Caregiver Outlook: An Intervention to Improve Caregiving in Serious Illness
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Heart Failure
- Sponsor
- VA Office of Research and Development
- Enrollment
- 286
- Locations
- 1
- Primary Endpoint
- Caregiver Anxiety
- Status
- Completed
- Last Updated
- 9 years ago
Overview
Brief Summary
Informal caregivers provide a majority of care for patients during serious illness. Lack of preparation and completion may leave caregivers less capable of caring for a loved one or making crucial decisions influencing care.
This study will examine whether a preparation and completion intervention reduces caregiver anxiety, depression, anticipatory grief, and burden and improves patient quality of life and health care use.
Detailed Description
The investigators propose a randomized control trial to evaluate an intervention of preparation and completion with Veterans and their caregivers during serious illness. Specific aims are to 1) Evaluate the impact of the caregiver Outlook intervention on caregiver anxiety, depression, anticipatory grief, completion, and burden; 2) Evaluate the impact of the home versus in hospital, emergency department, or nursing facility; 3) Evaluate the impact of the intervention session's qualitative content, examining variation associated with selected demographic variables, quality of family communication, and stage of illness on change. Caregivers in the first group ("Treatment", or "Preparation and life completion") will meet with a facilitator three times for a period of forty-five minutes each. In the first session, subjects will be asked to discuss issues related to relationship life review. In session two, participants will be asked to speak in more depth about issues such as regret and forgiveness. In the final session, subjects will focus on legacy and celebration. Caregivers in the second group ("attention control" or "relaxation meditation") will meet with a facilitator three times for a period of forty-five minutes each and be asked to listen to a non-guided relaxation compact disk (CD) or participate in a guided relaxation exercise. Participants in both groups will receive pre and post-test measures administered by a blinded interviewer. Outcome measures will be measures by the Functional Assessment of Cancer Therapy - General (FACT-G), Quality of life scale, FACIT-sp sub-scale, Anticipatory Grief Scale, Caregiver Reaction Assessment, the Qual-E completion and preparation sub-scales, and patient days at home.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients with advanced cancer/Congestive heart failure/COPD/End stage renal disease who have a primary caregiver. Caregivers of Durham VAMC patients with advanced disease.
Exclusion Criteria
- •No caregiver present.
- •Caregiver with Cognitive impairment/inability to speak on phone/non-English speaking
Outcomes
Primary Outcomes
Caregiver Anxiety
Time Frame: Measured at baseline, 5 weeks, and 8 weeks
Profile of Moods States (POMS) anxiety sub-scale The anxiety sub-scale from the modified Brief Profile of Mood States (POMS),7110 a six-item measure of psychological distress. Individual items used a 5 point Likert scale (0-4). The sub-scale minimum score was 0 and maximum was 24 (more anxious ).
Secondary Outcomes
- Caregiver Preparation(Measured at baseline, 5 weeks, and 8 weeks)
- Prolonged Grief - Number of Participants With Anticipatory Grief(Measured at baseline, 5 weeks, and 8 weeks)
- Spirituality(Measured at baseline, 5 weeks, and 8 weeks)
- Depression(Measured at baseline, 5 weeks, and 8 weeks)
- Patient Days of VA Hospital Use(In the 6 months after randomization)
- Caregiver Burden(Measured at baseline, 5 weeks, and 8 weeks)
- Caregiver Completion(Measured at baseline, 5 weeks, and 8 weeks)