Abstract
Context
Palliative care offers patient and family centered approaches that may mitigate risk
of caregiver burden and poor mood.
Objectives
To determine whether a palliative care intervention (CONNECT) improved burden, mood,
and self-efficacy among caregivers of patients with advanced cancer.
Methods
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).
Results
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).
Conclusion
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.
Key Words
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Article info
Publication history
Published online: December 08, 2022
Accepted:
November 29,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
