Does the use of the revised psychosocial assessment tool (PATrev) result in improved quality of life and reduced psychosocial risk in Canadian families with a child newly diagnosed with cancer? Providing general practice needs-based care for carers of people with advanced cancer: a randomised controlled trial. Touch, Caring, and Cancer: randomized controlled trial of a multimedia caregiver education program Enhancing quality of life and mastery of informal caregivers of high-grade glioma patients: a randomized controlled trial Feasibility of a Psychosocial Rehabilitation Intervention to Enhance the Involvement of Relatives in Cancer Rehabilitation: Pilot Study for a Randomized Controlled Trial Caregiver-assisted coping skills training for lung cancer: results of a randomized clinical trial. Effects of enhanced caregiver training program on cancer caregiver’s self-efficacy, preparedness, and psychological well-being A pilot randomized, controlled trial of the effectiveness of a psychoeducational intervention on family caregivers of patients with advanced cancer. The impact of a problem-solving intervention on increasing caregiver assistance and improving caregiver health Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers Improving psychosocial outcomes for caregivers of people with poor prognosis gastrointestinal cancers: a randomized controlled trial (Family Connect) Existential behavioural therapy for informal caregivers of palliative patients: a randomised controlled trial. Benefits of Early Versus Delayed Palliative Care to Informal Family Caregivers of Patients With Advanced Cancer: Outcomes From the ENABLE III Randomized Controlled Trial. A caregiver educational program improves quality of life and burden for cancer patients and their caregivers: a randomised clinical trial. Effects of music intervention with nursing presence and recorded music on psycho-physiological indices of cancer patient caregivers. Randomized clinical trial of a brief and extensive dyadic intervention for advanced cancer patients and their family caregivers. CHESS improves cancer caregivers' burden and mood: results of an eHealth RCT. A couple-based intervention for patients and caregivers facing end-stage cancer: outcomes of a randomized controlled trial. Effects of an Individualized Caregiver Training Intervention on Self-Efficacy of Cancer Caregivers Effects of a problem-solving intervention (COPE) on quality of life for patients with advanced cancer on clinical trials and their caregivers: simultaneous care educational intervention (SCEI): linking palliation and clinical trials. Mindfulness-Based Stress Reduction for lung cancer patients and their partners: Results of a mixed methods pilot study
OBJECTIVES Early psychosocial screening may guide interventions and ameliorate the adverse psychosocial effects of childhood cancer . The revised psychosocial assessment tool provides risk information - Universal ( typical distress ) , Targeted ( additional specific distress ) , and Clinical ( severe distress ) - about the child with cancer and his or her family . This pilot study investigated the benefits of providing a summary of family psychosocial risk information to the medical team treating the newly diagnosed child ( Experimental Group , EG ) . METHOD We conducted a pilot r and omized control trial with a sample of 67 parents , comparing the EG to the control group ( CG )  on parental perception of family psychosocial difficulties (  revised psychosocial assessment tool risk levels ) , child behavior ( behavior assessment scale for children-2 ) , pediatric quality of life ( PedsQL ) , and parental anxiety ( state-anxiety scale of the state-trait anxiety inventory ) , 2 - 4 weeks after diagnosis ( Time 1 ) and 6 months later ( Time 2 ) . RESULTS Compared to the CG , participants in the EG had significantly reduced targeted and clinical risk ( p < 0.001 ) , and improved pain related PedsQL at Time 2 ( p < 0.05 ) . Scores for PedsQL total and nearly all subscales improved over time in both groups ( p < 0.05 to p < 0.001 ) . No changes in behavior scores were noted . CONCLUSION Preliminary findings suggest that providing a summary of the Psychosocial Assessment Tool to the treating team shortly after diagnosis may help reduce family wide psychosocial risk 6 months later and improve quality of life related to pain for children who are undergoing treatment for cancer BACKGROUND Carers of patients with advanced cancer often have health and psychosocial needs , which are frequently overlooked . AIM To meet the needs of carers through a GP consultation directed by a self-completed carer needs checklist . DESIGN AND SETTING R and omised controlled trial in general practice with recruitment through specialist oncology clinics , in Brisbane , Australia . METHOD Intervention was ( a )  carer-GP consultations directed by a self-completed checklist of needs at baseline and 3 months ; and ( b ) a GP-Toolkit to assist GPs to address carer-identified needs . Control group received usual care . Outcome measures were intensity of needs , anxiety and depression , and quality of life . RESULTS Total recruitment 392 . Overall , no significant differences were detected in the number or