title: A Problem Solving Intervention for hospice caregivers: a pilot study.
abstract: The Problem Solving Intervention (PSI) is a structured, cognitive-behavioral intervention that provides people with problem-solving coping skills to help them face major negative life events and daily challenges. PSI has been applied to numerous settings but remains largely unexplored in the hospice setting. The aim of this pilot study was to demonstrate the feasibility of PSI targeting informal caregivers of hospice patients. We enrolled hospice caregivers who were receiving outpatient services from two hospice agencies. The intervention included three visits by a research team member. The agenda for each visit was informed by the problem-solving theoretical framework and was customized based on the most pressing problems identified by the caregivers. We enrolled 29 caregivers. Patient's pain was the most frequently identified problem. On average, caregivers reported a higher quality of life and lower level of anxiety postintervention than at baseline. An examination of the caregiver reaction assessment showed an increase of positive esteem average and a decrease of the average value of lack of family support, impact on finances, impact on schedules, and on health. After completing the intervention, caregivers reported lower levels of anxiety, improved problem solving skills, and a reduced negative impact of caregiving. Furthermore, caregivers reported high levels of satisfaction with the intervention, perceiving it as a platform to articulate their challenges and develop a plan to address them. Findings demonstrate the value of problem solving as a psycho-educational intervention in the hospice setting and call for further research in this area.
authors.affiliation: Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, WA 98195-7266, USA. gdemiris@u.washington.edu
authors.forename: George
authors.initials: G
authors.lastname: Demiris
authors.forename: Debra Parker
authors.initials: DP
authors.lastname: Oliver
authors.forename: Karla
authors.initials: K
authors.lastname: Washington
authors.forename: Lynne Thomas
authors.initials: LT
authors.lastname: Fruehling
authors.forename: Donna
authors.initials: D
authors.lastname: Haggarty-Robbins
authors.forename: Ardith
authors.initials: A
authors.lastname: Doorenbos
authors.forename: Hope
authors.initials: H
authors.lastname: Wechkin
authors.forename: Donna
authors.initials: D
authors.lastname: Berry
mesh_terms: D000223:Adaptation, Psychological; D001007:Anxiety / Q000517:prevention & control / Q000523:psychology; D001294:Attitude to Health; D017028:Caregivers / Q000193:education / Q000523:psychology; D015928:Cognitive Behavioral Therapy / Q000193:education / Q000379:methods; D017281:Cost of Illness; D005190:Family / Q000523:psychology; D005240:Feasibility Studies; D005260:Female; D006040:Goals; D006266:Health Education / Q000458:organization & administration*; D017051:Hospice Care / Q000379:methods / Q000523:psychology; D006801:Humans; D008016:Life Change Events; D008297:Male; D008960:Models, Psychological; D009922:Oregon; D010549:Personal Satisfaction; D010865:Pilot Projects; D011340:Problem Solving; D011788:Quality of Life / Q000523:psychology; D012649:Self Concept