CHESS improves cancer caregivers' burden and mood: results of an eHealth RCT.
OBJECTIVE
Informal caregivers (family and friends) of people with cancer are often unprepared for their caregiving role, leading to increased burden or distress. Comprehensive Health Enhancement Support System (CHESS) is a Web-based lung cancer information, communication, and coaching system for caregivers. This randomized trial reports the impact on caregiver burden, disruptiveness, and mood of providing caregivers access to CHESS versus the Internet with a list of recommended lung cancer websites.


METHODS
A total of 285 informal caregivers of patients with advanced nonsmall cell lung cancer were randomly assigned to a comparison group that received Internet or a treatment group that received Internet and CHESS. Caregivers were provided a computer and Internet service if needed. Written surveys were completed at pretest and during the intervention period bimonthly for up to 24 months. Analyses of covariance (ANCOVAs) compared the intervention's effect on caregivers' disruptiveness and burden (CQOLI-C), and negative mood (combined Anxiety, Depression, and Anger scales of the POMS) at 6 months, controlling for blocking variables (site, caregiver's race, and relationship to patient) and the given outcome at pretest.


RESULTS
Caregivers randomized to CHESS reported lower burden, t(84) = 2.36, p = .021, d = .39, and negative mood, t(86) = 2.82, p = .006, d = .44, than those in the Internet group. The effect on disruptiveness was not significant.


CONCLUSIONS
Although caring for someone with a terminal illness will always exact a toll on caregivers, eHealth interventions like CHESS may improve caregivers' understanding and coping skills and, as a result, ease their burden and mood.
Department of Psychiatry, School of Medicine and Public Health.
Lori L
LL
DuBenske
Center for Health Enhancement Systems Studies, University of Wisconsin.
David H
DH
Gustafson
Department of Community and Leadership Development, University of Kentucky.
Kang
K
Namkoong
Department of Journalism and Mass Communication, University of Wisconsin.
Robert P
RP
Hawkins
Center for Health Enhancement Systems Studies, University of Wisconsin.
Amy K
AK
Atwood
School of Nursing.
Roger L
RL
Brown
Center for Health Enhancement Systems Studies, University of Wisconsin.
Ming-Yuan
MY
Chih
Center for Health Enhancement Systems Studies, University of Wisconsin.
Fiona
F
McTavish
Department of Behavioral Science.
Cindy L
CL
Carmack
Beth Israel Deaconess Medical Center.
Mary K
MK
Buss
Oncology Division, Department of Medicine, Washington University.
Ramaswamy
R
Govindan
Hematology-Oncology Unit of the Department of Medicine, School of Medicine and Public Health, University of Wisconsin.
James F
JF
Cleary
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002289:Carcinoma, Non-Small-Cell Lung / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D054626:Consumer Health Information / Q000379:methods*; D005260:Female; D006801:Humans; D020407:Internet; D008175:Lung Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012944:Social Support; D017216:Telemedicine / Q000379:methods*; D013727:Terminal Care / Q000379:methods / Q000523:psychology*; D055815:Young Adult