intensity of need between groups . Compared to controls , intervention participants with baseline clinical anxiety showed improvements in mental wellbeing ( P = 0.027 ) , and those with baseline clinical depression had slower development of anxiety ( P = 0.044 ) at 6 months . For those not anxious , physical wellbeing improved at 1 month ( P = 0.040 ) . Carers looking after patients with poor functional status had more physical needs ( P = 0.037 ) at 1 month and more psychological and emotional needs at 3 months ( P = 0.034 ) . Those caring for less unwell patients showed improved mental wellbeing at 3 months ( P = 0.022 ) . CONCLUSION The intervention did not influence the number or intensity of needs reported by carers of people with advanced cancer . There was limited impact in people with pre-existing clinical anxiety and depression . For the carer of those most severely affected by advanced cancer , it drew attention to the needs arising from the caregiving role Purpose A r and omized controlled trial was conducted to evaluate outcomes of a multimedia instructional program for family caregivers in simple touch-based techniques to provide comfort to cancer patients at home . Methods A multilingual 78-min DVD and 66-page manual were produced for homebased instruction . Content addresses attitudes and communication about touch in cancer , psychological preparation for giving and receiving touch , safety pre caution s , massage techniques for comfort and relaxation , acupressure for specific cancer-related symptoms , and practice in the home setting . Material s were produced in English , Spanish , and Chinese versions . A community-based multiethnic sample of 97 adult patient/caregiver dyads was r and omized to experimental ( massage ) or attention control ( reading ) groups for 4 weeks .  Massage dyads received the program and instructions to practice at least three times per week , while control caregivers read to their patients for the same frequency . Self-report instruments assessed change in symptom severity , quality of life , perceived stress , and caregiver attitudes . Results Significant reductions in all symptoms occurred for patients after both activities : 12–28 % reductions after reading vs. 29–44 % after massage . Massage caregivers showed significant gains in confidence , comfort , and self-efficacy using touch and massage as forms of caregiving . Conclusions Multimedia instruction in touch and massage methods may offer family members a viable means of enhancing self-efficacy and satisfaction in caregiving while decreasing patient pain , depression , and other symptoms . Family members may be able to learn and apply safe and simple methods that increase patient comfort and reduce distress High- grade gliomas ( HGG ) are serious primary brain tumors that may prevent the patient from functioning normally in social , emotional and cognitive respect . Often the partner ’s role will convert to that of informal caregiver . Consequently , they may experience significant stress and reductions in caregiver mastery , negatively affecting their health-related quality of life ( HRQOL ) . We aim ed at ( 1 ) determining factors that impact HRQOL and mastery of caregivers of HGG patients , and ( 2 ) investigate if a structured intervention consisting of psychoeducation and cognitive behavioral therapy leads to improvements in the mental component of HRQOL and mastery of caregivers . Fifty-six patient-caregiver dyads were r and omly assigned to the intervention group or the care as usual group .  The intervention program consisted of six one-hour sessions with a psychologist . Participants completed question naires concerning their perceptions of the patients ’ HRQOL ( SF-36 ) , neurological functioning ( BN20 ) , and cognitive functioning ( MOS ) , and concerning their own HRQOL ( SF-36 ) and feelings of caregiver mastery ( CMS ) both at baseline ( i.e. before r and omization ) and every 2 months thereafter until 8 months later , five times in total . Patients ’ HRQOL and neurological functioning were found to be related to HRQOL and feelings of mastery of the informal caregiver at baseline . The intervention helped caregivers in maintaining a stable level of HRQOL and improved feelings of mastery over an 8 month period . Our findings suggest that informal caregivers can benefit from a psychological intervention as it is a helpful tool in maintaining a stable level of mental functioning and caregiver mastery Background Cancer often affects the quality of life and well-being of patients as well as their relatives . Previous studies have suggested that relatives should be involved in psychosocial rehabilitation to address the needs for an interpersonal relationship with others in the disease trajectory . We developed an innovative rehabilitation program to be offered to the patient and a relative as a pair . Objective The aim of the present pilot study was to examine the feasibility of the intervention in a r and omized controlled trial ( RCT ) and to evaluate the impact on quality of life . Methods The study was design ed as an RCT comparing the new multimodal psychosocial rehabilitation with the usual services . The intervention comprised three ‘ supportive