Reducing the psychological distress of family caregivers of home based palliative care patients: Longer term effects from a randomised controlled trial.

<p style="margin: 0px 0px 1em; padding: 0px; border: 0px; outline: 0px; font-size: 12px; vertical-align: baseline; line-height: 1.5em; background: transparent;">Background: Palliative care incorporates comprehensive support of family caregivers because many of them experience burden and distress. However, evidence-based support initiatives are few.</p><p style="margin: 0px 0px 1em; padding: 0px; border: 0px; outline: 0px; font-size: 12px; vertical-align: baseline; line-height: 1.5em; background: transparent;">Purpose: We evaluated a one-to-one psychoeducational intervention aimed at mitigating the distress of caregivers of patients with advanced cancer receiving home-based palliative care. We hypothesised that caregivers would report decreased distress as assessed by the General Health Questionnaire (GHQ).</p><p style="margin: 0px 0px 1em; padding: 0px; border: 0px; outline: 0px; font-size: 12px; vertical-align: baseline; line-height: 1.5em; background: transparent;">Method: A randomised controlled trial comparing two versions of the delivery 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.</p><p style="margin: 0px 0px 1em; padding: 0px; border: 0px; outline: 0px; font-size: 12px; vertical-align: baseline; line-height: 1.5em; background: transparent;">Results: 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 (1-week post-intervention) but significant gains in competence and preparedness. We report here changes in distress between times 1 and 3 (8-week post-death). There was significantly less worsening in distress between times 1 and 3 in the one visit intervention group than in the control group; however, no significant difference was found between the two visit intervention and the control group.</p><p style="margin: 0px 0px 1em; padding: 0px; border: 0px; outline: 0px; font-size: 12px; vertical-align: baseline; line-height: 1.5em; background: transparent;">Conclusions: These results are consistent with the aim of the intervention, and they support existing evidence demonstrating that relatively short psychoeducational 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 the subject of future inquiry. © 2014 The Authors. <em style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline; background: transparent;">Psycho-Oncology published by John Wiley & Sons Ltd.</em></p>