A Technology-Enhanced Nursing Intervention for Hospice Caregivers

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DESCRIPTION (provided by applicant): Family members and friends who act as informal caregivers of hospice patients are essential to the provision of palliative care services; however, this role is not without adverse effects on the caregivers themselves. Recent research has revealed that caregiver anxiety and burden can negatively impact morbidity and mortality among informal caregivers of hospice patients. Emotional needs of individuals caring for dying persons in their home are not well attended and the lack of interventions aiming to provide support to informal caregivers has public health implications. We are proposing the delivery of a proven coping skills intervention for informal caregivers of home hospice patients (COPE) based on the problem-solving framework of the prepared family caregiver model, using commercially available videophone technology. We propose a two year equivalence clinical trial. Our interdisciplinary research team will recruit 160 informal caregivers and their patients from a participating agency and will randomly assign them to either a group receiving standard hospice care with the addition of the COPE intervention delivered in person (Group 1), or a group receiving standard hospice care with the addition of the COPE intervention delivered via videophones (Group 2). We aim to evaluate the effectiveness of the videophone-based intervention for informal caregivers of hospice patients (focusing on informal caregivers' quality of life, caregiver burden related to patient symptoms and caregiver anxiety) and to assess caregivers' perceptions of and satisfaction with the videophone use as a communication mode. Finally, we also aim to compare the cost of delivering the COPE intervention for caregivers of hospice patients for the two groups (in person vs. videophone). If proven successful, this intervention can become a feasible and sustainable tool that increases the amount of support received by informal hospice caregivers during their often brief hospice experience, without increasing travel stress and costs for hospice staff. PUBLIC HEALTH RELEVANCE: Family members and friends who act as informal caregivers are essential to the provision of hospice services. The caregiving experience is not without adverse effects on the caregivers themselves as caregiving stress and burden can negatively impact their morbidity and mortality. The proposed research study explores an intervention that will improve clinical outcomes for hospice caregivers; thus, the study is highly relevant to public health as it affects the health of a continuously growing segment of our population and aims to demonstrate the value of a feasible and sustainable hospice intervention.