Informal Caregiver Training in Cancer Symptom Management

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DESCRIPTION (provided by applicant): Symptom management is identified as an essential component of effective home caregiving by informal caregivers of older cancer patients. However, most caregivers do not feel confident that they have the knowledge and skills needed in cancer symptom management. Inability to assist patients in alleviating their cancer symptoms adversely affects the psychological well-being of caregivers. Because of the reciprocal relationship in a caregiver-patient dyad, caregiver decline is likely to lead to patient decline as well. The specific aims of this experimental, prospective study are to examine the effects of experiential symptom management training on self-efficacy and psychological well-being of informal cancer caregivers, and on symptom distress and intensity and emergency care use for cancer-related symptoms of their patients. The individualized training will be at the bedside of older cancer patients during their hospitalization. The setting will be the oncology wards at Duke Medical Center. The sample will consist of 120 dyads equally assigned in the treatment and attention control groups. Subjects in the treatment group will receive individualized experiential training on interventions for cancer symptoms, while subjects in the attention control group will receive information on caregiver local community resources and healthy lifestyle habits. Patient data will be collected prior to hospital discharge, and at 1, 2, and 4 weeks after discharge. In addition, data on emergency care use for cancer-related symptoms will be collected at 1, 2, and 4 weeks after hospital discharge. Caregiver data will be collected before and after the training, and at 1, 2, and 4 weeks after discharge. Descriptive statistics and multivariate analysis including mixed models will be used for data analysis. This study is the first step in determining the effects of experiential training offered in an acute care setting on the dyad. The study results will be used to design a larger randomized clinical trial to evaluate the cost-effectiveness of this intervention. The long term goal is to refine and expand the experiential approach and offer it in acute care settings to teach caregivers of older patients suffering from other chronic illnesses. In so doing, nurses are offered an effective means to prepare informal caregivers for home caregiving, enabling older, chronically-ill patients to remain as long as possible within the comfort of their homes.