We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Impact of an automated, remote monitoring and coaching intervention in reducing hospice cancer family caregiving burden: A multisite randomized controlled trial.
- Authors
Mooney, Kathi H.; Coombs, Lorinda A.; Whisenant, Meagan S.; Wilson, Christina M.; Moraitis, Ann Marie; Steinbach, Mary N.; Sloss, Elizabeth A.; Lloyd, Jennifer L. E.; Alekhina, Natalya; Berry, Patricia H.; Kang, Youjeong; Iacob, Eli; Donaldson, Gary W.
- Abstract
Background: Care for those with life‐limiting cancer heavily involves family caregivers who may experience significant physical and emotional burden. The purpose of this study was to test the impact of Symptom Care at Home (SCH), an automated digital family caregiver coaching intervention, during home hospice, when compared to usual hospice care (UC) on the primary outcome of overall caregiver burden. Secondary outcomes included Caregiver Burden at weeks 1 and 8, Mood and Vitality subscales, overall moderate‐to‐severe caregiving symptoms, and sixth month spouse/partner bereavement outcomes. Methods: Using a randomized, multisite, nonblinded controlled trial, 332 cancer family caregivers were enrolled and analyzed (159 SCH vs. 173 UC). Caregivers were primarily White (92%), female (69%), and spouse caregivers (53%). Caregivers provided daily reports on severity levels (0–10 scale) for their anxiety, depressed mood, fatigue, disturbed sleep, and caregiving interference with normal activities. These scores combined constituted the Caregiver Burden primary outcome. Based on reported symptoms, SCH caregivers received automated, tailored coaching about improving their well‐being. Reports of moderate‐to‐severe caregiving symptoms also triggered hospice nurse notification. Secondary outcomes of Mood and Vitality were subcomponents of the Caregiver Burden score. A combined bereavement adjustment tool captured sixth month bereavement. Results: The SCH intervention reduced overall Caregiver Burden compared to UC (p <.001), with a 38% reduction at 8 weeks and a medium‐to‐large effect size (d =.61). SCH caregivers experienced less (p <.001) disruption in both Mood and Vitality. There were higher levels of moderate‐to‐severe caregiving symptoms overtime in UC (OR, 2.722). All SCH caregivers benefited regardless of caregiver: sex, caregiver relationship, age, patient diagnosis and family income. SCH spouse/partner caregivers achieved better sixth month bereavement adjustment than UC (p <.007). Conclusions: The SCH intervention significantly decreased caregiving burden over UC and supports the maintenance of family caregiver mood and vitality throughout caregiving with extended benefit into bereavement. The Symptom Care at Home intervention significantly decreased the caregiving burden over usual hospice care. It supports family caregiver mood and vitality throughout caregiving with extended benefit into bereavement.
- Subjects
SERVICES for caregivers; BURDEN of care; RESPITE care; RANDOMIZED controlled trials; CAREGIVERS; INCOME; HOSPICE nurses
- Publication
Cancer (0008543X), 2024, Vol 130, Issue 7, p1171
- ISSN
0008-543X
- Publication type
Article
- DOI
10.1002/cncr.35131