Rapid Fire Session 2014 World Cancer Congress

Reducing the psychological distress of family caregivers of home based palliative care patients: A randomised controlled trial (#432)

Peter Hudson 1 2 3 4 , Tom Trauer 1 2 3 , Brian Kelly 5 , Moira O’Connor 6 , Kristina Thomas 1 , Rachel Zordan 1 , Michael Summers 7
  1. Centre for Palliative Care, St Vincent‘s Hospital & The University of Melbourne, Melbourne, VIC, Australia
  2. St Vincent‘s Hospital, Melbourne, VIC, Australia
  3. University of Melbourne, Melbourne, VIC, Australia
  4. Queen’s University, Belfast, Ireland
  5. University of Newcastle, Newcastle, NSW, Australia
  6. Curtin University, Perth, WA, Australia
  7. La Trobe University, Melbourne, VIC, Australia

Background: Best practice in palliative care incorporates comprehensive support of family caregivers since many of them experience burden and distress. However, systematically implemented evidence-based psychological support initiatives are few.

Aim: We evaluated a one-to-one psycho-educational intervention aimed at mitigating the distress caregivers commonly experience when supporting a patient with advanced cancer receiving home-based palliative care. We hypothesised that primary caregivers receiving this intervention would report decreased distress.

 Methods: The study consisted of a randomised controlled trial comparing two versions of the intervention (one face-to-face home visit plus telephone calls versus two visits) plus standard care to a control group (standard care only) across four sites in Australia. Recruitment to the one visit condition was 57; the two visit condition 93, and the control: 148. We previously reported non-significant changes in distress between Times 1 (baseline) and 2 (one week post-intervention), but significant gains in caregivers’ sense of competence and preparedness for the role. Here, we report changes in distress (as assessed by the General Health Questionnaire (GHQ) between Times 1 and 3 (8 weeks post death). 

Results:There was significantly less worsening in GHQ scores between Times 1 and 3 in the two intervention groups combined than in the Control group. The 1 visit plus telephone calls intervention effect was significant but the two visit intervention was not. The results, particularly the one visit condition, are consistent with the aim of the intervention to confer some protection against the rise in distress observed in the Control group.  

Conclusions: These results support existing evidence demonstrating that relatively short psycho-educational interventions can help family caregivers who are supporting a dying relative. The sustained benefit during the bereavement period may also have positive resource implications, which should be explored in subsequent research.