Canada
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Alcide A, Potocky M. Adult Hospice Social Work Intervention Outcomes in the United States. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2015; 11:367-385. [PMID: 26654066 DOI: 10.1080/15524256.2015.1107806] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A descriptive and critical analysis of the available empirical literature on social work psychosocial intervention outcomes for adult hospice patients and caregivers was conducted. The electronic bibliographic databases CINHAL (EBSCO), MEDLINE, ProQuest, EMBASE, Campbell Collaboration, and The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library) were searched. Search criteria were (a) social work interventions, (b) intervention was tested, (c) adult hospice patients and/or caregivers, (d) studies within the United States, (e) and studies between 2004 and 2014. Of the 21 studies that met the initial search criteria, 5 publications met all review criteria. Based on assessment of study results, intervention effect, and quality of evidence, the ADAPT Problem-Solving Intervention (PSI) and the Hospice Caregiver Support Project have some indications of practical effect on caregiver quality of life, anxiety, stress, and problem-solving skills. The Caregiver Life Line (CaLL) intervention had little to no effect on caregiver role stress or coping skills. The few available studies provide foundational insight into the need for the expansion of research efforts to evaluate hospice social work interventions and document the contributions of social work to the field.
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Affiliation(s)
- Amary Alcide
- a Social Work, Florida International University , Miami , Florida , USA
| | - Miriam Potocky
- b Florida International University , School of Social Research , Miami , Florida , USA
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Caring for a spouse with end-stage heart failure through implantation of a left ventricular assist device as a destination therapy. Heart Lung 2013; 42:389-90. [PMID: 23928055 DOI: 10.1016/j.hrtlng.2013.06.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 06/28/2013] [Indexed: 11/21/2022]
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Oliver DP, Albright DL, Washington K, Wittenberg-Lyles E, Gage A, Mooney M, Demiris G. Hospice caregiver depression: the evidence surrounding the greatest pain of all. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2013; 9:256-271. [PMID: 24295096 PMCID: PMC3849709 DOI: 10.1080/15524256.2013.846891] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Terminal illness affects the entire family, both the one with the illness and their loved ones. These loved ones must deal not only with the loss but with the challenges of managing daily care. The purpose of the systematic review of the peer-reviewed literature was to identify and explore depression and related interventions for caregivers of hospice patients. While the prevalence of depression reported in the identified studies of hospice caregivers ranges from 26-57%, few interventions specific to this population have been tested and the research methods have been only moderately rigorous.
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Affiliation(s)
- Debra Parker Oliver
- Curtis W. and Ann H. Department of Family and Community Medicine, University of Missouri, Medical Annex 306G, Columbia, Mo 65212, 573-356-6719
| | | | | | | | - Ashley Gage
- School of Social Work, Senior Research Specialist, University of Missouri
| | | | - George Demiris
- Biobehavioral Nursing and Health Systems, School of Nursing & Biomedical and Health Informatics, School of Medicine, University of Washington
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