A Problem Solving Intervention for Hospice Caregivers
| Status: | Recruiting |
|---|---|
| Conditions: | Depression |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 10/31/2018 |
| Start Date: | October 23, 2018 |
| End Date: | April 30, 2021 |
| Contact: | George Demiris, PhD |
| Email: | gdemiris@upenn.edu |
| Phone: | 2158988559 |
Hospice care is conceptualized as quality compassionate care for people facing a
life-limiting illness, with services that cover clinical care, pain management, and emotional
and spiritual support tailored to patients' and families' needs and preferences. Family
members, spouses, friends or others who assume the unpaid or informal caregiving role are
essential to the delivery of hospice services; however, stress and caregiver burden can
negatively affect caregivers' morbidity and mortality. The emotional needs of individuals
caring for dying persons at home are not well attended, and interventions aiming to provide
support to hospice caregivers are notably lacking. The investigator team recently completed a
study with 514 hospice caregivers to test a problem-solving therapy (PST) intervention
tailored specifically for the hospice setting, entitled PISCES (Problem-solving Intervention
to Support Caregivers in End of Life care Settings). The findings demonstrate that the PISCES
intervention when delivered face to face was effective leading to statistically significant
decrease in anxiety and increase in quality of life when compared to the other groups (video
group and attention control). An additional lesson learned from that RCT study was that
caregivers wanted to focus not only on specific problems or challenges, but also on
recognizing the positive aspects of caregiving. This approach of positive reappraisal has
been found to enhance problem solving interventions in other settings. The specific aims of
this new study are: 1) to compare the effectiveness of the PISCES intervention when delivered
face to face and when delivered in a hybrid platform (with the first session in person and
remaining sessions via video) to hospice caregivers; 2) to compare the effectiveness of the
PISCES intervention to the refined PISCES intervention (PISCESplus) that integrates positive
reappraisal elements; 3) to assess caregivers' perceptions of and satisfaction with the
PISCESplus intervention; and 4) to conduct a cost analysis of the three intervention groups.
life-limiting illness, with services that cover clinical care, pain management, and emotional
and spiritual support tailored to patients' and families' needs and preferences. Family
members, spouses, friends or others who assume the unpaid or informal caregiving role are
essential to the delivery of hospice services; however, stress and caregiver burden can
negatively affect caregivers' morbidity and mortality. The emotional needs of individuals
caring for dying persons at home are not well attended, and interventions aiming to provide
support to hospice caregivers are notably lacking. The investigator team recently completed a
study with 514 hospice caregivers to test a problem-solving therapy (PST) intervention
tailored specifically for the hospice setting, entitled PISCES (Problem-solving Intervention
to Support Caregivers in End of Life care Settings). The findings demonstrate that the PISCES
intervention when delivered face to face was effective leading to statistically significant
decrease in anxiety and increase in quality of life when compared to the other groups (video
group and attention control). An additional lesson learned from that RCT study was that
caregivers wanted to focus not only on specific problems or challenges, but also on
recognizing the positive aspects of caregiving. This approach of positive reappraisal has
been found to enhance problem solving interventions in other settings. The specific aims of
this new study are: 1) to compare the effectiveness of the PISCES intervention when delivered
face to face and when delivered in a hybrid platform (with the first session in person and
remaining sessions via video) to hospice caregivers; 2) to compare the effectiveness of the
PISCES intervention to the refined PISCES intervention (PISCESplus) that integrates positive
reappraisal elements; 3) to assess caregivers' perceptions of and satisfaction with the
PISCESplus intervention; and 4) to conduct a cost analysis of the three intervention groups.
Inclusion Criteria:
- enrolled as a family/informal caregiver of a hospice patient
- 18 years or older
- with access to a standard phone line or Internet and computer access at home
- without functional hearing loss or with a hearing aid that allows the participant to
conduct telephone conversations as assessed by the research staff (by questioning and
observing the caregiver)
- speak and read English, with at least a 6th-grade education
Exclusion Criteria:
- hearing or visual impairment that prohibits from conducting phone conversations or
video conference sessions
We found this trial at
1
site
3451 Walnut St
Philadelphia, Pennsylvania 19104
Philadelphia, Pennsylvania 19104
1 (215) 898-5000
Phone: 215-898-8559
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