title: Evaluation of a short-term group intervention for informal carers of patients attending a home palliative care service.
abstract: Despite evidence of high psychological distress and unmet needs, evaluated interventions for informal caregivers in palliative care are few. This study involved an observational outcome evaluation of attendees, and a comparison group, in specialist home palliative care. The measures included carer psychological status and patient physical status at baseline, 8 weeks, and 20 weeks. Qualitative data were collected regarding content, satisfaction with, and impact of intervention. Process data described the uptake, resources, and group activity. The intervention combined informal multiprofessional teaching with facilitated peer exchange and support, and was delivered over 6 sessions of 90 minutes per week. The uptake rate was 25%; carers were less likely to accept if they were in paid employment (OR=0.26, P=0.06), and more likely to accept if they utilized avoidance coping (OR=1.13, P=0.04) or their patient had worse physical status (OR=2.1, P=0.03). Attendees described significant support and knowledge gains from the multiprofessional input and peer group. Most relied on social comparison processes to appraise their situation. Potential detection of significant effects on global psychological scores (i.e. anxiety, depression, and burden) using multivariate analysis was disallowed due to attrition. This acceptable and accessible intervention provided information and support; further outcome studies are needed for a range of interventions. Short-term interventions are unlikely to affect global psychological scores, and future evaluations should include additional time points of data collection to demonstrate support during attendance.
authors.affiliation: Department of Palliative Care and Policy, Guy's, King's, and St. Thomas' School of Medicine, London, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Harding
authors.forename: Irene J
authors.initials: IJ
authors.lastname: Higginson
authors.forename: Celia
authors.initials: C
authors.lastname: Leam
authors.forename: Nora
authors.initials: N
authors.lastname: Donaldson
authors.forename: Alison
authors.initials: A
authors.lastname: Pearce
authors.forename: Rob
authors.initials: R
authors.lastname: George
authors.forename: Vicky
authors.initials: V
authors.lastname: Robinson
authors.forename: Liz
authors.initials: L
authors.lastname: Taylor
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000193:education / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology* / Q000706:statistics & numerical data*; D015397:Program Evaluation; D011615:Psychotherapy, Group / Q000379:methods* / Q000706:statistics & numerical data*; D012657:Self-Help Groups; D040921:Stress Disorders, Traumatic / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology