Interventions for Caregivers
Few intervention studies have demonstrated efficacy in improving the quality of life of caregivers from the study entry point. Instead, most intervention studies have demonstrated efficacy in improving knowledge of and skills in caregiving. For example, interventions designed to educate caregivers about how to seek out medical information, identify psychosocial resources, or manage symptoms have helped improve caregivers' knowledge, confidence, and mood. Similarly, interventions designed to help caregivers develop problem-solving skills (e.g., coping with cancer) have demonstrated effectiveness in increasing caregiver self-efficacy in managing stress and in reducing psychological distress.
In one study, the psychosocial needs of not only the caregiver but also other family members and people close to the dying patient—all defined in this study as "secondary survivors"—were examined. A qualitative assessment of the needs of the secondary survivors, which occurred after 8 weeks of group psychoeducational grief intervention, revealed a sense of powerlessness and isolation in these individuals. Also, support was identified as a need extending beyond the traditional needs associated with the care of dying patients. The authors concluded that intervention by social workers directed toward the needs of secondary survivors may be helpful.[Level of evidence: II]
- Hudson PL, Aranda S, Kristjanson LJ: Meeting the supportive needs of family caregivers in palliative care: challenges for health professionals. J Palliat Med 7 (1): 19-25, 2004.
- Given BA, Given CW, Kozachik S: Family support in advanced cancer. CA Cancer J Clin 51 (4): 213-31, 2001 Jul-Aug.
- Chan RJ, Webster J, Marquart L: Information interventions for orienting patients and their carers to cancer care facilities. Cochrane Database Syst Rev (12): CD008273, 2011.
- Wong RK, Franssen E, Szumacher E, et al.: What do patients living with advanced cancer and their carers want to know? - a needs assessment. Support Care Cancer 10 (5): 408-15, 2002.
- McCorkle R, Pasacreta JV: Enhancing caregiver outcomes in palliative care. Cancer Control 8 (1): 36-45, 2001 Jan-Feb.
- Ferrell BR, Grant M, Chan J, et al.: The impact of cancer pain education on family caregivers of elderly patients. Oncol Nurs Forum 22 (8): 1211-8, 1995.
- Juarez G, Ferrell BR: Family and caregiver involvement in pain management. Clin Geriatr Med 12 (3): 531-47, 1996.
- Potter P, Olsen S, Kuhrik M, et al.: A DVD program on fall prevention skills training for cancer family caregivers. J Cancer Educ 27 (1): 83-90, 2012.
- Edgar L, Greenberg A, Remmer J: Providing internet lessons to oncology patients and family members: a shared project. Psychooncology 11 (5): 439-46, 2002 Sep-Oct.
- Ferrell BR, Taylor EJ, Grant M, et al.: Pain management at home. Struggle, comfort, and mission. Cancer Nurs 16 (3): 169-78, 1993.
- Nijboer C, Tempelaar R, Triemstra M, et al.: The role of social and psychologic resources in caregiving of cancer patients. Cancer 91 (5): 1029-39, 2001.
- Bucher JA, Houts PS, Nezu CM, et al.: Improving problem-solving skills of family caregivers through group education. Journal of Psychosocial Oncology 16 (3-4): 73-84, 1999.
- Harding R, Higginson IJ: What is the best way to help caregivers in cancer and palliative care? A systematic literature review of interventions and their effectiveness. Palliat Med 17 (1): 63-74, 2003.
- Grande GE, Todd CJ, Barclay SI, et al.: A randomized controlled trial of a hospital at home service for the terminally ill. Palliat Med 14 (5): 375-85, 2000.
- McCorkle R, Benoliel JQ, Donaldson G, et al.: A randomized clinical trial of home nursing care for lung cancer patients. Cancer 64 (6): 1375-82, 1989.
- Bee PE, Barnes P, Luker KA: A systematic review of informal caregivers' needs in providing home-based end-of-life care to people with cancer. J Clin Nurs 18 (10): 1379-93, 2009.
- Hodges LJ, Humphris GM, Macfarlane G: A meta-analytic investigation of the relationship between the psychological distress of cancer patients and their carers. Soc Sci Med 60 (1): 1-12, 2005.
- McMillan SC, Mahon M: Measuring quality of life in hospice patients using a newly developed Hospice Quality of Life Index. Qual Life Res 3 (6): 437-47, 1994.
- McMillan SC, Small BJ: Using the COPE intervention for family caregivers to improve symptoms of hospice homecare patients: a clinical trial. Oncol Nurs Forum 34 (2): 313-21, 2007.
- Meyers JL, Gray LN: The relationships between family primary caregiver characteristics and satisfaction with hospice care, quality of life, and burden. Oncol Nurs Forum 28 (1): 73-82, 2001 Jan-Feb.
- Haley WE: Family caregivers of elderly patients with cancer: understanding and minimizing the burden of care. J Support Oncol 1 (4 Suppl 2): 25-9, 2003 Nov-Dec.
- Houts PS, Nezu AM, Nezu CM, et al.: The prepared family caregiver: a problem-solving approach to family caregiver education. Patient Educ Couns 27 (1): 63-73, 1996.
- Naylor MD: Transitional care: a critical dimension of the home healthcare quality agenda. J Healthc Qual 28 (1): 48-54, 2006 Jan-Feb.
- Toseland RW, Blanchard CG, McCallion P: A problem solving intervention for caregivers of cancer patients. Soc Sci Med 40 (4): 517-28, 1995.
- Kurtz ME, Kurtz JC, Given CW, et al.: A randomized, controlled trial of a patient/caregiver symptom control intervention: effects on depressive symptomatology of caregivers of cancer patients. J Pain Symptom Manage 30 (2): 112-22, 2005.
- Pasacreta JV, Barg F, Nuamah I, et al.: Participant characteristics before and 4 months after attendance at a family caregiver cancer education program. Cancer Nurs 23 (4): 295-303, 2000.
- Honea NJ, Brintnall R, Given B, et al.: Putting Evidence into Practice: nursing assessment and interventions to reduce family caregiver strain and burden. Clin J Oncol Nurs 12 (3): 507-16, 2008.
- Kim Y, Given BA: Quality of life of family caregivers of cancer survivors: across the trajectory of the illness. Cancer 112 (11 Suppl): 2556-68, 2008.
- Clark PG, Brethwaite DS, Gnesdiloff S: Providing support at time of death from cancer: results of a 5-year post-bereavement group study. J Soc Work End Life Palliat Care 7 (2-3): 195-215, 2011 Apr-Sep.