talks ’ and a residential rehabilitation course . From March 2010 to March 2011 , participation was offered at the time of diagnosis to patients with lung or gynecological cancer from two departments at Odense University Hospital in Denmark . Question naires were used to estimate changes in quality of life ( EORTC-QLQ-C30 on global health status ) and well-being ( WHO-Five Well-Being Index ) at baseline and after 2 and 12 months . Information on the participants ’ views about the rehabilitation intervention was obtained from assessment charts and qualitative interviews . Results A total of 209 patients were assessed for eligibility , but only 42 pairs were r and omized to the study . The 2-month follow-up was completed by 34 patients and 32 relatives , and 19 patients and 21 relatives completed the 12-month follow-up . A higher dropout rate at the 12-month follow-up was reported in the intervention group compared with controls . Quality of life and well-being increased for patients and relatives in both the intervention and the control group , and no clinical ly significant difference was observed between the intervention and the control group . Pairs reported that the time of inclusion was inconvenient and that rehabilitation ought to meet their changing needs . Conclusions The pilot study showed that it may be difficult to conduct an RCT of a psychosocial rehabilitation intervention for pairs , and difficulties with inclusion and drop out have to be addressed . Interventions need to be carefully developed and tested before evaluating an effect in a large-scale study CONTEXT Lung cancer is one of the most common cancers in the United States and is associated with high levels of symptoms , including pain , fatigue , shortness of breath , and psychological distress . Caregivers and patients are adversely affected . However , previous studies of coping skills training ( CST ) interventions have not been tested in patients with lung cancer nor have systematic ally included caregivers . OBJECTIVES This study tested the efficacy of a caregiver-assisted CST protocol in a sample of patients with lung cancer . METHODS Two hundred thirty-three lung cancer patients and their caregivers were r and omly assigned to receive 14 telephone-based sessions of either caregiver-assisted CST or education/support involving the caregiver . Patients completed measures assessing pain , psychological distress , quality of life ( QOL ) , and self-efficacy for symptom management ; caregivers completed measures assessing psychological distress , caregiver strain , and self-efficacy for helping the patient manage symptoms . RESULTS Patients in both treatment conditions showed improvements in pain , depression , QOL , and self-efficacy , and caregivers in both conditions showed improvements in anxiety and self-efficacy from baseline to four-month follow-up . Results of exploratory analyses suggested that the CST intervention was more beneficial to patients /caregivers with Stage II and III cancers , whereas the education/support intervention was more beneficial to patients /caregivers with Stage I cancer . CONCLUSION Taken together with the broader literature in this area , results from this study suggest that psychosocial interventions can lead to improvements in a range of outcomes for cancer patients . Suggestions for future studies include the use of three-group design s ( e.g. , comparing two active interventions with a st and ard-care control ) and examining mechanisms of change Purpose We examined the effects of an enhanced informal caregiver training ( Enhanced-CT ) protocol in cancer symptom and caregiver stress management to caregivers of hospitalized cancer patients . Methods We recruited adult patients in oncology units and their informal caregivers . We utilized a two-armed , r and omized controlled trial design with data collected at baseline , post-training , and at 2 and 4 weeks after hospital discharge . Primary outcomes were self-efficacy for managing patients ’ cancer symptoms and caregiver stress and preparedness for caregiving . Secondary outcomes were caregiver depression , anxiety , and burden . The education comparison ( EDUC ) group received information about community re sources . We used general linear models to test for differences in the Enhanced-CT relative to the EDUC group . Results We consented and r and omized 138 dyads : Enhanced-CT = 68 and EDUC = 70 . The Enhanced-CT group had a greater increase in caregiver self-efficacy for cancer symptom management and stress management and preparation for caregiving at the post-training assessment compared to the EDUC group but not at 2- and 4-week post-discharge assessment s. There were no intervention group differences in depression , anxiety , and burden . Conclusion An Enhanced-CT protocol result ed in short-term improvements in self-efficacy for managing patients ’ cancer symptoms and caregiver stress and preparedness for caregiving but not in caregivers ’ psychological well-being . The lack of sustained effects may be related to the single-dose nature of our intervention and the changing needs of informal caregivers after hospital discharge PURPOSE / OBJECTIVES To evaluate the effectiveness of a