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Thana K, Sikorskii A, Lehto R, Guhaniyogi P, Brewer S, Victorson D, Pace T, Badger T, Wyatt G. Family caregivers of those with cancer: quality of life outcomes from a sequential multiple assignment randomized trial. Support Care Cancer 2022; 30:5891-5902. [PMID: 35378595 DOI: 10.1007/s00520-022-07012-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 03/24/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To conduct a secondary analysis focused on health-related quality of life (HRQOL) among caregivers engaged in a 12-week complementary therapy sequential multiple assignment randomized trial (SMART) of reflexology and/or meditative practices (MP), to manage cancer patients' symptoms. METHODS In this SMART, patient-caregiver dyads were initially randomized to 4 weeks of caregiver-delivered reflexology for the patient (N = 150), MP with the patient (N = 150), or control (N = 47). After 4 weeks, dyads with patients not improving on fatigue (non-responders, n = 69 to reflexology and n = 57 to MP) were re-randomized to continue the same therapy or add the other therapy for an additional 4 weeks. Week-12 caregiver HRQOL was measured using the Patient Reported Outcomes Measurement Information System (PROMIS) Profile-29 and the Caregiver Reaction Assessment Tool (CRAT) for caregiver burden; scores were analyzed using general linear models. RESULTS In the comparison of 4 adaptive intervention sequences: reflexology for 8 weeks, reflexology for 4 weeks followed by MP for 4 weeks if no response to reflexology, MP for 8 weeks, and MP for 4 weeks followed by reflexology for 4 weeks if no response to MP, there were no differences in PROMIS-29 scores. However, CRAT domains of impact on schedule, family support, and finances worsened when adding reflexology after the first 4 weeks of MP. The CRAT domain of health worsened by adding either intervention compared to continuing the same one. CONCLUSIONS Clinicians should be aware that caregiver engagement in more than one complementary therapy may increase caregiver burden in some domains but not affect other HRQOL domains. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02759146.
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Affiliation(s)
- Kanjana Thana
- College of Nursing, Michigan State University, 1355 Bogue Street, East Lansing, MI, 48824, USA
- Faculty of Nursing, Chiang Mai University, 110/406 Inthawaroros Road, Chiang Mai, 50200, Thailand
| | - Alla Sikorskii
- Department of Psychiatry, Michigan State University, 909 Wilson Road, Room 32, East Lansing, MI, 48824, USA
| | - Rebecca Lehto
- College of Nursing, Michigan State University, 1355 Bogue Street, East Lansing, MI, 48824, USA
| | - Pratim Guhaniyogi
- Department of Statistics and Probability, Michigan State University, 619 Red Cedar Road, East Lansing, MI, 48824, USA
| | - Sarah Brewer
- Department of Epidemiology and Biostatistics, Michigan State University, 909 Wilson Road, East Lansing, MI, 48824, USA
| | - David Victorson
- Northwestern University Feinberg School of Medicine, Evanston, IL, 60208, USA
| | - Thaddeus Pace
- University of Arizona College of Nursing, 1305 N. Martin Ave, PO Box 210203, Tucson, AZ, 85721, USA
| | - Terry Badger
- University of Arizona College of Nursing, 1305 N. Martin Ave, PO Box 210203, Tucson, AZ, 85721, USA
| | - Gwen Wyatt
- College of Nursing, Michigan State University, 1355 Bogue Street, East Lansing, MI, 48824, USA.
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