An individualized dyadic problem-solving education intervention for patients and family caregivers during allogeneic hematopoietic stem cell transplantation: a feasibility study.
BACKGROUND
Allogeneic hematopoietic stem cell transplantation (HSCT) generates multiple problems that vary in complexity and create significant distress for both patients and their caregivers. Interventions that address patient and family caregiver distress during allogeneic hematopoietic stem cell transplantation (HSCT) have not been tested.


OBJECTIVE
To evaluate the feasibility of conducting an individualized dyadic problem-solving education (PSE) intervention during HSCT and estimate a preliminary effect size on problem-solving skills and distress.


METHODS
The PSE intervention consisted of 4 sessions of the Prepared Family Caregiver PSE model. Data were collected with an interventionist log, subject interviews and standardized questionnaires.


RESULTS
Of the 34 adult dyads screened, 24 were ineligible primarily because of being non-English-speaking (n = 11) and inconsistent caregivers (n = 10). Ten dyads (n = 20) were enrolled, and 8 dyads (n = 16) completed the intervention. Of the 31 sessions, 29 were completed (94%). Worsening patient condition was the primary reason for sessions to be incomplete. Patients attended 90% of the sessions; caregivers attended 74%. Reasons for missed sessions included patient symptom distress and limited caregiver availability. Dyads reported being very satisfied (mean, 4.8 [SD, 1.8]; range, 1-5), stating "an opportunity to talk" and "creative thinking" were most beneficial.


CONCLUSIONS
Results suggest that dyads can participate in PSE during HSCT and view it as beneficial. Participants identified the active process of solving problems as helpful.


CONCLUSIONS
Targeted interventions that promote effective, meaningful behaviors are needed to guide patients and caregivers through HSCT. Future research recommendations include testing a version of PSE with fewer sessions, including spousal and nonspousal caregivers and those who are non-English speaking.
National Institutes of Health, Bethesda, Maryland, USA. mbevans@cc.nih.gov
Margaret
M
Bevans
Kathleen
K
Castro
Patricia
P
Prince
Nonniekaye
N
Shelburne
Olena
O
Prachenko
Matthew
M
Loscalzo
Karen
K
Soeken
James
J
Zabora
D000223:Adaptation, Psychological; D001294:Attitude to Health; D017028:Caregivers / Q000193:education / Q000523:psychology; D015928:Cognitive Behavioral Therapy; D005190:Family / Q000523:psychology*; D005240:Feasibility Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017145:Models, Educational; D016294:Models, Nursing; D015402:Nursing Education Research; D010347:Patient Care Planning / Q000458:organization & administration; D010353:Patient Education as Topic / Q000458:organization & administration*; D011340:Problem Solving; D015397:Program Evaluation; D018709:Statistics, Nonparametric; D013315:Stress, Psychological / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D014184:Transplantation, Homologous