title: A noninferiority trial of a problem-solving intervention for hospice caregivers: in person versus videophone.
abstract: OBJECTIVE
  Problem-solving therapy (PST) has been found effective when delivered to informal caregivers of patients with various conditions. In hospice, however, its translation to practice is impeded by the increased resources needed for its delivery. The study purpose was to compare the effectiveness of a PST intervention delivered face-to-face with one delivered via videophone to hospice primary caregivers.
  
  
  METHODS
  The study design was a randomized noninferiority trial with two groups, Group 1 in which caregivers received PST face-to-face, and Group 2 in which caregivers received PST via videophone. Family hospice caregivers were recruited from two urban hospice agencies and received the PST intervention (in three visits for Group 1 or three video-calls in Group 2) in an approximate period of 20 days after hospice admission. Standard caregiver demographic data were collected. Psychometric instruments administered to caregivers at baseline and at study completion included the CQLI-R (Caregiver Quality of Life Index-Revised), the STAI (State-Trait Anxiety Inventory), and the PSI (Problem-Solving Inventory).
  
  
  RESULTS
  One hundred twenty-six caregivers were recruited in the study; 77 were randomly assigned to Group 1 and 49 to Group 2. PST delivered via video was not inferior to face-to-face delivery. The observed changes in scores were similar for each group. Caregiver quality of life improved and state anxiety decreased under both conditions.
  
  
  CONCLUSIONS
  The delivery of PST via videophone was not inferior to face-to-face. Audiovisual feedback captured by technology may be sufficient, providing a solution to the geographic barriers that often inhibit the delivery of these types of interventions to older adults in hospice.
authors.affiliation: Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, Washington 98195-7266, USA. gdemiris@u.washington.edu
authors.forename: George
authors.initials: G
authors.lastname: Demiris
authors.forename: Debra
authors.initials: D
authors.lastname: Parker Oliver
authors.forename: Elaine
authors.initials: E
authors.lastname: Wittenberg-Lyles
authors.forename: Karla
authors.initials: K
authors.lastname: Washington
authors.forename: Ardith
authors.initials: A
authors.lastname: Doorenbos
authors.forename: Tessa
authors.initials: T
authors.lastname: Rue
authors.forename: Donna
authors.initials: D
authors.lastname: Berry
mesh_terms: D000368:Aged; D017028:Caregivers; D005260:Female; D006738:Hospices; D006801:Humans; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D013689:Telephone; D014741:Video Recording