psychoeducational intervention , the Caring for the Caregiver Programme ( CCP ) . DESIGN A pilot r and omized , controlled trial , two-group pretest , and repeated post-tests . SETTING Four home hospice organizations and an outpatient clinic in Singapore . SAMPLE 80 caregivers were r and omized into experimental and st and ard care groups . METHODS Outcomes were measured at baseline , week 4 , and week 8 after the intervention . The st and ard care group received routine home hospice care , and the intervention group received the CCP in addition to routine care . MAIN RESEARCH VARIABLES Quality of life ( QOL ) , social support , stress and depression , self-efficacy in self-care , closeness with the patient , rewards , and knowledge . FINDINGS Compared to the st and ard care group , the intervention group reported significantly higher QOL , social support satisfaction and number of supported people , closeness with the patient , self-efficacy in self-care , rewards of caregiving , and knowledge , and lower stress and depression . CONCLUSIONS The CCP had positive effects on family caregivers of patients with advanced cancer . IMPLICATION S FOR NURSING A psychoeducational intervention potentially could help caregivers cope with the dem and s of caregiving Purpose There is a paucity of research evaluating the impact of symptom management interventions on increasing  family caregiver involvement in symptom management and on caregivers ' emotional health . In addition , most caregiver interventions are delivered by a health care professional , which can be costly to implement in clinical practice . The purpose of this study was to determine whether , in patients with solid tumors , a nurse-delivered symptom management intervention was more effective than a coach-led intervention in increasing caregiver involvement in symptom management and improving caregivers ' emotional health . Methods Both caregivers and care recipients were recruited for the study . Inclusion criteria for patients were ≥40 years of age , English speaking , cognitively intact , and having a diagnosis of stage III or IV tumor . Dyads were r and omized to a nurse-delivered symptom management intervention ( N = 88 ) versus the coach-led group ( N = 81 ) . Data were collected via telephone interviews at baseline , 10 , and 16 weeks . Results There was no significant main effect of the problem-solving intervention  on symptom assistance at 10 weeks , but there were two significant interactions , between trial arm and depressive symptoms and between baseline assistance with symptoms and relationship to the patient . Caregivers with lower depressive symptoms were more likely ( OR = 1.99 , 95 % CI = 1.45–2.76 ) to provide assistance at 10 weeks if they received the nurse-delivered intervention . Spousal ( versus non-spouses ) caregivers who provided assistance at baseline were less likely to provide assistance at 10 weeks ( OR = 0.58 , 95 % CI 0.36–0.94 ) . No significant trial arm effects were found on caregiver emotional health , but assistance with greater number of symptoms was associated with worse caregiver depressive symptoms ( p < 0.01 ) and burden ( impact on schedule , p < 0.01 ) . Conclusions Findings suggest that a nurse-delivered problem-solving intervention increases  family caregivers ' level of assistance in symptom management for caregivers with lower levels of depressive symptoms . Data also suggest interventions focused solely on care recipient symptom management may not be effective in improving caregivers ' emotional health Background : The vital role played by  family caregivers  in supporting dying cancer patients is well recognized , but the burden and economic impact on caregivers is poorly understood . We prospect ively examined the psychosocial , occupational and economic impact of caring for a person with a terminal illness . Methods : We studied 89 caregivers of women with advanced breast cancer receiving care at either the Ottawa or Hamilton regional cancer centres in Ontario . Patients were followed until their death or study completion at 3 years . Patients identified a principal caregiver to participate in the study . The Karnofsky Performance Status ( KPS ) index , the Medical Outcomes Study 36-item Short Form ( SF-36 ) , the Hospital Anxiety and Depression Scale , the Zarit Burden Inventory , FAMCARE and the Medical Outcomes Study Social Support Survey  were administered during follow-up . Economic data were collected by means of a question naire administered by an interviewer . Assessment s were conducted every 3 months during the palliative period ( KPS score > 50 ) and every 2 weeks during the terminal period ( KPS score ≤ 50 ) . Results : Over half of the caregivers were male ( 55 % ) and the patient 's spouse or partner ( 52 % ) , with a mean age of 53 years . At the start of the palliative period , the caregivers ' mean physical functioning score was better than the patients ' ( 51.3 v. 35.1 , 95 % confidence interval [ CI ] 13.3–20.0 ) ; there were similar mean mental functioning scores ( 46.6 and 47.1 respectively ) ; similar proportions were depressed ( 11 % and 12 % ) ; and significantly more caregivers than patients were anxious ( 35 % v. 19 % , p = 0.009 ) . More caregivers were depressed ( 30 % v. 9 % , p = 0.02 ) and had a higher level of perceived burden ( 26.2 v. 19.4 , p = 0.02 ) at the start of the terminal period than at the start of the palliative period . Burden was the most important predictor of both anxiety and depression . Of employed caregivers , 69 % reported some form of adverse impact on work . In the terminal period 77 % reported missing work because of caregiving responsibilities . Prescription drugs were the most important component of financial burden . Interpretation :  Caregivers ' depression and perceived burden increase as patients ' functional status declines . Strategies are needed to help reduce the psychosocial , occupational and economic burden associated with caregiving Purpose This study investigated the effectiveness of a structured telephone intervention for caregivers of people diagnosed with poor prognosis gastrointestinal cancer to improve psychosocial outcomes for both caregivers and patients . Methods Caregivers of patients starting treatment for upper gastrointestinal or Dukes D colorectal cancer were r and omly assigned ( 1:1 ) to the Family Connect telephone intervention or usual care .  Caregivers in the intervention group received four st and ardized telephone calls in the 10 weeks following patient hospital discharge . Caregivers ’ quality of life ( QOL ) , caregiver burden , unmet supportive care needs and distress were assessed at 3 and 6 months . Patients ’ QOL , unmet supportive care needs , distress and health service utilization were also assessed at these time points . Results Caregivers ( 128 ) were r and omized to intervention or usual care groups . At 3 months , caregiver QOL scores and other caregiver-reported outcomes were similar in both groups . Intervention group participants experienced a greater sense of social support ( p = .049 ) and reduced worry about finances ( p = .014 ) . Patients whose caregiver was r and omized to the intervention also had fewer emergency department presentations and unplanned hospital readmissions at 3 months post-discharge ( total 17 vs. 5 , p = .01 ) . Conclusions This st and ardized intervention did not demonstrate any significant improvements in caregiver well-being but did result in a decrease in patient emergency department presentations and unplanned hospital readmissions in the immediate post-discharge period . The trend towards improvements in a number of caregiver outcomes and the improvement in health service utilization support further development of telephone-based caregiver-focused supportive care interventions BACKGROUND Existential behavioural therapy ( EBT ) was developed to support informal caregivers of palliative patients in the last stage of life and during bereavement as a manualised group psychotherapy comprising six sessions . We tested the effectiveness of EBT on mental stress and quality of life ( QOL ) . METHODS Informal caregivers were r and omly assigned ( 1:1 ) to EBT or a treatment-as-usual control group using computer-generated numbers in blocks of 10 . Primary outcomes were assessed with the Brief Symptom Inventory ( subscales somatisation , anxiety and depression ) , the Satisfaction with Life Scale ( SWLS ) , the WHOQOL-BREF and a numeric rating scale for QOL ( QOL-NRS , range 0 - 10 ) . Data were collected at baseline , pre-treatment , post-treatment and follow-ups after 3 and 12 months . Treatment effects were assessed with a multivariate analysis of covariance . RESULTS Out of 160 relatives , 81 were assigned to EBT and 79 to the control group . Participants were 54.5 ± 13.2 years old ; 69.9 % were female . The multivariate model was significant for the pre-/post-comparison ( p=0.005 ) and the pre-/12-month comparison ( p=0.05 ) but not for the pre-/3-month comparison . Medium to large effects on anxiety and QOL ( SWLS , WHOQOL-BREF , QOL-NRS ) were found at post-treatment ; medium effects on depression and QOL ( QOL-NRS ) emerged in the 12-month follow-up . No adverse effects of the intervention were observed . CONCLUSION Existential behavioural therapy appears to exert beneficial effects on distress and QOL of informal caregivers of palliative patients . Further longitudinal evidence is needed to confirm these findings PURPOSE To determine the effect of early versus delayed initiation of a palliative care intervention for family caregivers ( CGs ) of patients with advanced cancer . PATIENTS AND METHODS Between October 2010 and March 2013 , CGs of patients with advanced cancer were r and omly assigned to receive three structured weekly telephone coaching sessions , monthly follow-up , and a bereavement call either early after enrollment or 3 months later . CGs of patients with advanced cancer were recruited from a National Cancer Institute cancer center , a Veterans Administration Medical Center , and two community outreach clinics . Outcomes were quality of life ( QOL ) , depression , and burden ( objective , stress , and dem and ) . RESULTS A total of 122 CGs ( early , n = 61 ; delayed , n = 61 ) of 207 patients participated ; average age was 60 years , and most were female ( 78.7 % ) and white ( 92.6 % ) . Between-group differences in depression scores from enrollment to 3 