title: Using the COPE intervention for family caregivers to improve symptoms of hospice homecare patients: a clinical trial.
abstract: OBJECTIVE
  To test an intervention for hospice caregivers designed to help them better manage symptoms experienced by patients with cancer.
  
  
  METHODS
  A three-group comparative design with repeated measures.
  
  
  METHODS
  A large nonprofit hospice that primarily provides home care.
  
  
  METHODS
  329 hospice homecare patients with cancer and their caregivers were randomized into three groups: a control group (n = 109) receiving standard care, a group (n = 109) receiving standard care plus friendly visits, and a group (n = 111) receiving standard care plus the COPE intervention.
  
  
  METHODS
  Caregivers received experimental training in the COPE intervention (creativity, optimism, planning, expert information) over nine days to assist with symptom management.
  
  
  METHODS
  Intensity of pain, dyspnea, and constipation, overall symptom distress, and quality of life (QOL). Data were collected on admission and days 16 and 30.
  
  
  RESULTS
  Although symptom intensity for three target symptoms did not decrease, symptom distress was significantly improved (p = 0.009) in the COPE intervention group. QOL was not significantly different.
  
  
  CONCLUSIONS
  Symptom distress, a measure that encompasses patient suffering along with intensity, was significantly decreased in the group in which caregivers were trained to better manage patient symptoms.
  
  
  CONCLUSIONS
  The COPE intervention is effective and immediately translatable to the bedside for hospice homecare patients with advanced cancer.
authors.affiliation: College of Nursing, University of South Florida, Tampa, FL, USA. smcmilla@health.usf.edu
authors.forename: Susan C
authors.initials: SC
authors.lastname: McMillan
authors.forename: Brent J
authors.initials: BJ
authors.lastname: Small
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D017028:Caregivers; D005260:Female; D006701:Home Nursing / Q000379:methods*; D017051:Hospice Care / Q000379:methods*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000451:nursing* / Q000523:psychology*; D011340:Problem Solving; D011788:Quality of Life; D016896:Treatment Outcome; D014481:United States