Examining Caregiver Outcomes in the CONNECT Intervention for Patients With Advanced Cancer

Palliative care offers patient and family centered approaches that may mitigate risk of caregiver burden and poor mood. To determine whether a palliative care intervention (CONNECT) improved burden, mood, and self-efficacy among caregivers of patients with advanced cancer. In this cluster randomized...

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Bibliographic Details
Published in:Journal of pain and symptom management Vol. 65; no. 3; pp. 173 - 182
Main Authors: Semere, Wagahta, Althouse, Andrew D., Arnold, Robert, White, Douglas, Smith, Thomas J., Chu, Edward, Rosenzweig, Margaret Q., Schenker, Yael
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.03.2023
Subjects:
Advanced cancer
Anesthesia
Caregiver burden
Caregiver mood
Caregiver self-efficacy
Caregivers
Humans
Neoplasms - therapy
Pain Medicine
Palliative Care
Patients
Quality of Life
Palliative care
Advanced cancer
Caregiver burden
Caregiver mood
Caregiver self-efficacy
caregiver mood
advanced cancer
caregiver self-efficacy
palliative care
caregiver burden
ISSN:0885-3924, 1873-6513, 1873-6513
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Summary:Palliative care offers patient and family centered approaches that may mitigate risk of caregiver burden and poor mood. To determine whether a palliative care intervention (CONNECT) improved burden, mood, and self-efficacy among caregivers of patients with advanced cancer. In this cluster randomized trial, patients and their caregivers were recruited from 17 Oncology clinics in Pennsylvania. Participants attended nurse-led monthly visits, addressing patient symptoms, goals of care, and advance care planning. At baseline and three months, we measured caregiver burden using Zarit Burden Interview (ZBI-12; range 0–48), caregiver anxiety and depression using Hospital Anxiety and Depression Scales (HADS-A, range 0–21; HADS-D, range 0–21). We measured caregiver self-efficacy at three months using Caregiver Inventory (CGI; range 0–189). We enrolled 441 caregivers and 381 completed three-month assessments. We found no significant differences in caregiver burden (adjusted mean difference -0.39; 95% CI -1.07–0.29, P = 0.90), depression (adjusted mean difference -0.22, 95% CI -0.97–0.55, P = 0.26), or anxiety (adjusted mean difference 0.09; 95% CI -1.25–1.43, P = 0.58), between the intervention and standard care at three months. Caregiver self-efficacy was higher at three months in the intervention compared to standard care (adjusted mean difference 9.36; 95% CI 0.95–17.77, P = 0.030). Caregivers in CONNECT did not experience improved burden or mood, however, they reported higher self-efficacy compared to caregivers receiving standard care. This study highlights the need for strategies to optimize caregiver outcomes in palliative care interventions.
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Study concept and design: Schenker, Arnold, White, Smith, Chu; Acquisition of subjects and/or data: Schenker, Althouse, Arnold, White, Smith, Chu; Analysis and interpretation of data: Althouse, Semere, Schenker; Preparation of manuscript: Semere, Althouse, Arnold, White, Smith, Chu, Rosenzweig, Schenker.
Author Contributions
ISSN:0885-3924
1873-6513
1873-6513
DOI:10.1016/j.jpainsymman.2022.11.025