months ( before delayed group started intervention ) favored the early group ( mean difference , -3.4 ; SE , 1.5 ; d = -.32 ; P = .02 ) . There were no differences in QOL ( mean difference , -2 ; SE , 2.3 ; d = -.13 ; P = .39 ) or burden ( objective : mean difference , 0.3 ; SE , .7 ; d = .09 ; P = .64 ; stress : mean difference , -.5 ; SE , .5 ; d = -.2 ; P = .29 ; dem and : mean difference , 0 ; SE , .7 ; d = -.01 ; P = .97 ) . In decedents ' CGs , a terminal decline analysis indicated between-group differences favoring the early group for depression ( mean difference , -3.8 ; SE , 1.5 ; d = -.39 ; P = .02 ) and stress burden ( mean difference , -1.1 ; SE , .4 ; d = -.44 ; P = .01 ) but not for QOL ( mean difference , -4.9 ; SE , 2.6 ; d = -.3 ; P = .07 ) , objective burden ( mean difference , -.6 ; SE , .6 ; d = -.18 ; P = .27 ) , or dem and burden ( mean difference , -.7 ; SE , .6 ; d = -.23 ; P = .22 ) . CONCLUSION Early-group CGs had lower depression scores at 3 months and lower depression and stress burden in the terminal decline analysis . Palliative care for CGs should be initiated as early as possible to maximize benefits PURPOSE OF THE RESEARCH The French setting , including laws and guidelines , advocates greater involvement of informal caregivers in the care of cancer patients to protect the caregivers from depression , distress , and a decrease in their quality of life . This study aim ed to assess the efficacy of a caregiver educational programme by measuring two outcomes : patients ' and caregivers ' quality of life and caregivers ' burden . METHODS AND SAMPLE A multicentre r and omised controlled trial was performed in six oncology wards in French hospitals . Eligible patients had a cancer , a main caregiver , allowed their caregivers ' involvement , and received an inclusion agreement by a doctor/psychologist dyad . The experimental group participated in an educational programme performed by nurses to improve their skills in meal support , nursing care , welfare care , or symptom management . The SF36 and the Zarit burden scales were used to measure quality of life and caregivers ' burden at the beginning and at the end of the study . KEY RESULTS 67 patients were r and omised and 33 were included in the experimental group .  Evolution scores , which measured the difference between baseline and final scores , showed an improvement in patients ' and caregivers ' quality of life and an alleviated burden for experimental group caregivers . CONCLUSIONS An educational programme for caregivers encourages the involvement of patients , informal caregivers and health-care providers in a triangular relationship which enhances the quality of life of patients and caregivers alike and decreases caregivers ' burden . Care organisation should therefore be rethought as a triangular relationship between patients , caregivers and health-care providers , with nurses as the mainstay AIMS AND OBJECTIVES To compare the effects of music intervention with nursing presence and recorded music on blood volume pulse amplitude , the low/high frequency ratio component of heart rate variability , depression , anxiety and sleep quality in cancer patient caregivers ; to compare the participants evaluation of these two forms of musical intervention . BACKGROUND Presence is one of the activities of caring . However , little is known about the effect of music intervention with nursing presence on psycho-physiological indices . DESIGN R and omised crossover controlled trial . METHOD Thirty-four female participants were r and omly assigned to a music intervention with nursing presence/recorded music sequence or recorded music/music intervention with nursing presence sequence . Each intervention lasted 30 minutes and was held at the participant 's home . The music intervention with nursing presence consisted of an erhu and recorder performance . In the recorded music session , participants listened to prerecorded music for 30 minutes . Continuous measurements of blood volume pulse and low/high frequency ratio were taken throughout the procedure . Depression , anxiety and sleep quality were measured before and after each intervention . RESULTS Both music intervention with nursing presence and recorded music interventions had beneficial effects on anxiety , depression and blood volume pulse amplitude . Significant differences between the two interventions were also observed for anxiety .  Music intervention with nursing presence was more effective in lessening anxiety and on improving the ease of getting to sleep compared with recorded music ( p < 0·05 ) . All participants reported that they preferred music intervention with nursing presence to recorded music . Significant differences were found in music evaluation scores between the two interventions in terms of harmony and friendliness ( p < 0·05 ) . CONCLUSIONS Both music interventions were beneficial , as measured on psycho-physiological indices . The music intervention with nursing presence provided a more friendly music experience to the listeners . RELEVANCE TO CLINICAL PRACTICE The findings provide evidence for nurses that the therapeutic use of music and nursing presence as a research -based nursing intervention for