title: Reducing emotional distress in people caring for patients receiving specialist palliative care. Randomised trial.
abstract: BACKGROUND
  Caring for relatives with advanced cancer may cause psychological and physical ill health.
  
  
  OBJECTIVE
  To evaluate the effectiveness of increased support for distressed, informal carers of patients receiving palliative care.
  
  
  METHODS
  The sample was composed of 271 informal carers who scored over 5 on the 28-item General Health Questionnaire (GHQ-28). The intervention comprised six weekly visits by a trained advisor. Primary outcome was carer distress (GHQ-28) at 4-week, 9-week and 12-week follow-up. Secondary outcomes were carer strain and quality of life, satisfaction with care, and bereavement outcome.
  
  
  RESULTS
  Scores on the GHQ-28 fell below the threshold of 5/6 in a third of participants in each trial arm at any follow-up point. Mean scores in the intervention group were lower at all time points but these differences were not significant. No difference was observed in secondary outcomes. Carers receiving the intervention reported qualitative benefit.
  
  
  CONCLUSIONS
  The intervention might have been too brief, and ongoing help might have had accruing benefits. Alternatively, informal carers of patients with cancer may already receive considerable input and the advisor's help gave little additional advantage; or caring for a dying relative is extremely stressful and no amount of support is going to make it much better.
authors.affiliation: Department of Mental Health Sciences, Royal Free and University College Medical School, and St Joseph's Hospice, London NW3 2PF, UK.
authors.forename: Kiri
authors.initials: K
authors.lastname: Walsh
authors.forename: Louise
authors.initials: L
authors.lastname: Jones
authors.forename: Adrian
authors.initials: A
authors.lastname: Tookman
authors.forename: Christina
authors.initials: C
authors.lastname: Mason
authors.forename: Joanne
authors.initials: J
authors.lastname: McLoughlin
authors.forename: Robert
authors.initials: R
authors.lastname: Blizard
authors.forename: Michael
authors.initials: M
authors.lastname: King
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D006701:Home Nursing; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology*; D011787:Quality of Health Care / Q000592:standards*; D012944:Social Support; D013315:Stress, Psychological / Q000517:prevention & control*