title: Support needs of informal hospice caregivers: a qualitative study.
abstract: BACKGROUND
  Informal caregivers of hospice patients experience multiple stressors that can negatively impact physical, psychological, and emotional health. The goal of this qualitative study was to understand caregivers' needs to inform the feasibility, structure, and content of a telephone-based counseling intervention.
  
  
  METHODS
  Focus groups and interviews with 36 former hospice caregivers and 11 hospice staff from 6 hospices were conducted. Interviews and focus groups were audio-recorded, transcribed, and analyzed using a constant comparative approach.
  
  
  RESULTS
  Key content areas included coping, emotional support, self-care, logistical issues, and bereavement. Respondents supported telephone-based counseling, appreciating its relative anonymity and convenience. It was recommended that calls be initiated by the counselor, on a weekly basis, and that one counselor be assigned to each caregiver. Hospice staff emphasized the need to coordinate telephone counseling with hospice care, scheduling around and communicating with hospice staff. Most caregivers indicated that they would participate in telephone-based counseling were it available; hospice staff thought that half of caregivers would participate. A pervasive theme was that "there can never be enough support for a caregiver."
  
  
  CONCLUSIONS
  Informal caregivers of hospice patients have support needs that are amenable to telephone-based counseling designed to be complementary to existing hospice services. Based on these qualitative findings, we are pilot-testing a telephone-based cognitive-behavioral stress management program for informal caregivers of hospice patients.
authors.affiliation: Department of Internal Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA. jean.kutner@ucdenver.edu
authors.forename: Jean
authors.initials: J
authors.lastname: Kutner
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Kilbourn
authors.forename: Allison
authors.initials: A
authors.lastname: Costenaro
authors.forename: Courtney A
authors.initials: CA
authors.lastname: Lee
authors.forename: Carolyn
authors.initials: C
authors.lastname: Nowels
authors.forename: Jenny L
authors.initials: JL
authors.lastname: Vancura
authors.forename: Derek
authors.initials: D
authors.lastname: Anderson
authors.forename: Tarah Ellis
authors.initials: TE
authors.lastname: Keech
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001601:Bereavement; D017028:Caregivers / Q000523:psychology*; D003376:Counseling / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D017051:Hospice Care / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D036301:Qualitative Research; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology / Q000628:therapy*; D013689:Telephone