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Impact of coping skills intervention with family caregivers of hospice patients with cancer

A randomized clinical trial

  1. Susan C. McMillan Ph.D., A.R.N.P.1,2,†,*,
  2. Brent J. Small Ph.D.2,3,
  3. Michael Weitzner M.D.2,4,
  4. Ronald Schonwetter M.D.2,5,
  5. Mary Tittle Ph.D., A.R.N.P.2,6,
  6. Linda Moody Ph.D., A.R.N.P.1,2,
  7. William E. Haley Ph.D.2,3

Article first published online: 2 DEC 2005

DOI: 10.1002/cncr.21567

Issue

Cancer

Cancer

Volume 106, Issue 1, pages 214–222, 1 January 2006

Additional Information

How to Cite

McMillan, S. C., Small, B. J., Weitzner, M., Schonwetter, R., Tittle, M., Moody, L. and Haley, W. E. (2006), Impact of coping skills intervention with family caregivers of hospice patients with cancer. Cancer, 106: 214–222. doi: 10.1002/cncr.21567

Author Information

  1. 1

    College of Nursing, University of South Florida, Tampa, Florida

  2. 2

    Center for Hospice, Palliative Care, and End of Life Studies at the University of South Florida, Tampa, Florida

  3. 3

    School of Aging Studies, University of South Florida, Tampa, Florida

  4. 4

    Helios Pain & Psychiatry Center, Tampa, Florida

  5. 5

    Division of Geriatric Medicine, University of South Florida, Tampa, Florida

  6. 6

    St. Petersburg College, St. Petersburg, Florida

  1. †

    Fax: (813) 974–5418

*College of Nursing, MDC 22, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL 33612

  1. †

    Fax: (813) 974–5418

Publication History

  1. Issue published online: 23 DEC 2005
  2. Article first published online: 2 DEC 2005
  3. Manuscript Accepted: 27 JUL 2005
  4. Manuscript Revised: 21 JUL 2005
  5. Manuscript Received: 17 MAY 2005

Funded by

  • National Cancer Institute
  • National Institute for Nursing Research. Grant Number: 1 RO1 CA77307

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Keywords:

  • caregiver;
  • hospice;
  • QOL;
  • cancer

Abstract

BACKGROUND

Family caregivers for cancer patients experience high levels of stress and burden and diminished quality of life (QOL). Interventions to improve coping skills of caregivers have been shown to be effective with other populations, but their impact has not been assessed in the difficult context of hospice care. The purpose of this study was to determine whether hospice plus a coping skill training intervention improved family caregivers' QOL, burden, coping, and mastery, compared with hospice plus emotional support, and usual hospice care.

METHODS

A three group randomized controlled trial was conducted including baseline, 16 day, and 30 day assessments conducted from March 1999 to May 2003. The sample consisted of 354 family caregivers of community dwelling hospice patients with advanced cancer. Patient/caregiver dyads were randomly divided into three groups, including a control group (n = 109) who received standard hospice care, a group (n = 109) who received standard hospice care plus three supportive visits, and a group (n = 111) who received standard care plus three visits to teach a coping skills intervention. Primary outcomes included caregiver QOL, caregiver burden due to patient symptoms, caregiver burden due to tasks, and caregiver mastery.

RESULTS

At the 30-day follow-up, the coping skills intervention led to significantly greater improvement in caregiver QOL (estimate = −0.16, standard error [SE] = 0.07, P = 0.03), burden of patient symptoms (estimate = 0.28, SE = 0.07, P < 0.001), and caregiving task burden (estimate = −0.01, SE = 0.01, P = 0.038) than did the other two conditions. None of the groups showed significant change in overall caregiving mastery, caregiver mastery specific to caregiving tasks, problem-focused or emotion-focused coping.

CONCLUSIONS

The coping skills intervention was effective in improving caregiver QOL, reducing burden related to patients' symptoms, and caregiving tasks compared with hospice care alone or hospice plus emotional support. Structured caregiver skill-training interventions for caregivers are promising even in the difficult environment of end-of-life care and for families already receiving benefits of hospice care. Cancer 2006. © 2005 American Cancer Society.

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