the welfare of caregivers BACKGROUND Few intervention programs assist patients and their family caregivers to manage advanced cancer and maintain their quality of life ( QOL ) . This study examined ( i ) whether patient-caregiver dyads ( i.e. , pairs ) r and omly assigned to a brief or extensive dyadic intervention ( the FOCUS Program ) had better outcomes than dyads r and omly assigned to usual care and ( ii ) whether patients ' risk for distress and other factors moderated the effect of the brief or extensive program on outcomes . METHODS Advanced cancer patients and their caregivers ( N = 484 dyads ) were stratified by patients ' baseline risk for distress ( high versus low ) , cancer type ( lung , colorectal , breast , or prostate ) , and research site and then r and omly assigned to a brief ( three-session ) or extensive ( six-session ) intervention or control . The interventions offered dyads information and support . Intermediary outcomes were appraisal s ( i.e. , appraisal of illness/caregiving , uncertainty , and hopelessness ) and re sources ( i.e. , coping , interpersonal relationships , and self-efficacy ) . The primary outcome was QOL . Data were collected prior to intervention and post-intervention ( 3 and 6 months from baseline ) . The final sample was 302 dyads . Repeated measures MANCOVA was used to evaluate outcomes . RESULTS Significant group by time interactions showed that there was an improvement in dyads ' coping ( p < 0.05 ) , self-efficacy ( p < 0.05 ) , and social QOL ( p < 0.01 ) and in caregivers ' emotional QOL ( p < 0.05 ) . Effects varied by intervention dose . Most effects were found at 3 months only . Risk for distress accounted for very few moderation effects . CONCLUSIONS Both brief and extensive programs had positive outcomes for patient-caregiver dyads , but few sustained effects . Patient-caregiver dyads benefit when viewed as the ' unit of care ' OBJECTIVE Informal caregivers ( family and friends ) of people with cancer are often unprepared for their caregiving role , leading to increased burden or distress .  Comprehensive Health Enhancement Support System ( CHESS ) is a Web-based lung cancer information , communication , and coaching system for caregivers . This r and omized trial reports the impact on  caregiver burden , disruptiveness , and mood of providing caregivers access to CHESS versus the Internet with a list of recommended lung cancer websites . METHODS A total of 285 informal caregivers of patients with advanced nonsmall cell lung cancer were r and omly assigned to a comparison group that received Internet or a treatment group that received Internet and CHESS . Caregivers were provided a computer and Internet service if needed . Written surveys were completed at pretest and during the intervention period bimonthly for up to 24 months . Analyses of covariance ( ANCOVAs ) compared the intervention 's effect on caregivers ' disruptiveness and burden ( CQOLI-C ) , and negative mood ( combined Anxiety , Depression , and Anger scales of the POMS ) at 6 months , controlling for blocking variables ( site , caregiver 's race , and relationship to patient ) and the given outcome at pretest . RESULTS Caregivers r and omized to CHESS reported lower burden , t(84 ) = 2.36 , p = .021 , d = .39 , and negative mood , t(86 ) = 2.82 , p = .006 , d = .44 , than those in the Internet group . The effect on disruptiveness was not significant . CONCLUSIONS Although caring for someone with a terminal illness will always exact a toll on caregivers , eHealth interventions like CHESS may improve caregivers ' underst and ing and coping skills and , as a result , ease their burden and mood BACKGROUND We evaluated the effect of Emotionally Focused Therapy ( EFT ) [ intervention ( INT ) ] , modified for the advanced cancer population versus st and ard care [ control ( CTL ) ] , on marital functioning and psychosocial outcomes among distressed couples .  EFT examines the ways couples process patterns of interaction , facilitating change . METHODS Forty-two patients with metastatic cancer and their caregivers were assigned r and omly to receive eight sessions of EFT delivered by one EFT-trained psychologist or st and ard care provided by multidisciplinary clinicians . Partners completed measures of marital functioning , depression , hopelessness , empathic caregiving ( patient ) , and caregiver burden ( caregiver ) before r and omization at baseline ( T0 ) , post-intervention ( T1 ) , and 3-month post-intervention ( T2 ) . Data were analyzed using three-way analyses of covariance ; main effects were treatment , patient status , and sex . Multilevel modeling was also employed . RESULTS At T1 , INT group led to significant improvement in marital functioning ( p ≤ 0.0001 ) and patients ' experience of caregiver empathic care ( p = 0.02 ) versus CTL group . Effect sizes for these differences were in the large range ( d = 1.00 ) . In both groups , patients showed a marginally higher mean score for marital functioning compared with caregivers [ INT : M = 56.3 , st and ard deviation ( SD ) = 4.6 vs M = 54.3 , SD = 4.5 ; CTL group : M = 43.4 , SD = 10.3 vs M = 42.4 , SD = 6.8 , respectively ] . At T2 , results were maintained . CONCLUSIONS The