Family Caregiver Depressive Symptom and Grief Outcomes From the ENABLE III Randomized Controlled Trial
Family Caregiver Depressive Symptom and Grief Outcomes From the ENABLE III Randomized Controlled Trial
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DOI：
10.1016/j.jpainsymman.2016.03.014
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发表时间：
2016-09-01
影响因子：
4.7
通讯作者：
Bakitas, Marie A.
中科院分区：
文献类型：
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作者：
Dionne-Odom, J. Nicholas;Azuero, Andres;Bakitas, Marie A.
语境。对于家庭护理人员 (CG) 的早期姑息治疗 (EPC) 支持是否会影响护理对象死亡后的抑郁症状和悲伤，人们知之甚少。 目标。评估早期 CG 与延迟组 CG 相比的死后 CG 抑郁症状和悲伤评分。方法。我们在农村综合癌症中心、附属诊所和退伍军人管理局医疗中心进行了一项随机对照试验（10/2010-9/2013），针对 CG（n = 123）在护理对象晚期癌症诊断时（早期组）或 12 周后（延迟组）启动 EPC 远程医疗干预。 ENABLE [教育、培养、建议、生命结束前] CG 干预包括三周一次的会议、每月一次的随访和一次丧亲之痛电话。 CG 在护理对象死亡后 8-12 周完成流行病学研究中心抑郁症 (CES-D) 量表和普里格森复杂悲伤简表 (PG13)。使用一般线性模型估计和测试粗略和协变量调整的组间差异。结果。对于死亡的护理对象 (n = 70)，44 名 CG（早期：n = 19；延迟：n = 25）完成了死后调查问卷。早期组的平均抑郁症状评分 (CES-D) 为 14.6 (SD = 10.7)，延迟组为 17.6 (SD = 11.8)。早期组的平均复杂性悲伤评分 (PG13) 为 22.7 (SD = 4.9)，延迟组为 24.9 (SD = 6.9)。调整后的组间差异不具有统计学意义（CES-D：d = 0.07，P = 0.88；PG13：d = -0.21，P = 0.51）。结论。根据 EPC 支持的时间，CG 在护理对象死亡后 8-12 周的抑郁症状和复杂悲伤评分没有统计学差异。 CG EPC 干预时间对 CG 丧亲结果的影响需要进一步研究。 (C) 2016 年美国临终关怀和姑息医学学会。由爱思唯尔公司出版。保留所有权利。
Context. Little is known about whether early palliative care (EPC) support for family caregivers (CGs) impacts depressive symptoms and grief after care recipients die.Objectives. To assess after-death CG depressive symptom and grief scores for early compared to delayed group CGs.Methods. We conducted a randomized controlled trial (10/2010-9/2013) of an EPC telehealth intervention for CGs (n = 123) initiated at the time of care recipients' advanced cancer diagnosis (early group) or 12 weeks later (delayed group) in a rural comprehensive cancer center, affiliated clinics, and a Veterans Administration medical center. The ENABLE [ Educate, Nurture, Advise, Before Life Ends] CG intervention consisted of three weekly sessions, monthly follow-up, and a bereavement call. CGs completed the Center for Epidemiological Study-Depression (CES-D) scale and the Prigerson Inventory of Complicated Grief-Short Form (PG13) 8-12 weeks after care recipients' deaths. Crude and covariate-adjusted between-group differences were estimated and tested using general linear models.Results. For care recipients who died (n = 70), 44 CGs ( early: n = 19; delayed: n = 25) completed after-death questionnaires. Mean depressive symptom scores (CES-D) for the early group was 14.6 (SD = 10.7) and for the delayed group was 17.6 (SD = 11.8). Mean complicated grief scores (PG13) for the early group was 22.7 (SD = 4.9) and for the delayed group was 24.9 (SD = 6.9). Adjusted between-group differences were not statistically significant (CES-D: d = 0.07, P = 0.88; PG13: d = -0.21, P = 0.51).Conclusion. CGs' depressive symptom and complicated grief scores 8-12 weeks after care recipients' deaths were not statistically different based on the timing of EPC support. The impact of timing of CG EPC interventions on CGs bereavement outcomes requires further investigation. (C) 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.