effectiveness of and adherence to the EFT couple intervention for patients facing advanced cancer were demonstrated in this study . Larger r and omized control trials are needed to confirm these findings . Qualitative studies may help to further underst and the mechanism by which such an intervention may act Caring for older cancer patients after hospital discharge is challenging and many of their caregivers lack confidence to do so . This study investigated the effects of an individualized caregiver training program on self-efficacy in home care and symptom management . A total of 120 patient – caregiver dyads were r and omly assigned to either the treatment ( n = 60 ) or control group ( n = 60 ) . The training focused on prevention of infection , pain control , maintenance of nutrition and adequate elimination , and specific care issues identified by the caregiver . Control group received information about community-based re sources . Results revealed a significant increase in self-efficacy after the training in the treatment group but not in the control group . No intervention effect was seen on caregiver ’s psychological well-being ( depression , anxiety , and quality of life ) and patient ’s physical symptoms CONTEXT Patients on investigational clinical trials and their caregivers experience poor quality of life ( QOL )  , which declines as the disease progresses . OBJECTIVE To examine the effect of a st and ardized cognitive-behavioral problem-solving educational intervention on the QOL of patients enrolled on investigational clinical trials and their caregivers . DESIGN Prospect i ve , multi-institution , r and omized trial . QOL was measured repeatedly over 6 months . PARTICIPANTS Patients were simultaneously enrolled onto phase 1 , 2 , or 3 Institutional Review Board (IRB)-approved cancer clinical trials . INTERVENTION Intervention arm dyads participated in three conjoint educational sessions during the first month , learning the COPE problem solving model . Nonintervention arm dyads received usual care . OUTCOME MEASURES Global QOL was measured by the City of Hope Quality of Life Instruments for Patients or Caregivers ; problem solving skills were measured by the Social Problem Solving Inventory-Revised . RESULTS The results are reported using the CONSORT statement . The analytic data set included 476 dyads including 1596 patient data points and 1576 care giver data points .  Patient QOL showed no significant difference in the rate of change between the intervention and usual care arms ( p = 0.70 ) . Caregiver QOL scores in the intervention arm declined , but at less than half the rate in the control arm ( p = 0.02 ) . CONCLUSIONS The COPE intervention enabled the average caregiver to come much closer to stable QOL over the 6-month follow-up . Future studies should enroll subjects much earlier in the cancer illness trajectory , a common patient/caregiver theme . The maximum effect was seen in caregivers who completed the 6-month follow-up , suggesting that the impact may increase over time Background : Lung cancer patients and partners show high rates of impaired quality of life and heightened distress levels .  Mindfulness-Based Stress Reduction has proven to be effective in reducing psychological distress in cancer patients . However , studies barely included lung cancer patients . Aim : We examined whether Mindfulness-Based Stress Reduction might be a feasible and effective intervention for patients with lung cancer and partners . Design : Mindfulness-Based Stress Reduction is a training in which mindfulness practice s are combined with psycho-education to help participants cope with distress . In this mixed methods pilot study , question naires on psychological distress and quality of life were administered before , directly after and 3 months after the Mindfulness-Based Stress Reduction training , in combination with semi-structured interviews . Setting / participants : Patients with lung cancer and partners were recruited at one tertiary care academic medical centre . A total of 19 lung cancer patients and 16 partners participated in the Mindfulness-Based Stress Reduction training . Results : Most patients were diagnosed with advanced stage lung cancer . Vast majority completed the training . Those receiving anti-cancer treatment did not miss more sessions than patients who were not currently treated . Patients and partners felt positive about participating in a peer group and with their partner . Among participants no significant changes were found in psychological distress . Caregiver burden in partners decreased significantly after following Mindfulness-Based Stress Reduction . The qualitative analysis showed that the training seemed to instigate a process of change in participants . Conclusion : The Mindfulness-Based Stress Reduction training seemed to be feasible for patients with lung cancer and their partners . A r and omized controlled trial is needed to examine the effectiveness of Mindfulness-Based Stress Reduction in reducing psychological distress in lung cancer patients and partners
Objective : To systematic ally review the effect of psychosocial interventions on improving QoL , depression and anxiety of cancer caregivers .